On Biden's cognitive fitnesss, either we trust Jill or we don't. She sees him at his best, his worst, and everything in between. By Hal Brown, MSW

 

For me the crucial story on HUFFPOST (above) is Family Urges Biden in, debate be damned. As important as the article about the poll is and the all the other news about editorial boards, opinion writers, fellow Democrats, and others about his dropping out the president won't drop out unless he sees how this is the best course of action and the most persuasive person to help him decide this is Jill. She knows him better than anybody else. In some ways she may know him better than he knows himself.

Jill sees Joe at his best, his worst, and every way in between. More than anyone else, even more than her husband, she is in a position to evaluate his behavior for indications he is in the earliest stage of dementia. People in that stage are often in denial about what they blow off as irelevant memory lapses. This is why any full assessment for dementia includes both an interview, possibly with some testing, of the patient and also with one or more family members. 

While there is the major issue of public perception of Biden's cognitive ability when it comes to the election if he decides not to drop out I doubt this issue will change a significant number of votes. My position is that if he does have dementia I have faith in him to recognize that he may be slipping and will discuss it with Jill and others he trusts to see if they see the same thing. One doesn't need an expert assessment to recognize and accept that they are succumbing to dementia. If they have self-awareness, as I am sure Joe Biden does, they will see it in themselves and ask those who they trust the most if they observe the same things. 

I have no doubt that the Bidens are well aware of what happened with Ronald Reagan who revealed his Alzheimer's diagnosis five years after he left office (read article in Snopes).

If Biden is reelected and symptoms are interfering with his ability to govern I believe he will step down. This obviously would make Kamala Harris president. I have the utmost confidence in her. She could prove herself to the country and run successfully on her own in 2028.

If Biden doesn't have dementia

There is a good chance Biden doesn't have dementia. In fact the statistics suggest it is unlikely:

RISK

Women, People Ages 85 and Older, and Racial and Ethnic Minorities Face Greater Dementia Risk

Dementia is more prevalent at older ages. About 3% of adults ages 70 to 74 had dementia in 2019, compared with 22% of adults ages 85 to 89 and 33% of adults ages 90 and older.⁶

Women are slightly more likely to have dementia than men. Among adults ages 70 and older, 11% of women and 8% of men had dementia in 2019.⁷

Non-Hispanic white adults are less likely to develop dementia than most other racial and ethnic groups. Among those ages 70 and older, an estimated 8.5% of non-Hispanic white adults were living with dementia in 2019, compared with 16.1% of non-Hispanic Black adults and 16.4% of Hispanic adults.⁸

As they age, married older people may have a lower risk of dementia than their unmarried counterparts.⁹  Read more here.

I write this as an 80 year old former psychotherapist whose partner is 79, and who lives in a continuing care retirement community where I know dozens of elders. Neither of us shows signs of dementia. I have close friends in their early nineties who may need a walker to get around but who are almost as mentally sharp as they were 10 years ago when I first met them. 

About me: For going on 10 years I have seen people in all the stages of dementia. I wouldn't call myself an expert on dementia. I never had a course on it or went to a workshop on the subject. My knowledge comes from reading and observation.

These are my previous blogs related to this issue. Yesterday I wrote:

The Democrats saying (and they are saying it now as I write this on MSNBC) that Biden "merely" had a bad night and lauding his accomplishment as presdient are not addressing the possiblity that his "bad night" might have been a result of, in the worst case, actual dementia the symptoms of which are only evident in the evening, or in the best case the "aging brain" which is sharper during the day than at night. 

Democrats and people who care about democracy are voting for a brain. They deserve to know whether that the brain, like a car, is firing on all cylinders, or if running on batteries was fully chargred all day and after a good night's recharging, was ready to handle the duties of the presdiency the next morning. 

Update, an excerpt from The Wall Street journal article summarized in RawStory here:

The signs of Biden’s decline have been obvious long before his stumbling performance against Trump Thursday, the Journal's editorial board wrote.

“The Democratic press barely questioned Mr. Biden’s limited workday, his reliance on a teleprompter, and his rare unscripted media interviews,"

What they don't mention is Trump's typical workday as president and how often he spent time at his various homes frequently playing golf and Trump also using a teleprompter and how when he speaks extemporaneously it is often unhinged lunacy.

You can read this and previous blogs on two websites. One may look better than the other because of how the platforms present the page.

Read on the WordPress Stressline.org

or….

Read on the Google Blogger platform HalBrown.org This version has a Disquis comment section which makes it easy to post links and images.

It wasn't just one bad debate for Biden, it was a horrible debate, and we need to know why. By Hal Brown, MSW

 

Below, Rep. Hakeem Jeffries on MSNBC this morning defending Presdient Biden's debate performance as a merely a bad night.

This is what I saw when I looked at HUFFPOST to see what their top stories were. They had three.

NBC News: Biden Expected To Discuss Future Of Campaign With Family On Sunday

NBC News reports that President Joe Biden will travel to Camp David Sunday where he and First Lady Jill Biden are scheduled to join their children and grandchildren. 

The trip had been planned before Thursday's debate, in which Biden gave a disastrous performance that has left Democrats on edge.

According to NBC News sources, "there is an understanding among top Democrats that Biden should be given space to determine next steps." 

Insiders reportedly "believe only the president, in consultation with his family, can decide whether to move forward or to end his campaign early."

New Axios Report Suggests Reason Biden Appeared Sluggish At Debate

Biden is typically at his sharpest between 10 a.m. and 4 p.m., according to Axios, which cited discussions with eight current and former Biden aides.

Thursday night’s debate was five hours after that window. Quite simply, it might have been too late in the day for him to present his best self.

Axios reported that the staffers have seen “flashes of an absent-minded Biden” akin to the version who took long pauses and delivered meandering sentences in a low, hoarse voice onstage this week. But they reportedly dismiss these moments because he is alert and engaged at other times.

International travel is also particularly tiring for the president, the outlet said.

New Yorker editor David Remnick Calls For Biden To Drop Out Of Presidential Race

New Yorker Editor David Remnick called for Biden to drop out of the presidential race following his disastrous debate performance on Thursday.

In a scathing editorial, Remnick said Biden’s age can no longer be ignored, and that watching him fumble during the debate was an “agonizing experience.”

“You watched it, and, on the most basic human level, you could only feel pity for the man and, more, fear for the country,” Remnick wrote.

While Remnick acknowledged that finding a new nominee would be an “admittedly complicated process,” he argued that it would still be the more “rational course.”

“To stay in the race would be pure vanity, uncharacteristic of someone whom most have come to view as decent and devoted to public service,” Remnick added.

Read the full editorial at The New Yorker (subscription).

I addressed this issue in yesterday's blog.

We cannot treat what we saw with Biden during the debate as a one-off. If someone persistently had certain physical conditions that occurred at a consistent time of day if they had any sense they would see their doctor. Cognitive conditions tend to be treated differently. They are easier to dismiss.

I am 80 years old. I know I am more alert and articulate at certain times of the day than I am at others. I usually am up at 5 and working on my blog and I stay energized until 2 PM when I get sleepy and if at all possible I take a nap for an hour. Most of the time when I wake up I feel refreshed and alert, although sometimes I have trouble shaking the cobwebs out of my head. Then I am alert until about 7 PM when I start to get sleepy. I go to bed and watch MSNBC or listen to NPR for about two hours before I sleep, sometimes with the TV or radio on. 

When I wake up at around 11 to go to the bathroom I am fairly wide awake and often stay in bed thinking of a blog topic for the morning. I know I could get up and start to write it but instead of throwing my sleep pattern off I compose a a general outline in my mind and thankfully fall asleep and wake up remembering what I planned to write.

I consider what would happen if I had to help someone in crisis at that hour and I think I'd be able to rouse myself enough to assist them, even to (as has happened) drive them to the emergency room. If I was president or a member of the team that was called to the White House Situation Room in the wee hours of the morning I might not be at 100% right away but with a cup of high octane coffee I think I could fire up all cylinders. We have to know that Biden could do the same thing.

President Biden, as I have wirtten in the previous blogs, showed signs of sundowning in the debate which could be part of early dementia. "Could" doesn't mean is. He could just have what, for want of a more clinical term, an aging brain. If this is the case he could still continue as the excellent president he's been as long as this doesn't change significantly for the worse. That is of serious concern. The Biden we see today may not be the Biden of one or two years from now. 

Any elder with any self awareness knows this about themselves. My senior friends and I certainly do. We try to take advantage of the years we have left. I have a good friend who, when he turned 90 and was able to get around using just a cane, went with his entire family on a European tour. Now, 93, while mentally as sharp as he was at 90, he needs an electric wheelchair.

As for Biden, there are certainly work-arounds for cyclical daily cognitive changes. Scheduling meetings when you're at your best makes sense. Naps can be crucial. Consider the following from the website Somnology

1. “A night owl with a bedtime”

President Obama reportedly slept around 5 hours a night, preferring to hit the sack well past midnight and wake at 7 A.M. Sleep patterns like this are mostly dictated by our circadian rhythms, but these rhythms can be flexible depending on our personal schedules. Being a night owl (or an early bird), then, can sometimes be a blend of nature and nurture.  

2. “Napping across party lines”

Ronald Reagan, JFK, and Bill Clinton napped daily; Reagan even made a schedule for his naps and took them at the same time each day. While there are pros and cons to napping, research indicates that a properly executed nap increases alertness, performance, and memory. All great benefits to have if you’re the leader of the free world.

The questions about Biden's cognitive fitness to serve has caused a schism among his supporters with editorial boards and highly regarded opinion columnists call for him to step down and pundits minimizing the debate as just one bad night. 

This is by Charlie Dent, former representative for Pennsylvania’s 15th congressional district.

He wrote:

It's time to say the quiet part out loud: Democrats must replace President Joe Biden as their party's nominee for president. If Democrats truly believe Trump is a threat to the constitutional orderand the rights of Americans, then they will need a better candidate to make the argument. At Thursday night’s debate, Biden looked and acted old, tired and feeble. He struggled to cite facts and statistics to bolster his arguments. Some of his responses were incoherent and rambling, like one early in the debate that elicited a rare truthful and accurate statement from Trump: “I really don’t know what he said at the end of that sentence. I don’t think he knows what he said either.”

Ali Velchi on his MSNBC show just said that Biden's team has to convince voters not to let 90 minutes define a presidency. He talked about this Politico article.

I have to disagree with the notion that we can't let 90 minutes define a presidency. If those 90 minutes were disgnostic of either dementia or "an aging brain" we have to take the possiblity seriously. If this performance was caused by a cold medication (as I wrote yesterday) we need to know. 

It is quite possible that Biden is what scientists call a super-ager. Consider:

Excerpt:

When it comes to aging, we tend to assume that cognition gets worse as we get older. Our thoughts may slow down or become confused, or we may start to forget things, like the name of our high school English teacher or what we meant to buy at the grocery store.

But that’s not the case for everyone.

For a little over a decade, scientists have been studying a subset of people they call “super-agers.” These individuals are age 80 and up, but they have the memory ability of a person 20 to 30 years younger.

Most research on aging and memory focuses on the other side of the equation — people who develop dementia in their later years. But, “if we’re constantly talking about what’s going wrong in aging, it’s not capturing the full spectrum of what’s happening in the older adult population,” said Emily Rogalski, a professor of neurology at the University of Chicago, who published one of the first studies on super-agers in 2012.

A paper published Monday in the Journal of Neuroscience helps shed light on what’s so special about the brains of super-agers. The biggest takeaway, in combination with a companion study that came out last year on the same group of individuals, is that their brains have less atrophy than their peers’ do.

There has been speculation as to whether there will be a second debate. If Biden choses not to drop out I think there should be. I expect Trump wants to have a second go at Biden having seen how poorly he performed the first time, perhaps with new debate rules. For Biden's part I think he owes it to the nation to demonstrate that when necessary he can be the 10 AM to 4 PM Joe Biden between 9:00 PM and 10:30 PM.

This is a problem that won't go away. Even as I finish this bog it is being discussed again on MSNBC in referenceto this Atlanta Journal-Constitution article.

Jamie Raskin just said that Barack Obama had one bad night, referring to his first debate with Mitt Romney. Other's have also made this comparison. Nobody at the time suggested that Obama's bad debate performance might have been caused by dementia or an aging brian.

Update:

This is the current HUFFPOST main page:

The brain in the White House matters:

You can read this and previous blogs on two websites. One may look better than the other because of how the platforms present the page.

Read on the WordPress Stressline.org

or….

Read on the Google Blogger platform HalBrown.org This version has a Disquis comment section which makes it easy to post links and images.

Biden's bad debate performance may or may not have been due to early dementia or a bad cold. He, and we, need to know which. By Hal Brown, MSW

 

Update -

This is obviously relevant: New Report Suggests Reason Biden Appeared Sluggish At Debate

Biden is typically at his sharpest between 10 a.m. and 4 p.m., according to Axios, which cited discussions with eight current and former Biden aides.

Thursday night’s debate was five hours after that window. Quite simply, it might have been too late in the day for him to present his best self.

Axios reported that the staffers have seen “flashes of an absent-minded Biden” akin to the version who took long pauses and delivered meandering sentences in a low, hoarse voice onstage this week. But they reportedly dismiss these moments because he is alert and engaged at other times.

International travel is also particularly tiring for the president, the outlet said. 

.................

I speculated in yesterday's blog that Biden's bad debate perforance could have been due to the sundowning which often occurs in dementia.

Biden's North Carolina speech, albeit mostly read from a telepromtper, showed no indications of dementia. For example, in that speech Biden referenced the attacks on the Capitol and the police officers who were attacked as he has many dozens of times before. However, Biden fumbled when asked about the Jan. 6, 2021, coup attempt at the debate Thursday night. He failed to point out that the U.S. Capitol attack, instigated by Trump, included violent assaults on 140 police officers, with one dying hours later. Instead, Biden only mentioned the breaking of windows and overturning of desks in the building, as if the vandalism had been the worst of it. (From HuffPost)

But the debate was at 9:00 PM where someone with dementia not present during daylight hours could be manifesting symptoms. This is called sundowning.

There are other, perhaps more likely, explanations for what I described as possibly indicative of early dementia sundowning. 

We know he had a cold. It's possible that because of a severe cold he had a poor night's sleep the evening before. He may have taken an over-the-counter cold medicine, perhaps for the first time, and had an unexpected reaction to it. 

Some people have adverse reactions to common cold medications. Drowsiness is a common side effect. You may have had the experience of feeling "a little goofy" after taking a cold medicine. I can see why Biden wouldn't want to admit that he was off his game because he had taken Robitussin or Mucinex because it seem like he'd be making an excuse.

I can see why Biden wouldn't want to admit that he was off his game because he had taken Robitussin or Mucinex because it would seem like he'd be making an excuse. I've taken both products with no aside effects (and little if any effect on my symptoms) but friends have told me they make them feel spacey.

I don't see how an ordinary cold would account for the bad debate. However, a really bad cold could explain it, especially if he was having a reaction to cold medication.

The was reported in The Washington Post:

“As Joe said earlier today, he’s not a young man,” she continued, her voice upbeat. “After last night’s debate, he said, ‘You know, Jill, I don’t know what happened. I didn’t feel that great.’”

It was the most intimate detail anyone in Biden’s orbit had revealed about how the president viewed his debate performance on Thursday night, a dismal 90 minutes in which he stammered, stumbled and appeared to lose his train of thought.

If those closest to the president, especially Jill and his sister Valerie, notice that Biden is showing signs of dementia in the evening they would be well advised to talk to him about this. He should speak to his physician and if appropriate have a complete neuropsychological examination (read what this entails here). 

If if does turn out that he is in the earliest stage of dementia Biden has the character to recognize he has to step down. He won't need to be pushed by the few people in addition to his wife and sisters like Barack Obama, Bill Clinton and others listed here who he might be influenced by.

As for whether or ot Trump has dementia I am open to the possibilty, perhaps likelihood, that he does. Perhaps the symptoms are worse during the day. His sleep patterns are unsual. 

Consider the most recent example here: ‘Land Schlade’: Social media roasts Trump as he ‘slurs badly’ to ‘crowd of empty chairs. RawStory+ subscrption.

“We want a land schlade that’s — and remember this term, too big to rig. We want a landslide,” the ex-president said at his rally on Friday.

@Acyn wrote, “Trump slurs badly while attempting to say landslide: Land Schlade.”

@dcpoll said, “Hope he’s not having a heat stroke.”

@ArtCandee said on X, “Trump is unfit for office.”

@elliot_elraid66 wrote, “Mumbles having a tough day today.”

@cox_rea asked, “Drugs kicking in or wearing off?”

You can read this and previous blogs on two websites. One may look better than the other because of how the platforms present the page.

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Trump didn't definitively demonstrate dementia sundowning in debate but I was shocked to see signs that Biden did, By Hal Brown, MSW

 

If you haven't read the follow-up to this blog I suggets you read it here.

As someone who was holding off concluding that Trump had dementia until this debate when he'd be sundowning I didn't note this in the debate. I wrote about this on June 15th.

Trump was his usual malignant narcissistic self and when he unexpectedly saw a diminished Biden he responded like the sadistic bully he is. He verbally punched him again and again with a manic and repetitious unhinged attack filled with his usual lies and projections. 

While he seemed "demented" (meaning wild, irrational, and angry) what I didn't see was definitive signs of actual sundowning indicative of medical dementia. If anything I saw Trump as being more manic than usual. If he believed the lies he told he's clinically delusional. These psychopatholgies are not dementia.

I was however shocked to see that there were indications of at least very early dementia in President Biden, something I hadn't even considered before. 

Biden came across as off kilter but it was worse than this. He not only missed opportunities to counter-punch Trump but stumbled over his thoughts. Two or three times he referenced an important number, 400,000 and had to correct himself by saying he meant 40 million. 

What happened with Biden wasn't just his stuttering occassionaly. His cognition seemed to pause as if he was struggling to think of what he wanted to say.

There was one time when he seemed to have a "brain freeze" where his face went blank. When talking about the national debt he repeatedly lost his train of thought.

I wondered how he would do on the MoCA dementia screening test Trump bragged about acing. In his after-party when Jill Biden introduced him he told a story which seemed to come out of nowhere. He began his remarks with an anecdote he’s used before (see 2020 Vox article) which he says (perhaps erroneously) was in a John Wayne movie when he used the term "lying, dog-faced pony soldiers" where he is talking to "an Indian chief." I think he used the term "Indian" not Native American.

There were so many retorts Biden could have used. One came to mind as I was miserably trying to fall asleep last night. After the interchange about who was the worst president Biden could have said sarcastically something about how amazing it was that in the history of the country Americans had the opportunity to watch according to Trump both the worst president in history and the best president in history.

Another missed opportunity came when Trump said he was the one who had heart. Biden could have said that he hardly thought it showed heart when he pulled children out of the arms of their parents and put them in cages.

Then there was Trump bragging about his golf prowess and Biden countering with talking about his own golf handicap. Aside from the fact that many non-golfers don't know what a 2 hole improvement in a handicap means it was a foolish comeback.

This is an excerpt from "It’s time for Jill Biden to have a hard talk with her husband" in The Washington Post.

How Biden’s most passionate debate moment was defending his golf game. How, when he was served up a softball on abortion — Democrats’ most winning issue — he sputtered an incomprehensible answer about Roe v. Wade having “three trimesters. The first time, is between a woman and a doctor. Second time is between a doctor and an extreme situation. A third time is between the doctor, I mean, between the women and the state.”

Trump has an ad out suggesting Biden has dementia. I begins with a critique of Bidenonmics and then continues “Americans are struggling, Biden’s ignoring our problems. He keeps denying reality. Is it dishonesty or dementia?” The answer to the first part is, of course, that Biden is not being dishonest and if he does have early dementia it would have nothing to do with Biden's honesty. However, Americans need to know if Biden is either suffering from early dementia which may manifest itself symptomatically only in the evening at this stage or is in other ways is cognitively diminished to the extent he can't function adequately as president.

Updates:

Biden addressed a crowd at a rally in North Carolina today (below). Whether he was reading from a teleprompter or not he was a very different person than the one we saw last night. This was the Biden we hoped would be at the debate. One reason may be what I am suggesting. It is that he doesn't present symptoms of early dementia, or some kind of diminished cognition, during the day but when the sun goes down they emerge especially under pressure. This is the well document phenomina of dementia sundowning.

 Jon Stewart addressed Biden's debate performance (here) airing many painful moments and noting that this reaction to Trump was not a good look:

Then there's this:

Addendum: A neuropsychological assessement for dementia.

You can read this and previous blogs on two websites. One may look better than the other because of how the platforms present the page.

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CNN's Daniel Dale dares. He is live fact checking the debate live on X which will no doubt reveal how brainwashed Trump cultists are. They're already calling the him a liar. By Hal Brown, MSW

 

Rawstory has this article online today. 

They show Stephen Miller because he wrote "CNN pledges to 'fact check' Trump all night -- i.e. lie, smear and spin for Biden."

The CNN eporter that will be do the fact checking live on X is Daniel Dale. This is his X page with the top tweet currently about his cat.

As you see above the last time he tweeted was Sept. of 2023. The reason for the references to Canada is that (as Wikipedia tells us) Daniel Dale "is a Canadian journalist known for rebutting a large number of false claims made by United States PresidentDonald Trump during his 2016 presidential campaign and presidency. Dale credits an encounter with Toronto Mayor Rob Ford while covering the mayor and his brother Doug for the Toronto Star as the inspiration for developing his brand of adversarial journalism."

I tweeted my reply (top of page) to him. Almost all of the replies on his X tweet announcing this are very positive. RawStory found these negative ones:

One user, @socratic_badger, asked, "Does anyone actually still believe fact-checkers are unbiased?"

@sooo_nance wrote, "No one cares about fact checks."

@Gigi12341983135 said, "Make sure you fact check Biden and his lies," despite the fact that Dale never specified he was only fact checking one contestant.

@Lynnrx52 wrote, "Your fact checking needs fact checked. You really shouldn’t."

This prompted Rep. Jim Jordan to weigh in:

I also found these tweets attacking Dale:

This was posted by this X user:

For Daniel Dale's sake I hope he has help in this ambitious endeavor. He will need at least two computers, one to post his fact check tweets on X and the other to quickly look things up to find factual facts. Merely tweeting that he knows something is a lie won't cut the mustard with Trump supporters when he lies. He will have to do what Politifact and Snopes does when they publish sources to justify their conclusions. 

For example: 

I will be watching the debate on MSNBC though I may check to see if CNN is putting Dale's fact checks on the bottom of the screen. I don't think they should do this as it will give Trump and his supporters something else to rage about in addtion to the questions asked by Jake Tapper and Dana Bash who Trump's says are Trump haters.

I'm not planning to see how Fox News spins the debate when it's over. There's so much right-wing bullshit I can take. I will watch the MSNBC post debate discussion. What I may do periodically during the debate is look at Dale's X fact checks mostly to see how many Trump trolls he attracts. The more he gets the better as it will show at least that he has had an impact with some Trumpers. There's no way to reach the anyone in the Trump cult if they ignore you.

You can read this and previous blogs on two websites. One may look better than the other because of how the platforms present the page.

Read on the WordPress Stressline.org

or….

Read on the Google Blogger platform HalBrown.org This version has a Disquis comment section which makes it easy to post links and images.