Archive

Archive for August 11, 2019

Possible Medical Explanation for Joe Biden’s Obvious Cognitive Decline

August 11, 2019 3 comments

If you have watched more than a couple of Joe Biden’s recent public appearances where he had to speak extemporaneously, you might have noticed something peculiar. He often rambles about a topic without focus and also says stuff that highlights his inability to properly recall recent events. While everyone of us, regardless of age, will occasionally talk like that- Biden’s recent behavior is odd because it is far more frequently than would be the case for an otherwise healthy person of his age, especially one who has spent his life as a public figure. Compare him to Bernie Sanders, who is an year or two older than him, but still very sharp and in command of the facts. So this is not just about Biden’s age, something which becomes more obvious as we look deeper.

Compare his public speaking ability in 2019 to 2008 or even 2012. Go ahead and watch the entire vice-presidential debates from 2012 where he performs very well against Paul Ryan. Or watch his earlier speeches, debates or townhalls. My point is that Joe Biden was verbally adept (albeit ‘politically incorrect’) and mentally sharp for decades, even if he occasionally flubbed up things. Now see how he performed during the first two DNC debates and at numerous recent events since (link 1, link 2, link 3). Saying that poor kids are just as bright as white kids before hastily correcting himself, confusing Theresa May with Margaret Thatcher and claiming that he was VP during the Parkland school shooting in 2018 in spontaneous speeches during the past few days, combined with his performance during those debates is hard to dismiss as simple gaffes.

While I am no fan of diagnosing illness without properly examining a patient in person, there is a a plausible explanation for Joe Biden recently obvious cognitive decline. To understand what I am getting at, we have to first talk about an interesting but little known aspect of his medical history. In 1988, Joe Biden had surgery to treat a couple of aneurysms in his brain. The surgeries were apparently successful and after a 7-month absence from public life, he was back to normal and has had no more large aneurysms since then. All of this is good.. but have you ever wondered what causes cerebral or intra-cranial aneurysms? The short answer is that most are caused by certain cardiovascular conditions (hypertension, smoking, cocaine use etc) or they are genetic in nature. But a decent number of them are idiopathic aka without any apparent cause.

Regardless of the cause, the general mechanism of aneurysm formation in blood vessels is fairly similar and involves a section of some artery or arteriole becoming mechanically weaker than its neighbor because the underlying vascular wall is not being properly maintained by the body’s repair system. These weak segments usually develop in parts experiencing especially high blood pressure, near bifurcation points, within tight loops etc. The key point is that people who have one aneurysm have a significantly higher risk of getting another one, even if it is smaller. Emilia Clarke from ‘Game of Thrones’ suffered something like this years ago when she was in her 20s. To be clear, I am not claiming that Joe Biden has a large aneurysm in his brain right now.

What I am suggesting is a bit different. See.. people with one or more brain aneurysm, even after successful treatment, are at a significantly higher risk for microaneurysms, small subarachnoid bleeds and often have other cerebrovascular issues as they age. And this where things start get interesting or bad. The way your body reacts to small internal injuries and bleeds changes as you age. In the brain, even small and asymptomatic but repeated bleeds in old age leads to the increase in levels of soluble beta-amyloid and hyperphosphorylation of tau protein in neurons, which are calling cards of Alzheimer’s-type brain damage. The thing is.. most cases of Alzheimer’s display mixed vascular and neuronal pathology and there is tons of evidence that those processes feed into each other. Most cases of dementia in people over 75 are of the mixed type.

It is therefore likely that Biden is displaying symptoms of cerebrovascular dysfunction with a bit of classical Alzheimer’s type pathology. To reiterate, this is not unique to him, as those who have experienced mechanical cerebrovascular trauma (bad car accidents, aneurysms and other head injuries)when they were young or middle-aged have a significantly higher risk of senile dementia or impaired cerebrovascular function as they reach their 70s and beyond. In fact the same is true for any other organs or parts of the human body, from kidneys to bone joints, where damage or trauma in youth can often manifest itself as significantly reduced function in old age- even if the initial damage was treated and healed satisfactorily.

But why does any of this matter? Isn’t Trump not much better and probably on Adderall? Well.. here is why. At this moment, Biden is still the front-runner among those seeking the democratic party nomination for 2020 and older black primary voters are solidly behind a guy whose actions ruined the lives of their children and grandchildren, by the millions. At this moment, his handlers are shielding him from unscripted appearances and keeping his public exposure to a minimum. However keeping him away from unscripted appearances is going to become increasingly harder as we near the real campaign and election day. While other democratic contenders have, so far, not made his cognitive decline an issue- it is going to come out, one way or the other.

To make matters worse, if Biden ends up as the presidential nominee of democratic party, Trump is going to make his cognitive decline an issue for rest of the campaign. Between his obvious cognitive decline, inability of democarts to motivate voters beyond their base and sad obsession with ‘gun control’, it is likely we might see a repeat of 2016- where Trump loses the popular vote by somewhere between 3 and 5 million but ends up winning the electoral college and thus gets reelected. The question, then, is how do we avoid that outcome. In my opinion, Biden in 2020 is the equivalent of HRC in 2016, but with far more disastrous consequences.

What do you think? Comments?