# Age and health concerns about Joe Biden

Joe Biden was 78 years and 2 months old when he took office, then the oldest president ever at inauguration (this record was subsequently broken by Donald Trump in 2025), and was the first president of the United States to turn 80 while in office. During the campaign for the 2024 United States presidential election, there was concern from the public and then-former President Donald Trump about his health and fitness for office. These concerns increased after a poor performance by Biden during a debate against Trump in the 2024 presidential election, which led a number of commentators and some Democratic lawmakers to call for Biden to drop out of the 2024 presidential race. He later withdrew his candidacy while continuing to serve as president until the conclusion of his term on January 20, 2025. When his term ended, Biden was 82 years and 2 months old, the oldest sitting president in United States history upon leaving office.
Prior to the debate, in February 2024, prosecutor Robert Hur, who conducted interviews totalling five hours with Biden as part of his investigation into a classified documents incident, described Biden's memory as having "significant limitations" in his investigative report. At the time, liberal commentators and Democratic officials accused Hur of partisanship and including unnecessary detail, however on August 20, 2024, the Washington Post editorial board published an op-ed stating that Presiden Biden's "inner circle worked to conceal his decline". On January 17, 2025, the New York Times publicly acknowledged that President Biden was "faltering", with a "shaky condition", and was protected by his inner circle.

## Background

In February 1988, after experiencing numerous episodes of increasingly severe neck pain, Biden underwent surgery to correct a leaking intracranial berry aneurysm. While recuperating, he suffered a pulmonary embolism, a serious complication. After a second aneurysm was surgically repaired in May, Biden's recuperation kept him away from the Senate for seven months.
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In 2018, when Biden was considering running for president, he consulted with friends, aides, and longtime supporters as to whether he was too old to seek the presidency. By 2019, The New York Times, The Washington Post, Politico, CNN, The Atlantic, the Associated Press, and Slate all published articles on Biden's age and fitness for office. That year, in advance of the 2020 United States presidential election, many of his Democratic opponents used his age against Biden, who was 76 at the time. Biden supporters criticized this as ageist discrimination. According to ABC News, Vladimir Putin and the Russian government spread disinformation about Biden's mental health during the 2020 presidential election, and the Department of Homeland Security withheld publication of a bulletin warning law enforcement agencies about this campaign. During and prior to his 2020 presidential campaign, Biden was followed by rumors that he had undergone plastic surgery to appear younger. Olivia Nuzzi reported in 2019 that Biden's alleged cosmetic procedures were "a minor obsession" of the Trump White House.

## 2020 election

In April 2019, Joe Biden announced his entry into the 2020 Democratic Party presidential primaries to become the next president. Throughout the primaries the other Democratic candidates, primary voters, and journalists alike raised concerns surrounding Biden's age and mental acuity, viewing the issues as a potential detriment to his electability. At the time of his announcement, Joe Biden was 76 years of age. Some of the age-related concerns were easily dismissed as his main opponent, Bernie Sanders, was 77 years of age, making him older than Biden. Despite that, Biden still faced age-based criticisms due to lackluster debate performances and frequent gaffes. In September 2019, Julian Castro criticized Biden during a debate for seeming to forget a position he said minutes previously.
During the general election, Joe Biden faced the same criticisms and was consistently attacked by his opponent Donald Trump on the issue of age and mental fitness. Trump was 74 years of age at the time, which meant Biden was older than his opponent. During the campaign, Biden was criticized for limiting his public appearances due to the COVID-19 pandemic, with Trump often times accusing him of "hiding in the basement". Furthermore, Trump and his campaign would often react to Biden's gaffes by making false claims that he was suffering from dementia, and by calling him "Sleepy Joe" at rallies.

## Presidency

During Joe Biden's presidency, his former opponent Donald Trump and right-wing media outlets continued to perpetuate claims of dementia and cognitive decline. On a couple of occasions during the 2020 campaign Biden called himself a "bridge candidate", leading some to believe he would not seek a second term. The Biden administration has routinely aimed to make light of the president's age by poking fun and joking about it, in a similar manner to Ronald Reagan. This approach has been met with both praise and mockery. The Biden administration has also been criticized for allegedly gaslighting or harassing journalists who asked questions about Biden's health or age.
On his 81st birthday, Biden posted an image of a birthday cake with dozens of candles, jokingly captioned to be for his "146th birthday". The photo brought to the surface concerns among the public about Biden's age according to a majority of those polled at the time.
In 2022, a New York Times–Siena College poll found that 61% of Democratic voters wanted someone other than Biden to be the presidential nominee, citing his age as the main concern. Biden's aides dismissed age-related concerns as politically motivated attacks by Republicans. James Carville, Ezra Klein, and The Economist called for Biden to not run again as early as 2022. On July 28, 2022, U.S. Representative Dean Phillips became the first incumbent Democratic member of Congress to say President Biden should not run for re-election and called for "generational change," pointing to Biden's age. In a July 2023 television appearance, U.S. Representative Greg Murphy, who is also a medical doctor, accused Biden of having undergone extensive plastic surgery to appear younger. According to Biden's 2024 annual physical examination, he is in good health for a man of his age. Biden is on medication for non-valvular atrial fibrillation (a form of irregular heartbeat), has an obstructive sleep apnea which he receives treatments through positive airway pressure, has a sensory peripheral neuropathy, and has a stiff gait due to spinal arthritis and the aftereffects of injury.
According to a February 2024 poll, Biden's age and health were major or moderate concerns for 86% of voters generally, up from 76% earlier in 2020. According to another 2024 poll, most of those who voted for Biden in 2020 say they believe he is too old to be an effective president; The New York Times noted that these concerns "cut across generations, gender, race and education". The Wall Street Journal has reported that, Biden's team has limited his schedule, personal interactions, media appearances, interviews, and unscripted exchanges in order to minimize concerns about his age and mental acuity. Democrats were concerned about his ability to serve a second term, as he would be 86 years old by its end. Many of them were also concerned if he could beat Donald Trump a second time. After Trump's win in the presidential election, U.S. Representative Lloyd Doggett, who was the first sitting Democrat in Congress to openly call for President Joe Biden to withdraw from the 2024 United States presidential election after the first presidential debate, stated that "I only regret I didn't do it earlier ... I believe that the only person in our caucus who doesn't share some responsibility for the outcome is Dean Phillips, who came out early." On December 19, 2024, former CNN political commentator Chris Cilizza issued an apology about his Joe Biden coverage, stating, "I didn't push hard enough for information about his mental and physical decline in the moment. And I should have." Also on December 19, 2024, The Wall Street Journal released a detailed report on "How the White House Functioned With a Diminished Biden in Charge".

### Democratic presidential primaries

On October 27, 2023, Minnesota Congressman Dean Phillips formally launched his presidential campaign for the Democratic nomination. Phillips campaigned as a younger alternative to Biden, who would be a stronger opponent to Trump. Phillips argued during his campaign that President Biden would be a weak general election candidate due to his age and low approval ratings. In public, Phillips was ridiculed. In private, others in the Democratic Party shared his concerns. On January 20, 2024, Phillips told Axios that he thought it would be "impossible" for Biden to do the job for four more years, and that "At that stage of life, it is impossible ultimately to conduct, to prosecute the office of the American presidency in the way that this country in the world needs right now. That is an absolute truth." On January 23, 2024, Phillips won 19.6% of the vote in the New Hampshire primary. In late January or early February 2024, Larry Sabato, director of the Center for Politics at the University of Virginia, received a call from a Democratic senator where the senator reportedly told him that, "You do realise, off the record, that Joe Biden is not going to be our nominee? I just was at a meeting with him with several other senators and he couldn't even function. We can't run him." Phillips announced that he was dropping out on March 6, 2024, having not earned a single delegate up to that point. After having already suspended his campaign, Phillips won three delegates in the Ohio primary and won one delegate in the Nebraska primary. Phillips was still on the ballot for the Democratic Party's primary election days in Ohio and Nebraska, where he gained his delegates by meeting the 15% threshold of votes needed to receive a delegate in a congressional district in Ohio's 2nd, 6th, and 14th districts and by receiving the most votes of any candidate in Logan County, Nebraska. On December 26, 2024, Mother Jones named Phillips a "Hero of 2024" for being the only elected official to challenge Biden in the Democratic primary who tried to make the case that Biden was unfit for office. On December 28, 2024, Politico reported that Phillips was right about Biden's reelection campaign and that his decision to launch a primary challenge proved prescient after Biden's performance in his debate against Trump. On December 30, 2024, The New York Times dubbed Phillips the "Most Prophetic" in their 2024 High School Yearbook of American Politics for challenging Biden for the Democratic nomination. On January 5, 2025, an opinion letter to the editor for The Wall Street Journal argued that Phillips should be given his due "for questioning President Biden's fitness for office as early as July 2022". On January 7, 2025, a New York Times opinion piece by columnist Bret Stephens argued that Phillips should be nominated for a Profile in Courage Award because it was left to him to "play the part of the boy who says the emperor has no clothes".

### Longevity

In January 2024, Dr. Jay Olshansky gave Biden a close to 75% chance of living through a second term based on publicly available information about his health. This is about a 10% better survival chance when compared to other men his age.

### February 2024

Upon concluding the investigation into Biden's handling of classified documents, special counsel Robert Hur suggested that Biden would be able to present himself to a jury as an "elderly man with poor memory" and wrote that his memory "appeared to have significant limitations". White House lawyers disputed this characterization, and Biden rejected the claim in a televised press conference on the day the special counsel's report was released; during the conference, he referred to Egyptian President Abdel Fattah el-Sisi as President of Mexico. At the time, liberal commentators and Democratic officials accused Hur of partisanship and including unnecessary detail. Representative Dean Phillips (D-MN), who was primarying Biden at the time of its release, honed in on the parts about Biden’s age when he stated that the report “simply affirms what most Americans already know and all but handed the 2024 election to Donald Trump” if Biden is the Democratic nominee. Senator Rick Scott called for Biden to be removed from the presidency via the 25th Amendment after the special counsel described Biden’s memory in their report. He argued, “That does not describe someone who should be the Commander in Chief of our armed forces and the defender of American freedoms.”
The House Judiciary Committee and the Oversight Committee, both controlled by Republicans at that time, issued subpoenas for the full audio recordings of the interviews. A transcript had already been released to the committees. The White House withheld the recordings, accusing the Republicans of wishing to distort the audio for political gain. Ultimately, House Republicans passed a motion to hold Attorney General Merrick Garland in contempt of Congress for not complying with the congressional subpoenas to release the recordings. The Department of Justice which was run by Merrick Garland concluded that Garland did not commit a crime and did not charge him.

### June–July 2024
#### June 2024 debate

On June 27, 2024, Biden took part in the first presidential debate. The debate reinforced concerns about Biden's age, with Biden appearing confused and disoriented during its first half, giving meandering answers to questions, particularly on health policy. The New York Times reporter Reid Epstein wondered whether voters would see him as someone physically able to run the country, even if they preferred his policies to Trump's. Some Democrats were unsure whether he should continue his campaign. Many officials and foreign leaders who encountered Biden in the months to year preceding the debate noticed he was increasingly frail, tired, meandering, and less lucid in his speech. In many parts of Europe, this led to concern about a second Trump presidency. Biden declined to undergo a cognitive exam such as the Montreal Cognitive Assessment, saying that he has "a cognitive test every single day" in performing his presidential duties. It later emerged that a neurologist specializing in Parkinson's disease had met this year with Physician to the President Kevin O'Connor; O'Connor and the White House both said Biden was not being treated for the disease and that other officials use O'Connor as their physician.

#### Calls for removal under 25th Amendment after the first presidential debate

On June 28, 2024, Speaker of the House Mike Johnson said that "President Joe Biden’s Cabinet should discuss invoking the 25th Amendment in the wake of a politically disastrous debate that compounded age and acuity questions." Congressmen Clay Higgins (R-La.) and Chip Roy (R-Tx.) also filed a resolution after the debate that asked Vice President Kamala Harris to immediately invoke her power in the 25th amendment to convene the executive Cabinet and declare Biden as unfit to carry out his duty as Commander-in-Chief.

#### Inherent contempt of Congress resolution

On July 11, 2024, the House of Representatives voted on a resolution that could have held Attorney General Merrick Garland in inherent contempt of Congress. The resolution would have imposed a fine of $10,000 per day on Garland for defying a congressional subpoena until he handed over audio of former special counsel Robert Hur's interview with President Joe Biden. Republicans argued that they needed the audio so they could listen to details like Biden's tone or pauses in his answers. This attempt fell short in a 204 to 210 vote by the House of Representatives and Garland was not found in inherent contempt, with four Republicans voting with all Democrats to oppose the measure.

#### COVID-19 diagnosis

On July 17, 2024, Biden tested positive for COVID-19. He experienced mild symptoms, including a cough, runny nose, and "general malaise". Images of him looking frail exiting from Air Force One on the way to isolation fuelled further speculation on Biden's health.

#### Suspension of 2024 presidential campaign

On July 21, 2024, Biden announced his withdrawal from the 2024 presidential election and endorsed his vice president Kamala Harris to succeed him as the Democratic presidential nominee. More than 30 senior Democrats had called on him to withdraw two days before he announced his decision. After formally securing the Democratic nomination, Harris went on to lose the general election to Trump.