Dr. Sanjay Gupta: It’s time for President Biden to undergo detailed cognitive and neurological testing and share his results

When the 46th President of the United States took the debate stage a week ago, it became apparent, even from his first answer, that this would not be the performance he hoped for.

When the 46th President of the United States took the debate stage a week ago, it became apparent, even from his first answer, that this would not be the performance he hoped for. For me as a brain specialist, it was concerning to watch President Joe Biden, and it quickly became clear that I was not alone in my reaction. Over the past week, I received more than a dozen calls, texts and emails from medical colleagues who, like me, specialize in the brain. It wasn’t that what we noticed was necessarily new but that it was particularly pronounced, and right from the start of the debate. From a neurological standpoint, we were concerned with his confused rambling; sudden loss of concentration in the middle of a sentence; halting speech and absence of facial animation, resulting at times in a flat, open-mouthed expression. To be clear, these are only observations, not in any way diagnostic of something deeper, and none of these doctors wished to suggest that was the case. The consensus from the doctors reaching out to me, however, was that the president should be encouraged to undergo detailed cognitive and movement disorder testing, and those results should be made available to the public. Over the past five years, I have reported extensively on the advances in the world of treating and reducing risk of dementia, including Alzheimer’s disease, Lewy body dementia and vascular dementia. For the documentary “The Last Alzheimer’s Patient,” I even went through extensive cognitive testing to demonstrate what it entailed and determine whether I had problems with executive functioning, judgment or memory lapses, as well as blood tests to determine things like the level of abnormal proteins that may be present in my brain and my B12 levels. My sense of smell and my genetic risk factors were checked. This type of testing is not necessary for most people as a matter of routine, but every one of the brain doctors I spoke to recommended that level of examination for Biden. The last official report in February was a health summary which concluded that the president was “fit for duty.” The White House said a team of 20 doctors, including a neurologist, participated in completing his physical. An “extremely detailed” neurologic exam found nothing consistent with neurological disorders, the summary said. It also found no evidence of Parkinson’s disease that might explain his stiff gait and decreased expression in his face. Although Parkinson’s disease is the most common cause of parkinsonism - a set of movement symptoms such as stiffness and tremor – there are other causes as well, and it was not clear in the medical report that those had been investigated. They did find evidence of neuropathy and arthritis in his feet, which can cause numbness, weakness and pain. There was no mention of any sort of cognitive testing.