Hello, and welcome to this podcast from the BBC World Service.

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Really, think about it. Think about it. I know I'm 198 years old.

But are voters laughing? No. At least that's what polls are telling us. Again and again, his age comes up as an issue. Joe Biden has just turned 81. He's America's oldest President ever. His opponents have called him Sleepy Joe for a long time, but it seems now that even some of his allies are very worried.

There are worries. Two Democratic senators recently have raised with me without me prompting them the question of the President's age.

This is the global story. We're about one story with a fresh sound and a smart take on the world's news. Five days a week, Monday to Friday. In today's episode, is Joe Biden too old to be President? And what does the latest science say about how we can all age gracefully? Hello, I'm Katya Adler from the BBC World Service. This is The Global Story. Two key questions today and two very key guests. The BBC's US Special Correspondent, Katya Kay, our longtime voice and face in Washington, will be chatting together about age and politics. The BBC's medical editor, Focus Walsh, is also here. He'll help us understand the newest science on aging and also how we can outsmart or at least delay cognitive decline. Ferguson is in the Global Story headquarters in London. Katie and Ferguson, hello.

Hi.

Katja. Hi, Katja.

I have a question for both of you, first of all, just a quick one. Some might say it's even ageist that we're talking about Joe Biden's brain. So 30 seconds each. Why is Biden's bracket, aging, close bracket's brain, a story?

I think it's just fascinating from thousands of miles away to see the most powerful man on the planet, sometimes losing his way, tripping up. We all look at that and think, Goodness me, that is the person who has power of the most powerful military in the world, the biggest economy, and wants to be re-elected. We understandably question, does that person have what it takes physically and mentally to carry on doing that job for another four years?

Yeah, I think it's a totally legitimate question because Joe Biden, if he's re-elected, will be America's oldest elected President ever. So that, in and of itself is new and a phenomenon and worth talking about. But also because poll after poll shows us that Americans themselves are worried about this. They look at Joe Biden and they may like his policies, they may like what he's done for the country, but even the ones who like him, and even Democrats are saying to pollsters, We're worried about the fact that he's so old. So it would be crazy not to be having this conversation.

In May, there was a Washington Post and ABC news poll which suggested that 62% of Americans thought Joe Biden lacks the mental sharpness to be effective. By the way, 44% also thought Donald Trump was in the same category. He's four years younger than Joe Biden. And then this November, there was a New York Times Siena poll, and it confirmed that Joe Biden verdict. Almost two-thirds of people thought Joe Biden lacks mental sharpness. What do we mean there by mental sharpness? Is it actually a clinical term?

First of all, I would say it's always dangerous to diagnose people from afar, especially when like me, you have no medical qualifications. So let's get that out there first of all. But in terms of mental sharpness, I know what people mean. They're really talking about things like your processing speed, your memory, your mental acuity. Our brains age, and it happens to all of us, our physical and mental reactions do slow a bit. Processing speeds for older people may be slower. Older people may have more problems with multitasking. But knowledge, what we might call wisdom, may be better than when we're young. Studies also show that older adults often have much larger vocabularies. So one thing let's get out there as well, is it is normal to go upstairs at home and forget why you've gone up. -that is.

Not a problem. -i'm so glad you said that, Marcus.

I think with Joe Biden, it was very interesting that in February, when he was still 80, his physician released a five-page summary of his health status, including experts from optometry, dentistry, orthopedics, neurology, crucially, cardiology, dermatology. I found out far too much about Joe Biden that it really was quite an intrusive report when you read it. But it said, the conclusion was that he was a healthy, vigorous, eight-year-old then, who is fit to successfully execute the duties of the presidency.

And how humiliating, really, to have a study like that published or to have to feel that it has to be published. Is it also our attitudes to aging or optics? Because I think about village elders who are always so revered. Don't we start using different parts of our brain more or less effectively as we get older as well?

Sure. Well, let's go back to this thing called wisdom. What is not normal about aging is dementia. Now, dementia is an umbrella term for a whole range of effectively cognitive decline linked to decline in brain functions. But that is not a normal part of aging, and it is the condition that is most feared by all adults when you do surveys. It's more than cancer. I think it's partly a reflection of things like that. Also, I think partly people look at somebody who's in their 80s and saying, Blimey, would you really want to be doing that job when you're 81?

If you think about it, lots of countries have got screening tests for drivers over a certain age. Do you think we should be doing the same thing for someone who holds, in the case of the US President, the nuclear launch codes?

Well, I'm just not sure what that test would involve. I know what the tests are when you go to a memory clinic, when you're being asked if you've got problems with your reasoning and memory to do functions like, for example, start at 100 and take away seven and keep it going, which always fills me with dread because I always end up getting confused around about 77. And then very simple things where you would then have a pretty clear clue that somebody had real cognitive problems when you have a clock and you're asked to draw the numbers for, say, three o'clock or five o'clock, and often if you've got problems with reasoning, you may have difficulty doing that. But I think it would be, well, humiliating and difficult to come up with a test that people would regard as fair for things like that. And if people get elected, isn't that the test that we ultimately have?

To be honest, I think, Ferguson, when it comes to nuclear codes or taking military action or anything like that, as you say, wisdom also comes into play. You don't necessarily want a very young, impetuous person in charge either. Thanks, Ferguson. We're going to hear from you a bit later on how we can help our brain delay, decline, or at least try. Let's look specifically now, though, at Joe Biden and an elderly man doing the job of a US President. Now, critics say there's evidence that his age affects his communication skills. That's one issue, sounding slurry or a bit confused. But also, and surely this is key, Kathy, it affects his decision making, say, his critics. Have you had Biden moments that have stood out for you in that context?

I think Biden is long known and all throughout his political career. He's been famous for what are known in this town as Biden gaffs. He used to make them when he was a young senator up on Capitol Hill, and he makes more of them now. He does get confused. He might get confused about where he is. He might get confused sometimes about what time of day it is. But he also has unbelievable stamina. I mean, he does these whirlwind trips around the world, talking to people he's known for a long time. I think some of the gaffs that he makes are actually less concerning, partly because people know Joe Biden and know he's famous for them, than some of the physical stuff. I think it's that almost that the campaign is more worried about, it's that he looks old and he's running against somebody, or we all assume he will be running against somebody in Donald Trump who's 77 years old himself, so not that much younger, and also makes verbal gaffs and also confuses which town he's in sometimes out on the campaign trail. I think some of Donald Trump's verbal gaps mitigate against Joe Biden's.

I actually think it's the physical stuff in my conversations with the Biden White House and people in the White House who I speak to regularly, that's what worries them all.

Biden is 81, Donald Trump is 77. Focus, is there any clinical significance in that gap?

No, you simply can't. I did a report a few years ago with some aging cyclists all in their 80s, and they were very fit men and women. They all had the immune system of people in their 20s, and they had extraordinary brain function. And we all know older people. If you think of David Attenborough, who are extremely sharp in older age, and we also know young people who are not very sharp at all. So I think age and certainly a four-year gap between two people is not an issue. And like Kathy, I think it's the physical side of things that is also a little bit concerning when you have two quite elderly men who are vying for the White House. Can I jump in?

Yes, absolutely. Jump.

I think what Ferguson said is so interesting because part of the reason I think this is impacting voters is that you've got this huge wave of baby boomers in America who will all vote and vote in big numbers, people my age. And all of us who have had elderly parents have watched them decline. I mean, my parents died a couple of years ago, and I saw them after 80 get more frail. And I think for a lot of voters, we're almost transferring our own experiences of our parents. Even though I'm not 80, I know what it is to be 80. I saw my parents getting old and I saw them losing some of that physical ability and being less strong and being a bit more frail and maybe forgetting things sometimes. And I think we're almost transferring our own lived experiences onto Joe Biden. And it's not necessarily about his medical report, which by the way, every President, you have to release your medical report. So that's a pro-forma thing. And he is pretty healthy. I mean, that report, apart from the osteoarthritis, which causes him to shuffle a bit and drag his foot a little bit, which the White House is working on, it's that, I think, as much as anything.

It's that it's weirdly personal. I mean, you've got this country with lots of people who have old parents, and it's oddly personal to all of us.

Having looked at the aging body and aging mind, one of the things I've been very keen to do is to do reports with people who are older, who don't fit the stereotype of somebody using a frame to walk. I went to the States a few years ago and did a series of reports about super ages, and the things that those people had in common were partly they were lucky with their parents, their genes were good. They hadn't all lived a healthy lifestyle, but they were all engaged with life. And we'll come on, I've got a series of tips for you both and for people, if you would like them, on what we should all do to stack the odds in our favor.

Ferguson, I want you not to go anywhere, please, because I'm very keen for your tips, but I'm also very keen to get onto some politics now that we've looked at the science of it, the politics of Biden's aging brain. How big a deal is it for voters in the US? Will they change the way they vote just to avoid an elderly candidate? I'm Katya Adler, and this is The Global Story, where we aim to strip away all of those screaming headlines you're bombarded with to peel back lazy assumptions and provide you with fresh global perspectives on the stories that matter. Do subscribe wherever you get your podcasts. It helps others find us. First of all, I'd love to play you an extraordinary piece of archive. It's from the 19th of December, 1972. President Nixon is in the Oval Office and he's recording all his calls. Yes, please. Could you get the new senator from Delaware? Mr. Biden, on the phone, please. Thank you. Hello, Mr. Nixon. How are you? Senator, I know this is a very tragic day for you, but I wanted you to know that all of us here at the White House were thinking about you and praying for you.

Joe Biden has just been elected to the US Senate for the first time. But tragically, his wife and daughter have also just been killed in a car crash. You have the great fortune of being young. I remember I was two years older than you when I went to the house. But the main, Biden, is you can remember that she was there when you won a great victory and you enjoyed it together. Now, I'm sure that she'll be watching you from now on. Good luck to you. Thank you very much, Mr. President. I'm glad you go. I appreciate it. Now, I wanted to play that clip because, well, first of all, it's incredible to hear that intimate exchange at such high political level, but also because it shows how long Joe Biden has been in top-level politics, more than 50 years. And that's his chief defense, actually, against the criticism about his age. And, Kat, it's not a bad one, is it? I think Ronald Reagan used that argument too.

Yeah. In a way, Joe Biden's campaign has made the decision recently to lean in to the age issue. He makes jokes about it. He says out on the campaign trail, Well, when you're 110, like me, or I may look 30, but actually I've been around a long time. So he's trying to treat it with humor and then also make the point that with age comes wisdom and experience. And look, he has been in the Senate in political life in America since 1972. He has seen a lot of things. He's seen the end of the Cold War. He's seen the Berlin Wall come down. He has dealt with China multiple times. He's lived through multiple wars. I think he would make the argument, and his campaign certainly makes the argument, that he brings that wealth of experience to the office and at a time of high tension around the world when America is also supporting different countries that are in wars, that wisdom and that experience is particularly useful. I mean, there's... We went through a populist wave in the country, and it's the argument that Donald Trump made when he was elected in 2016, which is that you want outsiders with no political experience because the politicians have done such a bad job.

Joe Biden is trying to flip that and make the counterargument, which is that actually you want people with a lot of experience and a lot of wisdom in brackets. Oh, and that means somebody older is okay, because actually he will do a better job in this high stakes moment than his counterpart will do.

I mean, you talk to his campaign people. There are worries inside that camp, though, however bullish they might try to appear on the outside.

Look, there are worries. The latest meeting I had with a senior advisor at the White House, who's not on the campaign, and there's a distinction between the campaign and the White House, but obviously has been very close to Biden and has worked with Joe Biden for a long time, was saying that the polls are worrying them. I think initially, the White House's reaction to grumblings about Joe Biden's age was slightly to dismiss it, actually, to say, That's ridiculous. He's doing a great job. This phrase, Stop bedwetting about the President's age. It's always Democrats who complain about Democrats are always call bedwetters in this town. God knows why, but anyway. So stop complaining about bedweting and he's fine. They were slightly angry with journalists who raised this issue, but we were all out on the trail. When I speak to Americans in senior positions in the Senate, when I speak to Democratic senators, they will raise Joe Biden's age, and when I speak to normal voters, they will raise Joe Biden's age. I think the White House has recently, in the last few weeks, realized that this is too much of a pervasive problem. They're trying to have a rethink on how do we deal with this age problem.

For example, they've stepped up the amount of physical therapy that he's getting. He works out every day, so he has a trainer every day. He has a physical therapist most days. He's now wearing sneakers and gym shoes out when he's out walking rather than stiff shoes because that makes him less likely to trip over. They're having discussions about how do we put him in a setting where he doesn't look so frail? Maybe he travels less than most presidents do. They're talking about doing a rose garden campaign where Biden spends a lot of time campaigning from the White House. He doesn't travel all over the country. They're trying to get Kamala Harris's approval ratings up so that she can do more of the traveling around the country and take on more of those traditional campaign duties, because, my God, I can tell you, having covered now far too many of these American presidential campaigns, they are nothing if not grueling. And you need a ton of stamina to get through them. So the more they can help him with that, the better.

Well, the Kamala Harris side of things is, of course, a whole other podcast with you, Kathy.

Which I'll come back.

Yeah. It can't help, though, can it? When you have people who, let's put it this way, should be on your side making very public statements at a high level. I'm thinking about David Axelrod, the Obama's Chief Election strategist.

Yeah, David Axelrod, who is probably not on Joe Biden's Christmas card list at the moment, Katya.

He raised a storm, didn't he? Recently, he posted on X, formerly Twitter, that Joe Biden needs to ask himself whether it's in his best interest and the country's to run again.

In fact, I think there was a good Joe Biden healthy, exploitive, which was used to describe Axelrod after he said that. Some insiders say that there's never been much love lost between David Axelrod and Joe Biden and that they didn't get on particularly well, even when Joe Biden was President, Obama's Vice President. But I think Axel Rodd is reflecting what I have heard in private from other senior Democrats. I go up to the Senate on a reasonably regular basis just to sit down and have conversations with senators. Two Democratic senators recently have raised with me without me prompting them the question of the President's age. And should Joe Biden have been a one-term President, a transitional President who then passed the baton on to somebody else. I get no indications from the White House that he's intending to do that now.

Wasn't that the suggestion at the time when he ran for President that that would indeed be.

The case? Yeah. I think you're right that in 2020, he felt that he was the President who could be beat Donald Trump. I mean, it was all about beating Donald Trump, and he felt he was the one that could do that because he had this appeal with white working class voters. So he ran, but with the suggestion that he would be transitional. Then what happened, and I think what I have been told from the White House is that before the midterm elections in 2022, Biden was considering saying that he was not going to run again and that he would say, Right, it's up to another younger Democrat to take over. But then the Democrats did really well in 2022 in the election, and also Kamala Harris's approval ratings, and she would be the de facto leader of the Democratic Party in a way, were not particularly strong. That made him, I've been told, decide that he should run again.

I'd love to talk a bit about Donald Trump now, because the two men aren't that far apart in age. Yet, Donald Trump does appear to get away with more, if you think about his ramblings or bizarre things he says sometimes, like mosquitoes killing tens of thousands of Americans or all sorts of things, he seems to get away with more than Joe Biden, who comes across or is perceived as being doddery. Is it because Joe Biden, can I even say it, seems a bit boring?

So this drives the White House and the Biden campaign absolutely bonkers. They just cannot understand it. What the heck? Donald Trump has a terrible diet, famously eats hamburgers and drinks Coke, doesn't work out, thinks exercises for sissies, and yet nobody seems to worry about his age. It just confounds them. I think it comes back to this thing of physicality. Now what Democrats are trying to do is they're trying to highlight all of the times that Donald Trump makes a mistake. Donald Trump famously recently said that Joe Biden was going to get us into World War II. I'm sure he meant World War III because World War II would be hard to get us back into now, and he'll forget what town he's in. He'll be out in Iowa campaigning and say he's in Des Moines, actually, he's in Sioux City or something, and his aides have to correct him on stage. You'd think all of that would make voters think that he's old too. Yet on all the polling, he gets away with the age question. I think it is this physical thing that Donald Trump bounds onto the stage. He's a big man. He doesn't stumble in the same way physically that Joe Biden does.

He doesn't drag his feet. So Democrats are trying to reverse the narrative and say, But look, Donald Trump thinks we're going to get into World War II again and can't remember which town he's in, and makes gaffs all the time. But Donald Trump's supporters just put that down to Donald Trump being Donald Trump. There's just nothing Donald Trump can say that will stop them thinking he's great. I don't think that the Democrats will have much chance reversing the polling narrative on the age question, but it is funny how it drives them just nuts in the White House.

It's not just in the United States. I just wonder if there's something about this vigorous image that can be projected by older male politicians. I'm thinking of Vladimir Putin, for example, or, I mean, Sylvia Bedrosconi. I followed him throughout his entire political career. And similarly to Donald Trump, he came from outside politics. He wasn't quite as orange as Donald Trump, although he did like to sport a tan all year round of some sort. But something else that he had in common was this just incredible, rumbuxious, confident, and lots of references to his sexual activity, which his opponents hoped would count against him, but actually, with some of his supporters, counted in his favor.

Yeah. I think the fact that Donald Trump has this supermodel wife, Melania, endears him to male voters. I think there are a lot of men who look at the way Donald Trump speak about women, that famous Access Hollywood tape that I was convinced was going to sink Donald Trump's political fortunes when it was released just before the 2016 campaign, in which he talks about grabbing women by the private parts and how you can kiss them and if you're famous, you can just get away with anything. We all thought, Oh, my God, that's the end of that. Donald Trump defies gravity. He's Teflon in some ways. Those comments might repel certain sections of the population, but they may enhance his appeal amongst other segments of the population. I do think there's something about his virility, if you like. It's interesting that you compare him, Katya, to Berlusconi because you saw Berlusconi up close for so many years.

Not too close.

Yeah, exactly. Thank God not too close, either of us. But there are a lot of women that look at that and think, Oh, no thanks. But there might be a lot of men that look at that and think, Yeah, I want what he has.

I want what he has at that age as well, which was, of course, the same as Sylvia Berlusconi, who right up until the end was in politics and with a very young wife and giving great hints about what he was getting up to with her. We've talked about voters then, some very concerned about having older presidents or presidential candidates, others perhaps wanting to emulate them. Do you think in the end, voters will change how they vote because of age concerns, particularly when it comes to Joe Biden?

I think they might do. I really think this is the biggest problem for the Biden campaign, and what's frustrating is that they cannot do much about it, because in a year's time, Joe Biden will be one year old and not one year younger. And when people walk into the ballot booth, Joe Biden will be almost 82 years old. I think it's a factor that will weigh on people's minds. Very few people will make up this election. It's going to only be 100,000 Americans, give or take, who decide whether it's going to be Joe Biden or probably Donald Trump as the next President. So it doesn't take very many people in a handful of states to walk into the polling booth and say, Oh, you know what? My dad had a fall yesterday, and my dad is 82, or I'm 75, and I'm feeling just a little bit creaky today, and I don't know if I could be President at my age. That's the thing. It'll be a personal connection to age or fear about age or you walk into the bowling booth and your grandmother has just got sick and she's 82 and it might just make you think, Oh, you know what?

I'll go with the person who seems slightly younger, even if they're not very much younger. I think it's those individual, personal moments that could make a difference.

Well, Cathy, thanks so much for sharing that with us. These are going to be fascinating months to watch, and I'm very glad you'll help us watch them. Before you go, because I want to end on a high, which is how we try to keep our brains as young as possible. Fugus, in a minute for the science, Kathy, is there anything that you do that you think, Right, this I'm doing for my brain.

Oh, for my brain? Well, my brain is probably working and staying working and trying new projects. So, for example, this new project, Influentials, that I have for the BBC, has stretched my brain in a way that I haven't done before. I'm very versed in news. I'm very versed in news presenting, but I haven't really done long-form interviews with chefs and actors and dancers and trying to keep my brain active and engaged in new challenges. I think that's one way. And then physically, actually, this summer I took up ballet classes again, having not done them for almost 40 years. And it is an exercise in complete humility because I'm so bad at it compared to how I used to be. But I do think that that's the exercise that I hope will keep me fit and healthy for another decade or two.

Well, much to my children's giforing, I'm telling you, amusement. I tried my hand at windsurfing this summer. But yeah, I think our jobs, yes, it challenges our brains, just as I think being US President will keep challenging the incumbent's brain as well. Ferguson, please give us the science and most importantly, the tips.

Five top tips for us all to be Super Agers. First one, physical activity. Find something that you like doing, and when you get over 50, do some weight training, resistance training, because we have inevitable muscle decline and falls when you get much older are one of the key things that lead to decline and can lead to death as well. Keep blood pressure under control. So that's the physical side. Second, get a good night's sleep, as well as that managing your stress. Third thing, have a reasonably healthy diet. So we talk about a Mediterranean-style diet. Have a colorful plate is what I say to people. I don't mean a plate of M&Ms. I mean a colorful plate of different vegetables, fruit, and such like moderate drinking, obviously not smoking, don't vape either. Number four would be being socially connected. In a lot of these what they call blue zones, places like Sardinia, lovely Italian villages in the mountains, people are socially connected. They walk up the hill as part of their physical activity to go and pick their grapes and get their olive oil and all the rest of it. So stay socially connected. And that involves also treating hearing loss.

Hearing loss is very common in older age. And people who have untreated hearing loss are much more likely to develop dementia. And then the final one, a lot of people say, Well, when I retire, I'm going to take up doing crosswords or I'm going to learn a language. The time to do this is when you're much younger, the signs of dementia as, especially things like Alzheimer's, they build up over 10, 20 years before symptoms show. So it's really important to build up what they call cognitive reserve. So mentally stimulating activities, playing an instrument, It's the goal, don't I'm afraid, speaking a foreign language or learning a foreign language, do stuff every day that challenges you. So you think of your brain like a balloon that has got a tiny hole in it from the age of 20. You've got to keep inflating it. And the more inflated it is, the more your cognition will remain intact for as long as possible.

Well, if we look at things that challenge us, Vegas, I would say that possibly being a US President would help challenging. But I think next time we discuss this, you, Katie, and I should discuss this in Sardinia, Upper Mountain, with some lovely Italian red wine, perhaps. In moderation. In moderation, of course. Thanks so much, Vegas. Thank you so, so much for joining us. Pleasure. Katie, Katie K, our voice, face and brain in Washington. Thanks so much.

No problem. Take care. Have fun.

What do you do for brain gymnastics? How do you keep your brain young? What's your experience with cognitive decline, either in your life or with those that you love? We want to hear about it. Send us a voice note on +4.4, 3-3-0, 1-2-3-9-4-8-0. That's +4.4, 3-3-0, 1-2-3-9-4-80. That way we can get you on the program, or you can email us the GlobalStory@bc. Com. Keep your cognitive reserve topped up by subscribing to The Global Story wherever you get to the end of the podcast, we give you the smart take and fresh, sometimes provocative perspectives, things to chew over long after the podcast has ended. If you like, please leave us a review. Five Stars is a very good option, and it helps others find us. Wherever you're listening in the world, this has been The Global Story with Katya Adler. Thank you and goodbye.