Health
Doctors express concern about Biden’s apparent cognitive issues during debate: 'Troubling indicators'
The first presidential debate of 2024 left many Americans and even some traditional Democratic allies wondering about President Biden’s mental fitness for office based on what appeared to be his unclear train of thought at times and his raspy voice on Thursday night.
The White House responded to these concerns, claiming that the president, who is 81, was fighting a cold, but some doctors said they perceive the health issues go beyond the sniffles — with one noting that “it is an issue of fitness, not of age.”
Dr. Brett Osborn, a Florida neurosurgeon who specializes in cognitive function, told Fox News Digital on Friday about his concerns.
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“President Biden’s performance in [Thursday] night’s debate reignited longstanding discussions about his cognitive abilities and his overall leadership capacity,” Osborn told Fox News Digital.
“Throughout the evening, Biden struggled to maintain a coherent narrative, often losing his train of thought mid-sentence, and providing vague, rambling and undecipherable answers to highly critical questions,” said Osborn, expressing his professional opinion.
Joe Biden is shown on Friday, June 28, the day after the debate, at a rally in Raleigh, North Carolina. Dr. Marc Siegel, inset left, and Dr. Brett Osborn, inset right, weighed in on President Biden’s performance during the Thursday night presidential debate, sharing concerns about his health from their point of view. (Fox News; Getty Images; Dr. Brett Osborn)
“His frequent pauses, stumbling over words and reliance on notes underscored concerns about his mental acuity,” Osborn added.
“Biden struggled to maintain a coherent narrative, often losing his train of thought mid-sentence.”
These seeming signs of cognitive decline highlight a “growing inability” to manage the complexities required by the job of the presidency, according to the neurosurgeon.
“His difficulty in articulating clear, concise responses and his apparent disorientation during the debate were seen by many – including his own constituents – as very troubling indicators of his overall health and an obvious decline in his cognitive function,” Osborn said.
Former President Donald Trump and President Joe Biden are shown during the first presidential debate of the 2024 election at CNN’s studios in Atlanta, Georgia, on Thursday, June 27, 2024. (Jabin Botsford/The Washington Post)
“President Biden lacks the mental sharpness required for the highest office in the land … especially amid [today’s] current national and international crises.”
The neurosurgeon, who has not treated Biden personally, also mentioned the 46th president has undergone multiple surgeries for brain aneurysms.
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There is a famous saying in neurosurgery, Osborn noted: “When the air hits your brain, you’re never the same.”
The surgeon surmised, “The odds have been stacked against him for years, long before his presidency.”
Joe Biden reacts as supporters greet him at his debate watch party at Hyatt Regency Atlanta on June 27, 2024, in Atlanta, Georgia. (Derek White/Getty Images for DNC)
Dr. Marc Siegel, physician, clinical professor of medicine at NYU Langone Medical Center and a Fox News medical contributor, also spoke with Fox News Digital about concerns from his end.
“The debate is, in a way, a psychiatric or cognitive stress test,” he told Fox News Digital.
Although Biden was able to respond to questions and seemed to be spatially aware, according to Siegel, the president did display “frequent disorientation” and had “problems with spontaneity or redirecting,” the doctor said.
He has not personally examined Biden.
Dr. Marc Siegel, at right, joined “Fox & Friends” on Friday, June 28, to discuss the presidential debate on Thursday evening. (Kevin D. Liles for The Washington Post via Getty Images; Fox News)
Siegel described Biden’s speech as “meandering,” noting that he ended sentences in different places than intended, and “often mixed up ‘trillions’ and ‘billions’ and ‘millions.’”
Siegel confirmed that a physical illness, even with a cold, can bring out cognitive issues “even more.”
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“Even so, it’s hard to believe this is all from a cold,” Siegel told Fox News Digital. “Either way, we need someone who is sharp despite a cold.”
The NYU Langone physician noted that cognitive issues “wax and wane,” so they won’t always present the same way.
President Joe Biden looks over at former President Donald Trump during the first presidential debate of the 2024 election season on June 27, 2024. (Andrew Caballero-Reynolds/AFP via Getty Images)
While the age of both candidates has been raised as a concern, Siegel countered that what’s important is a president’s physical and mental fitness.
“It is an issue of fitness, not of age,” he said. “It is an issue of mental acuity, which is especially important if there is a crisis.”
While Biden is 81 (he turns 82 in November), Trump is 78 years old.
During an appearance on “Fox & Friends” on Friday morning, Siegel also spoke about the possibility of cold medications impacting Biden’s performance.
“It is an issue of fitness, not of age. It is an issue of mental acuity.”
“None of the medications that he would be taking for a cold, except something that might make him drowsy, would be relevant here,” he said.
“And I don’t think they would give him something that would make him drowsy before a debate,” he said.
He added, “We’ve been watching this a long time. This is something progressive.”
Fox News Digital reached out to the Biden campaign and to the White House press office for comment.
Earlier this year, concerns emerged about Biden’s age and memory after the release of a special counsel’s report. (AP Photo/Damian Dovarganes)
Earlier this year, concerns emerged about Biden’s age and memory after the release of a special counsel’s report. The report described the Democrat’s memory as “hazy,” “fuzzy,” “faulty,” “poor” and having “significant limitations,” the Associated Press noted at the time.
The report indicated that Biden could not recall certain milestones in his own life, such as the date his own son Beau died of brain cancer, as Fox News Digital reported at the time. (Beau Biden passed away on May 30, 2015.)
“My memory is fine,” Biden responded afterward from the White House.
“A person with growing problems of memory and judgment is frequently the last to acknowledge it.”
The New York Times editorial board and others have called on Biden to step out of the race after his debate performance.
Vice President Kamala Harris acknowledged that Biden had a “slow start” to the debate, but she defended his performance overall and his record during his time in the White House.
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Said Dr. Siegel in a New York Post opinion piece that ran in the publication on Saturday morning, “This isn’t a question of age. Cognition varies widely with age, and it isn’t fair to say that executive function is automatically impaired at a certain point in life. But it’s a sad medical fact that a person with growing problems of memory and judgment is frequently the last to acknowledge it.”
Over the two and a half years following the 2022 rollout of the 988 national suicide prevention hotline, the rate of suicides among young people in the United States dropped 11 percent below projections, decreasing most sharply in states with a higher volume of answered 988 calls, a new study has found.
The findings, published today as a research letter in JAMA, compared suicide deaths from July 2022 to December 2024 with sophisticated mathematical projections that were based on historical trends. This yielded good news, with 4,372 fewer suicides of adolescents and young adults, ages 15 to 34, than had been projected.
To ensure that the decline was related to the use of the hotline, researchers at Harvard Medical School teased out the trends in states with high and low usage of the hotline. The findings were striking: The 10 states with the largest increases in 988 calls experienced an 18.2 percent reduction in observed suicides compared with expected suicides; in the 10 states with the lowest uptake, the reduction was smaller, 10.6 percent.
The results suggest that the government’s investment in the 988 rollout has translated into “a measurable reduction of deaths,” said Dr. Vishal Patel, a resident physician at Brigham and Women’s Hospital and one of the authors of the study.
“What our study has added,” he said, “is evidence for the deeper benefit of the program, and that is, that at the population level, among young people at least, suicide mortality is lower than it would have been without the program.”
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He added, “The implication of that is that sustained funding for this program matters.”
The United States rolled out the three-digit hotline with bipartisan support in July 2022, replacing a 10-digit hotline number, and augmented it with a $1.5 billion investment in crisis center capacity. Since its inception, the service has fielded more than 25 million contacts, according to the Department of Health and Human Services. The agency has asked Congress for $534.6 million to fund the program for 2027.
Last summer, the Trump administration terminated one element of the hotline, the Press 3 option for L.G.B.T.Q.+ callers. The Substance Abuse and Mental Health Services Administration said that the Press 3 option was being discontinued because it had exhausted its funding from Congress and that the hotline would “focus on serving all help seekers.”
But advocacy groups and policymakers protested the decision, and in testimony before the Senate on Tuesday, the health secretary, Robert F. Kennedy Jr., said his agency was planning to restore the Press 3 option.
Dr. Patel said his group had become curious about measuring the program’s effectiveness after Press 3 was eliminated. While call volume and satisfaction surveys suggested that 988 was succeeding, he said, the harder question was, “Did the creation of this 988 program, the transition from the old hotline to this hotline, actually move the needle on suicide mortality?”
Experts said it was difficult to tease out the beneficial effect of 988 from other things that changed in 2022, the year that the new hotline was created. Around that time, suicide prevention programs were being introduced in schools, in faith communities and on social media, but more important, the pandemic was ending.
“We were finally out of this crazy time, and there was a sense of optimism and hope,” said Jonathan B. Singer, a professor of social work at Loyola University Chicago and a co-author of “Suicide in Schools.” He called the downward trend in youth suicides “encouraging, but it is tempered by the fact that we don’t have a good explanation as to why.”
The authors acknowledged that their findings could not account for the influence of social and economic changes, changes in mental health services or public awareness about services.
But they did make comparisons to exclude other possible explanations. The authors looked for similar effects among American adults over 65, who are less likely to use the hotline. In that group, there was a reduction in suicides that exceeded expectations, but it was smaller, at just 4.5 percent.
To ensure the decline in suicides did not reflect a general improvement in young-adult mortality, the researchers tracked cancer deaths, and found there was no change. They also looked at the rates of suicide among young people in England, where no change had been made to the national crisis line in that time period; they found no reduction in youth suicides there.
Hannah Wesolowski, chief advocacy officer for the National Alliance on Mental Illness, said she was persuaded that the hotline had contributed to the improvement in suicide rates, in part because it did not appear among English youths or in older Americans.
“To me, that really helps hone in that this might really be the differentiator,” she said. “We are seeing potentially a pretty significant decline in suicides among young people. For public policy, this is strong evidence to double down on that we are doing.”
Emily Hilliard, a senior press secretary at the Department of Health and Human Services, said H.H.S. and SAMHSA are “committed to ensuring that all Americans have access” the 988 line, which she said “clearly provides lifesaving support, helping millions of people every year.”
If you are having thoughts of suicide, call or text 988 to reach the 988 Suicide and Crisis Lifeline or go to SpeakingOfSuicide.com/resources for a list of additional resources.
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A highly contagious digestive virus is surging across the U.S., experts warn.
Rotavirus, a double-stranded RNA virus, causes acute gastroenteritis — inflammation of the stomach and intestines — which can lead to severe diarrhea, vomiting, fever and stomach pain.
The virus primarily affects infants and young children, but there have also been outbreaks in elderly populations, such as nursing homes.
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Data from the Centers for Disease Control and Prevention shows that in the week ending April 4, out of 2,329 rotavirus tests, 7.3% were positive for the infection. Last year’s highest infection rate was 6.77% as of the week ending April 19.
Rotavirus, a double-stranded RNA virus, causes acute gastroenteritis — inflammation of the stomach and intestines — which can lead to severe diarrhea, vomiting, fever and stomach pain. (iStock)
“We’re seeing a lot of rotavirus in the wastewater right now,” Dr. Marc Siegel, Fox News senior medical analyst, confirmed to Fox News Digital. “Testing for rotavirus is way down, but the percentage of positive tests is up.”
While the virus typically peaks in the spring, it is not currently slowing down, he noted.
Why cases may be rising
Patricia Pinto-Garcia, M.D., a medical editor at GoodRx who is based in California, said there are several possible reasons for the rotavirus spike.
“Vaccine rates are down overall among young children, as they decreased during COVID,” she told Fox News Digital. “This means there’s a growing number of infants and young children who are vulnerable to infection.”
The rotavirus vaccine series must be completed by the time a child is 8 months old, she noted.
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As a result of the declining vaccinations, herd immunity isn’t protecting vulnerable children, according to Pinto-Garcia. “Children who haven’t finished the vaccine series yet, are too young to get vaccinated, or can’t get the vaccine due to medical illness are more likely to get exposed to the illness because other children aren’t vaccinated,” she said.
Siegel noted that before the vaccine became available, rotavirus resulted in 55,000 to 70,000 in the U.S. per year.
“Vaccine rates are down overall among young children, as they decreased during COVID,” a doctor told Fox News Digital. “This means there’s a growing number of infants and young children who are vulnerable to infection.” (iStock)
“I am concerned that the vaccination rate has been declining over the past seven years and is continuing to decline in the current climate of vaccine skepticism,” he said.
Surveillance methods are also much better than they used to be, Pinto-Garcia noted, which means public health experts are able to pick up and track cases better than ever before.
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“But we see that rotavirus-related healthcare visits are also up, so improved detection is not the only reason we are seeing this spike,” she said.
The COVID pandemic also disrupted the pattern of infections, according to Pinto-Garcia, so it’s “tricky” to compare the current levels against older cycles.
“It’s possible that what we are seeing is still some post-pandemic rebound, but it’s unlikely that this year’s pattern is fully explained by just this factor,” she added.
Transmission and risk
Dr. Zachary Hoy, a pediatric infectious disease specialist at Pediatrix Medical Group based in Nashville, Tennessee, often sees young patients with rotavirus.
“Rotavirus is spread via the fecal-oral route, meaning that a person comes into contact with virus droplets from contact with other children or adults, or from contact with objects such as toys that have been contaminated with the virus from someone who is sick,” he told Fox News Digital. “This can lead to outbreaks, especially at schools where many young children share the same toys.”
“It’s possible that what we are seeing is still some post-pandemic rebound, but it’s unlikely that this year’s pattern is fully explained by just this factor.”
Rotavirus is associated with many dehydration cases in the hospital due to the degree of diarrhea, according to Hoy.
In some severe cases, the virus can lead to seizures due to electrolyte imbalances from dehydration and loss of electrolytes in the stool.
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“Younger children do not have the reserves that older children and adults have, so they can become more dehydrated quicker and develop more severe electrolyte imbalances, leading to more severe infections,” Hoy said.
“Patients with problems with their immune systems or on medications that can decrease their immune systems can have more severe and prolonged infections, too.”
Treatment and care
Because rotavirus is a viral infection, antibiotics are not effective against it. There is no specific antiviral treatment for the condition, with doctors typically recommending supportive care.
“The mainstay of treatment is hospitalization for rehydration via intravenous (IV) fluids,” Hoy told Fox News Digital. “Sometimes it can take up to two to three days of IV fluids to help get patients rehydrated.”
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Blood draws are often necessary to evaluate patients’ electrolyte levels, such as sodium, potassium, calcium and magnesium, according to the doctor.
“If these electrolyte levels are significantly low, sometimes patients need special IV solutions or individual electrolyte medications,” he added.
“The mainstay of treatment is hospitalization for rehydration via intravenous (IV) fluids,” a doctor told Fox News Digital. (iStock)
Dr. Daniel Park, medical director of the Pediatric Emergency Department at UNC Health in Chapel Hill, North Carolina, noted that most children recover with supportive care, but parents should seek medical attention if a child shows signs of dehydration. Those include decreased urination, lethargy or inability to keep fluids down.
“While rare, rotavirus can be life-threatening in vulnerable populations, especially very young infants or children with underlying medical conditions,” Park told Fox News Digital.
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Prevention strategies
Given the lack of antiviral medications for rotavirus, doctors emphasize the importance of prevention, primarily the vaccine.
There are two rotavirus vaccines – Rotateq (a three-dose series) and Rotarix (a two-dose series). They are given starting at age 2 months as oral drops, not injections, according to Hoy.
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“It’s important to get the rotavirus vaccines on schedule, because these younger infants are at greatest risk if they get rotavirus,” he advised.
Other recommended prevention methods include handwashing with soap and water.
Every day we’re faced with a zillion small choices: Go to sleep early, or watch one more episode of that Netflix drama. Call an old friend to catch up, or cruise social media. Of course, no single action will guarantee a long, healthy life or doom you to an early grave. But those little daily decisions do add up, and over the long term they can make a difference when it comes to both your longevity and your health span, the amount of life spent in relatively good health.
Scroll through this theoretical “day in the life” and select the option that best fits your typical day. Not every situation will apply perfectly, but think about which choice you’d be most likely to make. This isn’t a formal scientific assessment. The goal here isn’t to assign you a “good” or “bad” score, but to help you understand the central factors that shape the way we age and how long we live.
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