Health
Amid concerns about Biden’s mental acuity, experts reveal how cognitive tests work and what they reveal
After President Biden’s lackluster debate performance sparked renewed concerns about his mental acuity, both sides of the political spectrum have been clamoring for him to take a cognitive test.
Biden has not seen a neurologist, but did undergo his annual physical exam in February, Dr. Kevin O’Connor, physician for the president, said in a July 8 statement from the White House.
The doctor reiterated that Biden’s physical exam did not reveal concerns about a neurological disorder.
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In a recent interview with George Stephanopoulos, Biden remained noncommittal about formal cognitive testing, noting, “I have a cognitive test every single day” — meaning by performing his duties as president of the United States.
Many Americans, however, have wanted greater transparency.
In a recent interview, Biden remained noncommittal about formal cognitive testing, noting, “I have a cognitive test every single day” — meaning by performing his duties as president of the United States. (ANDREW CABALLERO-REYNOLDS/AFP via Getty Images)
“I am writing today to request that you urge President Biden, in the strongest possible terms, to take a cognitive and neurological exam and to share the results with the American people,” Sen. Lindsey Graham (R-S.C.) wrote to Dr. O’Connor on July 12.
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The United States Preventative Services Task Force (USPSTF) states on its website that there is insufficient evidence to recommend screening tests for cognitive impairment in older adults.
The free Medicare annual wellness visit, however, does cover detection of cognitive impairment, according to the Centers for Medicare & Medicaid Services website.
What exactly is a cognitive test?
Fox News Digital spoke with leading neurologists to determine how cognitive tests work, as well as what they can and can’t identify.
None of the doctors who offered comments have assessed or treated President Biden.
There are three main types of cognitive testing available, experts said. Those include the MMSE (Mini-Mental State Examination), the MoCA (Montreal Cognitive Assessment), and neuropsychological testing. (iStock)
“Cognitive tests are designed to measure a range of mental functions and abilities, targeting specific areas such as memory, attention and concentration, language and processing speed,” Dr. Fred Cohen, assistant professor of medicine and neurology at the Icahn School of Medicine at Mount Sinai in New York, told Fox News Digital.
These tests are divided into three types: screening tests, mental status examinations and neuropsychological testing.
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“The Montreal Cognitive Assessment (MoCA), the Mini-Mental State Examination (MMSE) and neuropsychological testing are all important tools doctors and neuropsychologists can employ to assess a person’s behavior and thinking ability,” Dr. Michael S. Okun, medical adviser for the Parkinson’s Foundation and director of the Fixel Institute for Neurological Diseases at University of Florida Health, told Fox News Digital.
The first step is often a screening test, but that does not diagnose any specific disease – it can only suggest the possibility of cognitive impairment, experts say.
Further testing is needed to identify the underlying cause.
What is dementia?
Dementia describes a group of conditions in which people have an impaired ability to remember, think or make decisions, which disrupts their daily activities, according to the U.S. Centers for Disease Control and Prevention (CDC)’s website.
There are many types of dementia, but Alzheimer’s disease is the most common.
“Cognitive tests are designed to measure a range of mental functions and abilities, targeting specific areas such as memory, attention and concentration, language and processing speed,” an expert said. (iStock)
“There is rock-solid data that 5% to 8% of folks over the age of 60 will later develop dementia,” Okun said.
This data was partly why Congress passed a law prohibiting commercial pilots from flying after the age of 65, he noted.
Dementia risk increases with age. By the time people are in their 80s or 90s, the chances are between 10% and 30%, according to Okun.
What is the MMSE?
The MMSE (Mini-Mental State Examination) is a 30-point questionnaire that assesses various cognitive functions, including memory and orientation.
It can be used to monitor changes over time, Cohen said.
The 11-question test, introduced in 1975, is a quick dementia screen that typically takes about five to 10 minutes to administer, according to experts.
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Some of the questions ask the person to perform specific tasks, like providing the current date and year, subtracting 7 from 100 repeatedly, recalling three unrelated objects after three minutes, and following a three-step command, such as “take a paper in your right hand, fold it in half and put it on the floor,” Cohen said.
What is the MoCA?
Like the MMSE, the MoCA (Montreal Cognitive Assessment) is scored out of 30 points, but takes slightly longer to administer, Cohen said.
It includes tasks such as drawing a clock, naming animals, recalling lists of words or numbers, and making “abstractions” — such as stating “fruit” when given an apple and orange.
Most cognitive tests don’t consider the mood of the individual – so if someone is depressed, that person may score lower, experts warn.
“Former President Trump has mentioned that he took a cognitive test that included identifying animals, indicating that he was likely given the MoCA,” Cohen said.
People receive points for correct answers on both tests — lower scores indicate greater concern for cognitive deficiency.
“The MoCA takes about 10 minutes to administer, and it is a little better than the MMSE, especially if your goal is to screen for mild cognitive impairment,” Okun added.
The first step is often a screening test, but that does not diagnose any specific disease – it can only suggest the possibility of cognitive impairment, experts say. (iStock)
These tests can only reveal what is going on at that moment in time; they cannot determine how someone is functioning in their everyday life, according to experts.
The screening tools may identify potential cognitive issues, but more comprehensive testing is required if a deficiency is suspected, Cohen cautioned.
“The MoCA and MMSE are considered by experts to be broad and shallow tests, and therefore should only be applied for screening and triage,” Okun added.
People can achieve a perfect or near-perfect score on a MoCA or MMSE but still have significant cognitive impairment, he noted.
The tests also don’t consider the mood of the individual – so if someone is depressed, that person may score lower, according to previous research.
Language barriers, physical handicaps or lower levels of education can also affect the results, experts say.
What is neuropsychological testing?
This type of testing, which takes several hours, is a true comprehensive assessment that can be applied for diagnosis of cognitive disorders, according to Okun.
A neuropsychologist tailors the test to the individual’s presenting symptoms.
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“Neuropsychologists spend a great deal of time gathering a detailed history that goes well beyond what a general doctor, neurologist or psychiatrist may have time to collect during their usually brief consultation(s),” he added.
The specialist may ask if the person has difficulty searching for words in conversation or uttering the wrong words or sounds within a word.
After President Biden’s lackluster debate performance sparked renewed concerns about his mental acuity, both sides of the political spectrum have clamored for him to take a cognitive test. (Getty Images; iStock)
Specialists may also ask if someone forgets notable events or repeats the same comment, misplaces items, bumps into things or gets lost in thought.
“Folks should be aware that the MoCA and the MMSE are not a replacement for neuropsychological testing, even if a person achieves perfect or near-perfect scores,” Okun advised.
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He recommends considering this testing when family and friends notice any changes, no matter how small, in their loved one’s behavior or job performance.
Added Okun, “The comprehensive testing will form the basis for a treatment plan and provide a critical baseline performance, which can be used to track disease progression.”
Health
How much red meat is too much? Experts weigh in on food pyramid updates
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The release of an updated food pyramid this week has sparked mixed reactions from doctors and dietitians.
One of the most noteworthy shifts in the 2025-2030 Dietary Guidelines for Americans — announced by HHS officials during a Jan. 7 press conference at the White House — is a greater emphasis on “high-quality proteins,” including red meat and eggs, as well as full-fat dairy.
The new guidelines focus on “real, whole, nutrient-dense foods,” and a dramatic reduction in highly processed foods, added sugars, refined carbohydrates and unhealthy fats.
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“Protein and healthy fats are essential and were wrongly discouraged in prior dietary guidelines,” Health Secretary Robert F. Kennedy Jr. said during the press conference. “We are ending the war on saturated fats.”
Nick Norwitz, a Harvard- and Oxford-trained researcher known for his work in metabolic health, shared his reaction to the new guidelines.
The release of an updated food pyramid this week has sparked mixed reactions from doctors and dietitians. (realfood.gov)
Despite how the new pyramid is presented, he noted, the actual guidelines for saturated fat consumption haven’t changed, as they still state that, “in general, saturated fat consumption should not exceed 10% of total daily calories.”
The intake of unprocessed whole foods rich in saturated fat, especially dairy fat, tends to be associated with improved health outcomes, according to Norwitz.
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“Full-fat dairy — especially cheese, for example — tends to be associated with lower BMI, reduced rates of diabetes and even reduced dementia risk,” he told Fox News Digital. “There are, of course, nuances — but ‘ending the war’ on saturated fat seems reasonable.”
Risks vary, experts say
Experts cautioned about the potential health risks of exceeding the recommended intake of saturated fat, including higher rates of LDL “bad” cholesterol, which is known to increase the risk of cardiovascular disease.
“The recommendation to limit saturated fat to 10% of total calories is based on the research showing that higher rates increase LDL cholesterol and associated risks for cardiovascular disease,” Sherry Coleman Collins, a food allergy dietitian and expert from the Atlanta metropolitan area, told Fox News Digital.
One of the most noteworthy shifts in the 2025-2030 Dietary Guidelines for Americans is a greater emphasis on “high-quality proteins” — including red meat and eggs — as well as full-fat dairy. (iStock)
Nutrition should be personalized and is dependent on multiple factors, she said, including age, gender, activity level and genetic risk factors.
“The total saturated fat an individual might safely consume is influenced by their size and total calorie needs, as well as potentially genetic differences,” Coleman Collins said.
Norwitz agreed, adding that “the specific food source and interaction with the unique host and their broader dietary context should take the spotlight.”
Dr. Pooja Gidwani, a double board-certified doctor of internal medicine and obesity medicine in Los Angeles, pointed out that not everyone has the same “tolerance” for saturated fats.
“If increasing saturated fat leads to a meaningful rise in LDL cholesterol or ApoB (Apolipoprotein B, a protein found on the surface of certain cholesterol-carrying particles in the blood), that intake level is excessive for that individual, regardless of improvements in weight or glucose metrics,” she said.
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“This personalized approach becomes increasingly important in midlife and beyond, when cardiovascular disease becomes the dominant driver of morbidity and mortality and when tolerance for cumulative atherogenic (artery-clogging) exposure is lower.”
For those who need to reduce LDL cholesterol or have a higher cardiovascular risk, the American Heart Association recommends an even lower amount of saturated fats — less than 6% of total daily calories.
Experts cautioned about the potential health risks of exceeding the recommended intake of saturated fat, including higher rates of LDL “bad” cholesterol. (iStock)
Gidwani also cautioned that diets emphasizing saturated fat could crowd out fiber and unsaturated fats, “both of which play independent roles in cholesterol clearance, insulin sensitivity, gut health and inflammation.”
“Saturated fat-heavy patterns are also calorie-dense, which can quietly undermine long-term weight management if intake is not carefully regulated,” she added.
Not all saturated fats are equal, experts say
The effects of saturated fat depend on what specific foods are being consumed, according to experts.
“I would recommend choosing minimally processed or unprocessed forms of foods,” said Tanya Freirich, a registered dietitian nutritionist in Charlotte, North Carolina. “For example, in place of a hot dog — which has additives, nitrites, sodium and fillers — consuming a chicken thigh would be a much better choice.”
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Gidwani reiterated that the amount of processing plays a big role.
“Processed meats are consistently associated with worse cardiometabolic outcomes and represent the clearest category to limit,” she said. “The risk here is not only saturated fat, but also sodium load, preservatives and the broader dietary pattern they tend to accompany.”
“Full-fat dairy — especially cheese, for example — tends to be associated with lower BMI, reduced rates of diabetes and even reduced dementia risk,” an expert told Fox News Digital. (iStock)
Unprocessed red meat, the doctor said, can fit into an overall healthy diet in smaller amounts, particularly when consumed alongside fiber-rich plants and minimally processed foods.
“However, from a longevity perspective, it should be viewed as optional rather than foundational, especially for individuals with elevated cardiovascular risk,” she added.
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When it comes to dairy, Gidwani noted that fermented options are “metabolically more favorable” than butter or cream.
“However, saturated fat from dairy is still not necessary to prioritize for metabolic health or longevity,” she said. “Excessive reliance on dairy fat can displace healthier fat sources without offering clear long-term benefit.”
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Overall, the doctor recommends unsaturated fat sources, including extra virgin olive oil, nuts, seeds, avocado and omega-3-rich fish, as primary dietary fats.
“These consistently support lipid profiles, insulin sensitivity and vascular health,” Gidwani said. “Saturated fat can exist within a balanced diet, but it should remain secondary rather than emphasized.”
Why the big picture matters
Saturated fat is just one piece of a much wider nutrition puzzle, the experts agreed.
Unprocessed red meat can fit into an overall healthy diet in smaller amounts, particularly when consumed alongside fiber-rich plants and minimally processed foods, one expert said. (iStock)
“Our heart health is not determined by one type of fat or one type of cholesterol, but the sum of many parts — our entire diet, our exercise habits, our stress and so much more,” Freirich said.
She recommends consulting a registered dietitian for guidance on unique dietary needs based on age, gender, activity level and medical history.
“Our heart health is not determined by one type of fat or one type of cholesterol, but the sum of many parts — our entire diet, our exercise habits, our stress and so much more,” said an expert. (iStock)
New Jersey-based dietitian Erin Palinski-Wade, author of “2-Day Diabetes Diet,” added that the message should be to focus more on overall patterns.
That means “plenty of fiber-rich plants, lean protein at every meal (including those that also contain fiber, such as nuts and seeds) and a reduction in overall intake of added sugars.”
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“That change will drive true health improvements,” she said.
Health
The Wegovy Pill Is Here: See the Cost and How Much Weight You Can Lose
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Health
Missing sleep may take a hidden toll on your brain and longevity, research reveals
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Missing out on adequate sleep could be taking years off your life.
New research from the Oregon Health & Science University (OHSU), published in the journal Sleep Advances, found that poor sleep may shorten life expectancy more than other lifestyle factors like diet, exercise and loneliness.
The researchers analyzed nationwide CDC survey data, identifying trends associated with average life expectancy by county, according to a press release.
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The study found that lack of adequate sleep led to higher mortality risk in every U.S. state and was the top behavioral driver compared to other factors, only behind smoking.
Senior study author Andrew McHill, Ph.D., associate professor and director of the Sleep, Chronobiology, and Health Laboratory in the OHSU School of Nursing, noted in a statement that he did not expect sleep to be “so strongly correlated” to life expectancy.
Poor sleep is directly correlated with shorter life expectancy, the study reveals. (iStock)
“We’ve always thought sleep is important, but this research really drives that point home: People really should strive to get seven to nine hours of sleep, if at all possible,” he said.
“This research shows that we need to prioritize sleep at least as much as we do [in] what we eat or how we exercise.”
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In a previous interview with Fox News Digital, Dr. Daniel Amen, psychiatrist and owner of Amen Clinics in California, emphasized how important sleep is for brain function and longevity.
Researchers suggest people should prioritize sleep just as much as diet and exercise. (iStock)
“Sleep is so important,” he said. “When you sleep, your brain cleans and washes itself. And if you don’t sleep seven to nine hours at night, your brain looks older than you are — there’s less blood flow, and it increases inflammation in the brain.”
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“Your brain doesn’t have enough time to get rid of the toxins that build up during the day.”
Lack of adequate sleep can lead to poor decisions and foster toxic cycles, the doctor warned.
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“If your brain has less activity in the front part, not only are you tired, but you’re also hungrier, and you’re more likely to not make the best decisions,” he said.
“Which, of course, will stress you out, and then you won’t sleep well the next night.”
A doctor suggests being “purposeful” about going to bed and waking up each day. (iStock)
One small change to promote longevity and brain health is to try getting to bed 15 minutes earlier, Amen suggested.
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“Really be purposeful about not being distracted by Netflix or your phone,” he said.
“And when you get up in the morning, say to yourself, ‘Today is going to be a great day.’ The more positive you are, the better your brain.”
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