Barack Obama sometimes spoke of teachable moments — when either something went wrong or perhaps right, the reasons for which sometimes provide useful lessons for the future. 

We were at such a moment when Joe Biden announced his withdrawal from the U.S. presidential campaign.

The U.S. presidency is one of the toughest, most demanding and unrelenting jobs in the world given the powers of the office and demands on the president to keep the nation and its allies safe in an increasingly hostile world, while providing peace and prosperity for those at home.

The job demands physical stamina, emotional stability, experience and wisdom. The best presidents in the past had all these and some an uncanny ability to connect with fellow Americans to help the nation through crises.

Biden was an effective senator, vice-president and, for the first two years of his presidency, an effective president who galvanized NATO and supplied the arms necessary for Ukraine to defend itself against Russia.

However, almost from the beginning of his first term all was not well. His stamina began to wane especially in the last year in the face of the terrible conflict in the Middle East, including a bullying Israeli prime minister, an out-of-control southern border and a looming Trump second term threatening all Biden’s achievements

Throughout the Middle East conflict, Biden seemed increasingly out of his depth and ability to influence events. Public unscripted moments, especially news conferences were rare and when he spoke, his messages became increasingly cryptic, and disorderly, especially when he spoke off the cuff. All was glaringly obvious in his debate with Trump.

Connect the dots and look back; it seems Biden obvious was suffering from some form of dementia, which affected his memory, speech, thought processes and planning — made worse by the bad news piling up on his desk and pressure at home and abroad to look “in command.”

Biden appears to have what is all too common in the late life — dementia — and no one, not his aides, those in the federal government, and certainly not Biden ‘fessed up to what some neurologists and gerontologists worried about as early as 2020 and in the last year became obvious to all who witnessed the debate. 

Characteristics of dementia often include a lack of awareness of the problem by the patient and sometimes anger when their shortcomings are pointed out. Then there’s the issue of those closest to him, his wife and family members, who daily witnessed these shortcomings — yet were reluctant to confront the man they love.

In the case of Alzheimer’s disease, the runup to clinically obvious evidence of dementia may take as much as three decades, during which imaging studies often reveal accumulations of beta amyloid and sometimes tau or perhaps significant microvascular disease, or both. 

The earliest signs of dementia may be sensed by those around them in subtle behavioural changes and increasing difficulties assimilating and making sense of complex issues and problems — limitations made worse by stress and becoming overwhelmed on the job. Sounds like a portrait of dementia in a president to me.

But what are the teaching moments?

First, it took a long time for Biden and those close to him, to own the problem — the president appears to have a serious brain disorder, which, by common standards applicable in other professions, should disqualify him for the job.

The coverup was massive. I’ll bet there were many quiet conversations by those close to Biden about his behaviour and shortcomings. 

Some of those conversations probably began as early as 2020 but were papered over by loyalty and an unwillingness to bring it up with the president until suddenly, with the yawning realization recently that Biden could lose badly and carry many Democrats with him, what were private concerns surfaced.

Given that half of those in their 80s eventually develop significant cognitive impairment, why wouldn’t there be a congressional review of suitability for office requirements for presidents and other civil servants past the age of 70?

Why would we think presidents are any more immune to age-related cognitive and significant physical impairments than surgeons and physicians who retire at or before 65 or past 70, continue to practise with the caveat that they must have mandatory peer reviews every few years in Ontario and most other provinces.

I had three assessments, which I thought were well done.

The teaching moment here should be that presidents and other elected officials should be assessed every five years or less after the age or 65 (or perhaps 70) and mandated anytime there’s good reason to think that elected officials, from small towns to presidents and prime ministers, might be falling short of the cognitive mark and their ability to fulfil the requirements of their office is in jeopardy.

Politicians won’t like age limits and given their ingrained habit of continuing in office well past their cognitive due dates most are probably not the best judges for legislation to impose age limits on public office holders. 

If so, our duty is to force them through the ballot box by voting on the issue at election time and a referendum specifically dealing with the issue of cognitive decline and assessments of those in public office 70 years of age and older.

There’s another side to this too, the longer politicians stay in office, the longer it takes to get younger blood with fresh, less-entrenched ideas into positions of learning and responsibility.

What’s your take on the issue of age and competence?