In February 1988, after several episodes of increasingly severe neck pain, Biden underwent surgery to correct a leaking
intracranial berry aneurysm.[5][6] While recuperating, he suffered a
pulmonary embolism, a serious complication.[6] After a second aneurysm was surgically repaired in May,[6][7] Biden's recuperation kept him away from the Senate for seven months.[8]
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.[9] 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.[10] 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.[11] According to ABC News,
Vladimir Putin and the Russian government spread disinformation about Biden's mental health during the 2020 presidential election,[12] and the
Department of Homeland Security withheld publication of a bulletin warning law enforcement agencies about this campaign.[13]
During and in the years since the 2020 presidential campaign, Trump has claimed, without evidence, that Biden has dementia, calling him "
Sleepy Joe" at rallies.[14] This angle has remained popular among
right-wing media outlets.[15][16][17] 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.[18] The Biden administration has routinely aimed to make light of the president's age by poking fun and joking about it. This approach has been met with both praise and mockery.[19][20][2] The Biden administration has also been criticized for allegedly
gaslighting or harassing journalists who asked questions about Biden's health or age.[21]
For Biden's 81st birthday, he had a birthday cake with 81 individual candles. The image, which was jokingly captioned to be for his "146th birthday", brought to the surface concerns among the public about Biden's age according to a majority of those polled at the time.[22][23]
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.[24]James Carville,[25]Ezra Klein,[26] and The Economist called for Biden to not run again as early as 2022.[27] According to Biden's 2023 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 a mild sensory
peripheral neuropathy, and has a stiff
gait due to spinal
arthritis and the aftereffects of injury. No signs of cognitive decline or
dementia were noted.[28][29]
According to a 2024 poll, Biden's age and health are major or moderate concerns for 86% of voters generally,[30] up from 76% earlier in 2020.[31] 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".[32]The Wall Street Journal has reported that since 2023 or earlier, 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.[33]
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".[34] White House lawyers disputed this characterization,[31] 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.[35]
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.[36]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.[37] Some Democrats were unsure whether he should continue his campaign.[38][39] Many officials and foreign leaders who encountered Biden in the months or 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.[40] 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.[41] 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.[42][43][44]
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".[45] Images of him looking frail exiting from
Air Force One on the way to isolation fuelled further speculation on Biden's health.[46]
Biden had announced that he would
run for re-election in the 2024 presidential election on April 25, 2023, with Harris again as his running mate.[47] Biden won an overwhelming majority of delegates in the
2024 Democratic Party presidential primaries and was already considered the presumptive nominee before the primaries were over. However, public age and health concerns surrounding Biden had emerged during his presidency, particularly about his fitness for the office and ability to carry out a second term.
These concerns spiked after
a debate between Biden and
Republican Party candidate
Donald Trump in June 2024. Biden's performance was widely criticized, with commentators noting he frequently lost his train of thought and gave meandering answers, had a faltering appearance, spoke with a hoarse voice, and failed to recall statistics or coherently express his opinion on several occasions.[48] Biden subsequently faced calls to withdraw from the race from fellow Democrats[49] and from the
editorial boards of major news outlets.[50][51] By July 19, 2024, more than 30 senior Democrats had called for him to withdraw.[52]
Biden repeatedly insisted for weeks after the debate that he would remain a candidate, despite numerous calls for him to withdraw.[53] On July 21, 2024, he withdrew his candidacy via a signed letter posted on his personal
X account, writing that this was "in the best interest of my party and the country", while stating that he would continue serving as president until the conclusion of his term.[54] Biden was the first incumbent president since
Lyndon B. Johnson in 1968 to withdraw from a reelection race, the first since the 19th century to withdraw after serving only one term,[a] and the only one ever to withdraw after already winning
the primaries.[55][57]
^All three incumbents in the 20th century to withdraw or not seek reelection—Calvin Coolidge, Harry S. Truman, and Lyndon B. Johnson—had succeeded to the presidency when their predecessor died, then won a second term in their own right.[55] Three presidents in the 1800s made and kept pledges to serve only one term, most recently
Rutherford B. Hayes.[56]
^Saric, Ivana (July 3, 2024).
"How Biden went from "bridge" candidate to two-term hopeful". Axios.
Archived from the original on July 25, 2024. Retrieved July 13, 2024. Between the lines: Biden's campaign comments likely signaled that he was only running because of who his opponent was, Anthony Fowler, a professor at the University of Chicago's Harris School of Public Policy, told Axios. "You could argue he's trying to kind of have it both ways. He's trying to kind of tell people, 'Don't worry, I'm only running for one term,' without ever actually explicitly promising that," Fowler said.