Of course Biden's age is a legitimate voter concern

So is Trump's, but an extra four years makes a difference, and it could be the difference in the election.

An AP-NORC poll published last week found that 77 percent of American adults think President Biden is “too old to be effective for four more years”; 51 percent of respondents said the same of Donald Trump.

Biden is slightly more than three-and-a-half years older than Trump. He’s currently 80 and would be 82 years and two months old on January 20, 2025 if inaugurated for a second term. Trump is 77 now, and would be 78 years and roughly seven months old on 1/20/25.

Mitch McConnell freezing up at a public appearance last week (via Reuters). What if this happened to Biden?

The relatively large gap in assessments of the candidates may partly reflect tactical answers by partisan respondents. Among Democrats, roughly equal numbers say that Biden and Trump are too old — presumably they respond that way because it’s hard to single out the other party’s candidate for being too old when your guy is even older. Among Republicans, however, 89 percent say that Biden is too old while only 28 percent say the same of Trump.

However, the differences can’t entirely be chalked up to partisanship — 74 percent of independents also said that Biden was too old, while just 48 percent said that of Trump.

Obviously some of this comes down to voters’ subjective views of the candidates and the way their age and health is portrayed in the media. However, I don’t think voters assessments are entirely subjective, or at least not necessarily so. The 3.6-year age difference between Biden and Trump is potentially meaningful, at least based on broad population-level statistics.

Here, for instance, is a chart depicting the annual risk of death for an American non-Hispanic white male in 2019 and 2020, according to the CDC.¹

The age of Biden and Trump during their potential second terms corresponds to infection point at which the risk of death begins to increase meaningfully every year. I’d say the increase is exponential, but it’s actually slightly steeper than that. (I’ve drawn a faint, dashed exponential-fit curve in the graphic for comparison; you can see that it doesn’t ramp up as steeply as the thicker curve that reflects the CDC numbers.) The late 70s and early 80s are a period when medical problems often get much worse for the typical American man.

At age 70 — Trump’s age when he was inaugurated for his first term — the risk of death in the upcoming year for a white American male is 2.4 percent. By age 78 —Trump’s age in 2025 — the risk has roughly doubled to 4.9 percent. At 82 — Biden’s age if he’s reinaugurated in 2025 — it’s increased further to 7.3 percent. And the risk of dying is 11.0 percent by age 86, which would be Biden’s age at the end of his second term.

Note that those are annual risks — not cumulative over the four-year term.

According to the Alzheimer’s Association², this age range is also associated with a sharp increase in Alzheimer’s dementia:

Age is the greatest of these three risk factors, with the vast majority of people with Alzheimer’s dementia being age 65 or older. As noted in the Prevalence section (see page 17), the percentage of people with Alzheimer’s dementia increases dramatically with age: 3 percent of people age 65-74, 17 percent of people age 75-84 and 32 percent of people age 85 or older have Alzheimer’s dementia.

So again, if voters are diagnosing the candidates just based on population-level data — or perhaps based on their personal experience of being around aging parents and relatives — it’s hardly crazy for them to think the age gap between Biden and Trump is relevant.

For me personally, I’d draw the line younger than both of them. As of last year, only two Fortune 500 CEOs (Warren Buffet and Roger Penske) were older than 77. No current U.S. governor is older than 78. And while there are quite a few old U.S. Senators, we’re seeing serious consequences from that, whether it’s Mitch McConnell repeatedly freezing up during press conferences or Diane Feinstein’s manifestly diminished capacities.

It’s also reasonable, of course, to ask whether population-level data should apply to U.S. presidents. On the one hand, presidents have access to world-class medical care. And recent American presidents have an excellent track record of longevity. Ronald Reagan and Gerald Ford both lived until 93, George H.W. Bush to 94, and Jimmy Carter is still going at 97. (LBJ, who died at 64, was the last president to pass away while relatively young.)

On the other hand, presidents have the most stressful job in the world, and the presidency is frequently said to age people prematurely, although the academic research on that question seems speculative to me.

It’s not just death that voters have a right to be worried about, however. It’s also underperformance — perhaps coupled with a Feinstein-like refusal to step down.³ In principle, the presidency ought to require an extremely high level of cognitive ability 365 days a year. In practice, presidents with significant impairments could potentially put the country at risk, as in the case of Woodrow Wilson (stroke), Richard Nixon (alcohol abuse) and arguably second-term Reagan (Alzheimer’s).

As of what to make of Biden and Trump in particular — look, I have my judgments and you have yours. Cognitively, they both seem considerably less sharp to me than they did in their primes. Health-wise, it’s bad that Trump is overweight; it’s good that neither of them smokes or drinks and that all four of their parents lived to age 86 or older.

Beyond that, I’m not sure how much we can confidently say. Trump was notably cagey with his medical history as president. But there’s a long history of presidents from FDR to JFK withholding vital details of their medical conditions, so it strikes me as naive to take any candidate’s public disclosures at face value.

And I definitely don’t think we should just take an attitude of “leaving it up to the experts”, like the “aging expert” cited in the AP article:

All of this is dispiriting to S. Jay Olshansky, a public-health professor and aging expert at the University of Illinois at Chicago. He thinks age, when sizing up a presidential candidate, is no more relevant than eye color and the public’s focus on it shortchanges the gift of wisdom and experience.

“It’s sort of the classic ageism that we’ve been battling for the last 50 years,” he said. “The age of the individual is irrelevant. It’s the policies that they bring to the table that are important. And the number of times around the sun just doesn’t cut it as an important variable at all.”

From observing both men from afar and examining their medical records, Olshansky regards Biden and Trump as likely “super agers” despite signs of frailty from Biden and Trump’s excess weight.

Age “is no more relevant than eye color”? Are you kidding me??!?!? Your eye color doesn’t affect your annual risk of death or severe cognitive impairment by a factor of 100x or more! At the very least, voters ought to be pay much more attention than usual to the bottom of the ticket and consider how they’d feel about a President Kamala Harris or a President Ramsawamy or whomever else Trump picks as his VP.

Let me say this very carefully:

• I’m not advocating for Biden to be replaced on the ballot.

• It helps Biden that Trump is also quite old and often sounds like your crazy uncle. If the GOP nominee is someone other than Trump (as hard as it is to see that happening at the moment) the salience of Biden’s age increases further.

• Given improving economic conditions, I think Biden a favorite to get re-elected despite his age, although we could debate how much of a favorite.

• I don’t think age is the singularly most importantly issue — for instance, I’d rather elect someone who will be 86 at the end of his term than someone who might refuse to step down at the end of it.

But for all that said — if the expert class doesn’t understand that Biden’s age is both a real concern for voters and a valid concern, they’d better be prepared for a getting second Trump term instead. This election is probably going to be close, and Trump might be only one Biden-has-a-McConnell-moment away from winning.

1. The data comes from the here; I’ve simply averaged the two years together because I don’t want to get sidetracked into a discussion of whether elevated death rates from COVID (which affected 2020 but not 2019) will reflect the steady state going forward.

2. The original source for their estimates is here.

3. Although for presidents, unlike with senators, there is at least the 25th Amendment.