Biden aides decided against a cognitive test to avoid questions about his age, reveals book

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Former US president Joe Biden during a briefing at the White House in Washington, on Jan 9, 2025.

Former US president Joe Biden during a briefing at the White House in Washington on Jan 9.

PHOTO: ERIN SCHAFF/NYTIMES

Reid J. Epstein

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Months before former US president Joe Biden was forced to abandon his re-election campaign, his top White House aides debated having him undergo a cognitive test to prove his fitness for a second term but ultimately decided against the move, according to a forthcoming book.

The account illustrates the degree to which Mr Biden’s top aides harboured deep fears about

how voters viewed his age and mental acuity

.

The book, 2024: How Trump Retook The White House And The Democrats Lost America, by Mr Tyler Pager of The New York Times, Mr Josh Dawsey of The Wall Street Journal and Mr Isaac Arnsdorf of The Washington Post, is set to be released in July.

Mr Biden’s aides were confident that he would pass a cognitive test, according to the book, but they worried that the mere fact of his taking one would raise new questions about his mental abilities.

At the same time, Mr Biden’s long-time doctor Kevin O’Connor had told aides that he would not take the 81-year-old president’s political standing into consideration when treating him.

The discussion took place in February 2024, a few weeks before Mr Biden’s final White House physical exam and a period preceding some of his most damaging public episodes.

A representative for Mr Biden declined to comment.

The same month that Biden aides considered the cognitive test, Mr Robert Hur, the special counsel who investigated Mr Biden’s handling of classified documents, released a report concluding that the president was “a sympathetic, well-meaning, elderly man with a poor memory”.

Mr Biden held a late-night news conference to deliver an angry response, in which he referred to the President of Egypt as the President of Mexico and declared: “My memory is fine.”

By then, it was becoming obvious that then former president Donald Trump would be the Republican nominee.

Mr Trump, three years younger than Mr Biden, had bragged during his first term about having passed a cognitive test, though details were sketchy.

His repetition of a five-word sequence he had been asked to memorise – “person, woman, man, camera, TV” – became a running joke in Washington political circles in 2020.

Throughout Mr Biden’s presidency and especially during his re-election bid, his aides and advisers often argued that the news media was unfair in how it covered his age, fuelling voters’ negative perception of his vigour.

Few influential figures in the White House or on his campaign would entertain the idea that he was struggling to perform his presidential duties.

“On the topic of his age, I thought the best answer was going to be performance,” Mr Mike Donilon, a senior adviser to Mr Biden who had worked for him since the 1980s, told The Harvard Political Review in March.

“Every day, I kept seeing him do the job. I still think he’s the best person to be president today.”

But outside Mr Biden’s tight inner circle, many Democratic politicians and strategists began to worry quietly as his re-election bid took shape.

By June 2022, Democrats were talking among themselves about his potential to drag down the 2024 ticket, with many suggesting he should not run again.

A New York Times article that month included an interview with Mr David Axelrod, a former adviser to former president Barack Obama who has become one of the party’s elder statesmen.

Mr Axelrod said that Mr Biden “looks his age” – then 79 – and that he was feeding a narrative that he was no longer up to the job of being president.

“The stark reality is the president would be closer to 90 than 80 at the end of a second term, and that would be a major issue,” he said.

That comment prompted an angry call to Mr Axelrod from Mr Ron Klain, then Mr Biden’s chief of staff, according to the book.

Mr Klain wanted to know why Mr Axelrod was fuelling doubts about a Democratic president who was on track to begin a re-election campaign.

“There’s no Obama out there, Axe,” Mr Klain told him, the book recounts. “Who’s going to do it if he doesn’t do it?” NYTIMES

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