Is Joe Biden a superager? We’re asking all the wrong questions.

Is President Biden, at age 81, too old to run for president? Does his chronological (calendar) age suggest he won’t survive another four-year term? Are claims of cognitive decline warranted? 

These and other age-related questions have surfaced in this election cycle because, let’s face it, Biden (and Trump) are the two oldest presidents in American history. Either would break the presidential longevity record again if elected in 2024. The question of presidential age has reached a fever pitch with no sign of abatement.

These are the wrong questions to ask at exactly the wrong time. 

The answers we’ve seen so far are often colored by politics, influenced by misinformation or misinterpretation and accompanied by ageist images of politicians that perpetuate harmful stereotypes about aging. Importantly, they belie the wonder of humanity’s success in already having changed the face of aging. 

While aging is not what it used to be, we acknowledge that Bette Davis was right:

“Old Age Ain’t No Place For Sissies”

There is no sugarcoating aging. Living a long life is like driving a car beyond its warranty period — the longer it’s driven the more things go wrong. But unlike cars, some aspects of life, including some cognitive abilities, actually improve with age. 

Verbal memory, inductive reasoning and vocabulary increase with age — cognitive skills particularly important for decision-making. It’s true that “fluid intelligence” (the capacity to learn new ways of solving problems and performing activities quickly and abstractly) does indeed decline with age, but “crystallized intelligence” (accumulated knowledge that allows for intelligent decision-making) and “tacit knowledge” (practical or pragmatic knowledge learned through experience) increase with age. 

In practical terms, someone President Biden’s age might take a longer time to learn how to fly a plane, but he would be less likely to crash it relative to a younger person. Furthermore, public health, medicine and other scientific disciplines have already found ways to help us adapt to changes in body and mind — rendering some of what goes wrong with age into little more than nuisances.

The longevity revolution that began in the 20th century has already transformed what it means to grow old for Biden’s generation — and all future generations. Stereotypical pictures of older people as “greedy geezers” — disengaged from life, a burden to friends and family and a high cost to society — are false narratives. It is not now, and in fact, never has been, the fate of most people that reach advanced ages. 

These unfortunate scenarios do happen, but people aged 65 and older today could just as well be telling stories about their workout routines, mountain climbing and marathon times. They run companies, compete in sporting events, perform volunteer work, travel the world, care for grandchildren — and are often icons of society. They are innovators often sought after for their wisdom as physicians, lawyers and other professionals due to their acumen and experience. They serve in Congress, the military, as presidents and are senior thought leaders on boards across the globe. They’re often happier than people half their age — with many of the same desires and goals.

Rate of Aging Revealed at High School Reunions

Biological aging — the age of your important organs (such as your brain, cardiovascular system, lungs and skin) does not occur at the same pace for everyone. Just attend a high school reunion where it is evident that the rate of biological aging has touched some more than others. For those who appear to have been touched lightly by aging, this mostly reflects an advantage driven by genetics, lifestyle and psychosocial factors — although makeup and plastic surgery can influence appearance. The evidence supports the view that the metronomes for aging move at a slower pace for some. 

For example, the 2003 Medical Expenditure Panel Survey and the 2004 Health and Retirement Study, among the best studies used to examine factors that influence aging, make a bold statement. An examination of their results, coauthored by one of us, shows that a significant proportion of older Americans were healthy past age 50. In fact, among those aged 85 and older, 56 percent reported no health-based limitations in work or housework, and 28 percent reported excellent or very good health.

The Facts Belie the Stereotypes

Many people age like fine wine. We aspire to enjoy the fruits of an extended life and perform jobs at extremely high levels of competence and efficiency — making older generations one of society’s most valuable natural resources.

Just before the 2020 presidential election, independent research scientists with expertise in aging and longevity reviewed, assessed and published  all of Biden’s publicly available medical records. The information evaluated included his family history, behavioral risk factors, medical history, physical examinations, laboratory and other diagnostic tests, including aging-related biomarkers. 

The conclusion was that Biden was in excellent health for a 77-year-old man. His health challenges were minimal, his laboratory blood work reflected that of a healthy younger man, and his physical activity was exceptional. He has a family history of dementia-free longevity and there was no evidence of cognitive decline in his personal medical records.  

While Biden’s formal health status will be reevaluated closer to the forthcoming election, his medical records published in his years since taking office so far indicate no significant change in physical or mental health status has occurred.

Biden was projected in 2020 to have over a 95 percent chance of surviving a first term in office (about 13 percent better survival than for an average man his age). Today his chances of surviving through a second term in office are close to 75 percent (about 10 percent better survival than for an average man his age). Similar, although slightly less favorable survival prospects are present for Trump.

The geriatricians evaluating Biden’s medical history in 2020 found evidence to suggest he could be a “superager” — a subgroup of people aged 80 years and older that operate physically and cognitively at a level that is common among those much younger.

There is no clinical evidence for cognitive decline in President Biden — despite armchair gerontologists declaring otherwise. It may be tempting to conclude that such evidence does not exist because an extensive battery of diagnostic assessments of cognitive functioning has not been ordered (to our knowledge) by his personal physician, and if done, something significant might be revealed. 

But presidents are evaluated by their physicians just like everyone else — cognitive functioning tests are not done unless the physician suspects a problem or if requested by the patient. Even then, a screening test of cognitive function is done first, followed by other more in-depth diagnostic assessments if the screen shows a worrisome score. Since Biden’s personal physician seems not to have felt cognitive screening testing was medically indicated, this represents evidence that such issues are unlikely to be present consistent with his family history of dementia-free longevity. 

  

It is also common to mistake Biden’s lifelong speech impediment for cognitive decline, his cough for an inability to speak clearly, his changed gate for a man in significant decline, an occasional misstatement as a sign of mental decay, etc. Each of us bears our own challenges with age — this is not a reason to dismiss and discard. It’s a recognition that along with the privilege of long life, come changes that require adaptation.  

We see them in Biden because he’s under a 24/7 spotlight. Place the same bright light of the media on any of the rest of us — at any age — and few would survive the scrutiny without a similar negative profile.

The Right Questions to Ask

We’re not presumptuous enough to tell readers what they should take into consideration when entering the voting booth. What we can state with confidence is that chronological age should not be one of them.

President Biden exhibits characteristics consistent with superager status. The evidence so far — evaluated by experts in medicine and aging science and uninfluenced by politics and rapid judgments based on limited information — is that President Biden’s chronological age should not be an impediment to running for a second term in office. 

It’s how old you are on the inside that counts.

S. Jay Olshansky, Ph.D., is a professor in the School of Public Health at the University of Illinois at Chicago, a research associate at the Center on Aging at the University of Chicago and the London School of Hygiene and Tropical Medicine, and a chief scientist at Lapetus Solutions, Inc. 

Ben Barnes formerly served as Speaker of the Texas House of Representatives from 1965 to 1969 and 36th lieutenant governor of Texas. 

Dr. Bradley Willcox, M.D., MSc, FGSA, is a professor and director of research at the Department of Geriatric Medicine, John A. Burns School of Medicine, University of Hawai‘i Mānoa.