We worry about politicians who trip over sandbags, walk gingerly down rain-soaked stage ramps, or have “episodes” during press conferences or Congressional meetings. Typically, these frailties are attributed to “old age.” How much of a threat is this to national security, and are these incidents a harbinger of their ability to govern appropriately?
Remember the aging graph of a baby in a crib, progressing to crawling, walking, and running, then declining to walking cane, wheelchair, and back to bed. It doesn’t mean mental status follows the same course. There is a difference when one loses mental abilities versus physical abilities.
At any age we are allowed “senior moments.” But as a geriatric physician, only a small fraction of my older adults become mentally incapacitated and are unable to function adequately in life, let alone run the government.
Can physical problems result in mental problems? Certainly, especially if a balance problem results in a fall with resultant head trauma. For any age, head trauma may result in a concussion, stroke, intracranial bleeding, and disruption of the neural pathways. If we fear diminished mental status, a Mini-Mental State Exam (MMSE) can help in this evaluation.
Most of the time though, a politician’s gained experience and wisdom can be utilized to move forward communities, society, and the nation no matter what party you might be affiliated with.
Therefore, chronologic and physical age rarely matters. What matters is the onset of memory and mental problems. This is the real threat.
So when you see someone tripping over a sandbag, gingerly walking down a rain-soaked stage ramp, or even having an occasional senior moment, there is no need to fret.
As long as they haven’t hit their head, had a stroke, or failed the MMSE, we can find security they can still mentally do their job.
By the way, this applies to all older adults.
Gene Dorio, M.D.
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