Why do politicians so often feel they can carry on in public office, much beyond 70, even 80 years of age, despite cognitive problems?
That was the case for Joe Biden and continues for some members of U.S. Congress. Ditto probably for U.K. and Canadian politicians.
Biologically speaking, life can be divided into three stages: first, development (in utero to the early 30s), then maturation marked by growing experience and maturity (early 30s to the early 60s, and thereafter by what some so aptly call progressive diminishment beginning in the mid to late sixties through to death.
By the 60s, atrophy of the brain and losses of nerve cells are obvious. About this time, MRIs reveal microvascular changes and even small asymptomatic infarcts in five to 10 per cent of brains between 60 and 69 years of age, figures which rise to 10 to 24 per cent of brains between 70-79 years of age, and 25 to 40 per cent of brains for those over 80. Those are striking numbers.
That doesn’t mean that older folk can’t be sharp (many are), but increasingly we’re aware, as I am approaching 87, that we’re not quite as sharp, our memories not quite as reliable, our senses not quite as keen and we don’t get about as effortlessly as we did in mid-life and certainly nowhere close to teenagers with their boundless energy, young bodies and clean-slate learning machines for brains primed to learn much faster than we and I can.
Young brains are probably why most truly original thinking in theoretical physics and mathematics takes place in the 20s or early 30s of life, and related to that, why complex, fast, highly co-ordinated activities such as gymnastics are best learned in the teens — young brains to co-ordinate young muscles and joints.
Fortunately, there’s plenty of evidence that regular exercise, healthy diets and richer cognitive lives slow the aging clock — but not the inevitability of aging. If you have lingering doubts about the effects of aging, just watch teenagers and children at play or talking. It’s hard to keep up with the speed with which they talk, understand and move.
The sweet spot, as I call it, for effective politicians lies somewhere between the early 40s and mid-60s when the brain, if not quite at its peak, remains high-functioning, they’ve acquired the requisite experience and judgement, and possess the needed stamina required for demanding jobs. Mark Carney is 60 and obviously high-functioning.
But given the silent accumulation of age-related changes in the brain, is it any surprise that leaders begin to fumble cognitively and behaviorally in their 70s and much beyond — and earlier for impaired judgement and discretion?
During President Biden’s first term and even during the run-up to that election, there were growing worries about his physical and cognitive fitness for the job: he looked frail, moved slowly and gingerly, and once in office appeared increasingly dependent on lap notes to keep track of names and the agenda when hosting world leaders in the Oval Office.
Then, in the first presidential debate for his second election bid, he lost his wit and focus badly, leaving a nationwide audience to gasp and wonder what happened, and could what they witnessed happen again — perhaps many times or worse while he was president?
Eventually, Biden caved under mounting pressure from his party and increasingly unfavourable poll numbers and gave up his run for a second term, while never acknowledging his health problems. He was 81 at the time and would have been 85-86 at the end of a second term — a frightening prospect, given his obvious decline in the first term.
Biden wasn’t the only worry. Mitch McConnell, the Republican head in the Senate, twice froze and looked blank in mid-sentence at the podium while fielding questions. The cause was never made public but might have been speech arrest related to a localized seizure or ischemic event. There had been other events, including falls. That was fall 2023. But only with the coming midterm election this November is he finally slated to retire.
McConnell and Biden aren’t the only examples of questionable suitability for office. One common trait in the early stages of dementia is denial that there’s anything wrong, which reveals poor judgment and even hubris.
A selection of political leaders in European, Middle Eastern and Asian countries reveals six in their 70s, three in their 60s, one in his 50s and two in their 40s, with the oldest being Donald Trump, soon to turn 80. Six are in the sweet spot, 40 to 65, and six in their 70s — beyond the cognitive sweet spot.
For comparison, many Nobel Prize winners in the sciences win prizes in their 60s and 70s for work carried out 20 to 30 years earlier, well within the sweet spot when they were most productive.
Many make it to their 80s, even 90s, cognitively in good shape, but overall, the numbers tell a story of progressive physical and cognitive diminishment in the last third of life.
The trouble is that politicians have a habit of hanging on long after their best-before dates, believing the country, province/state and local government can’t get by without them. That’s a sign of cognitive impairment, not an encouragement.
Dr. William Brown is a professor of neurology at McMaster University and co-founder of the InfoHealth series at the Niagara-on-the-Lake Public Library.
