In a recent surprising turn of events, President Joe Biden announced his decision to withdraw from the upcoming presidential race. This sudden development has left many wondering about the state of his cognitive health. As a specialist in brain health, I’ve received numerous inquiries asking for my thoughts on the matter. 

While I must emphasize that I have not personally examined President Biden, nor do I have access to his medical records, I can offer an opinion based on observational analysis and publicly available information. Please remember that this is not medical advice, but rather an informed perspective.

The Privacy Dilemma in Public Office

President Biden has frequently dismissed the idea of formal cognitive testing, insisting that he “gets cognitive tests every day as president.” While I firmly believe in the right to privacy, there’s an undeniable tension when potential health concerns could interfere with one’s ability to perform a demanding job—especially one as critical as leading a country.

Public speculation has only intensified as various videos and reports emerge, depicting moments where Biden appears confused or disoriented. While explanations such as a cold or side effects from medication have been offered, much of what we know is conjecture, as insiders close to Biden remain tight-lipped.

Comparing Biden’s Cognitive Function Over Time

When comparing video footage from today to just four years ago, there’s a noticeable difference in his cognitive agility. Biden still manages well when he’s prepared, using a teleprompter, and following a prescripted narrative. However, it’s when he’s required to respond spontaneously or reason through complex, unscripted situations that difficulties become apparent.

Short-term memory seems to be one of the more affected areas. Biden typically performs better during the late morning to early afternoon, between 10 AM and 3 PM, but struggles as the day progresses, a phenomenon commonly referred to as “sundowning.” This term is often used to describe the worsening of cognitive symptoms in the evening and may suggest that certain parts of Biden’s brain are on unstable footing, functioning best when he is well-rested.

The Cognitive Demands of Public Interaction

Engaging in conversation, especially in a setting like a dinner party, requires a high level of cognitive function. It’s not just about remembering what you want to say, but also monitoring what others are saying, planning your next response, and staying aware of the environment around you. This kind of interaction is a workout for the brain and can be challenging for someone like Biden when they’re off-script or placed in a new, potentially stressful situation.

The fact that Biden can manage when he knows the questions in advance but struggles with spontaneity suggests that his cognitive issues may be linked to specific parts of the brain responsible for reasoning and integrating new information—more than just simple memorization.

The Brain Regions Affected

To understand what might be happening, it’s important to discuss the key regions of the brain that could be involved:

• Frontal Lobes: These are crucial for executive functions, including problem-solving, four-second memory, language, judgment, and impulse control. They help us make decisions, plan for the future, and adapt to new situations.
• Temporal Lobes: Located on the sides of the brain, these areas are vital for processing auditory information and are heavily involved in the formation of long-term memories. 
• Cerebellum: While primarily associated with coordination and balance, the cerebellum also plays a role in some cognitive functions, such as attention and language.

President Biden’s cognitive challenges might involve a decline in the functionality of these regions, which would explain the observed difficulties with spontaneous decision-making and memory retention.

The Long-Term Management of Cognitive Health

It’s not unprecedented for a sitting president to experience cognitive decline while in office. Former President Ronald Reagan managed to keep his early signs of Alzheimer’s largely hidden from the public eye. President Biden, having already suffered a stroke, may not have started with a perfectly healthy brain, making him more susceptible to cognitive decline as he ages.

For those concerned about maintaining their cognitive health, here are some general recommendations based on current research:

• Omega-3 Fatty Acids: Consuming 3 grams of omega-3s daily has been shown to support brain health by reducing inflammation and supporting neuronal function.
• Creatine: Taking up to 5 grams a day of creatine can support neurotransmitter function, aiding in cognitive processes. Creatine is commonly known for its role in muscle energy production but also plays a significant part in brain health.
• Nitric Oxide: Supplements like Cardio Miracle can help ensure adequate blood flow to the brain, delivering the necessary nutrients and oxygen to maintain cognitive function. 

As we continue to observe and speculate on President Biden’s cognitive health, it’s crucial to approach the topic with sensitivity and a clear understanding of the complexities involved. Remember, the information shared here is based on public observations and should not replace professional medical advice.

Disclaimer: President Biden is not my patient, and I have not examined him. My analysis is based solely on media reports and publicly available information.