President Biden has shown signs of poor cognitive performance in private meetings with congressional lawmakers, as his age and mental acuity continue to come into question ahead of November’s presidential election.

Biden, 81, is the oldest person to hold the presidency and has faced skepticism from voters and Republican lawmakers about his ability to do his job. Many Republicans and even some Democrats said the president showed his age in private meetings, according to The Wall Street Journal, which spoke with 45 lawmakers and administration officials about the president’s mental performance.

Most of the people interviewed by the outlet who were critical of Biden’s performance were Republicans, although some Democrats said the president showed his age in several exchanges. These interviewees participated in meetings with Biden or were briefed on them contemporaneously, including administration officials and other Democrats who did not express concerns about how the president handled the meetings.

When meeting with congressional leaders in January to negotiate a deal to send additional funding to Ukraine, Biden spoke so softly at times that some people struggled to hear him, five people familiar with the meeting told The Wall Street Journal. The president read from notes to make obvious points, paused for extended periods of time and even closed his eyes for so long that some people in the meeting wondered if he had tuned out.

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In February, when Biden met one-on-one with House Speaker Mike Johnson, the president said a recent policy change by his administration that jeopardizes some big energy projects was just a study, according to six people who were told at the time about what Johnson recalled from the meeting. Johnson was concerned the president had forgotten about the details of his own policy.

Last year, when Biden was negotiating with House Republicans to lift the debt ceiling, his demeanor and command of the details appeared to change from one day to the next, then-House Speaker Kevin McCarthy and two others familiar with the talks said. He appeared sharp with loose and spontaneous exchanges with Republicans on one day, and mumbled and seemed to rely on notes on other days.

“I used to meet with him when he was vice president. I’d go to his house. He’s not the same person,” McCarthy said.

Previously having a reputation in Washington for being a master negotiator of legislative deals, possessing detailed knowledge of issues and insights into the other side’s motivations and needs and for excelling under pressure, Biden is now perceived, particularly in the last year after Republicans took control of the House, as an aging president with poor cognitive ability at times.

White House officials, however, dismissed many of the accounts from people who have met with the president or been briefed on those meetings, saying such criticisms were motivated by partisan politics.

“Congressional Republicans, foreign leaders and nonpartisan national-security experts have made clear in their own words that President Biden is a savvy and effective leader who has a deep record of legislative accomplishment,” White House spokesman Andrew Bates said. “Now, in 2024, House Republicans are making false claims as a political tactic that flatly contradict previous statements made by themselves and their colleagues.”

In Biden’s meeting on Ukraine in January, the president laid out a compelling case for providing aid, according to administration officials and some participants, who said it is common practice to use notes in these meetings. Bates also denied claims that Biden had misspoken during his meeting with Johnson in February about energy policy.

Administration aides familiar with last year’s debt-ceiling negotiations recalled that Biden was effective, that he was not directly involved and had provided detailed instructions behind the scenes. The aides said McCarthy privately told administration officials at the time that he was impressed with Biden’s performance, and that the former Speaker suggested in public remarks that the president appeared sharp.

The aides said the passage of both Ukraine funding and a debt-ceiling increase without major concessions to Republicans shows he succeeded. 

Former President Trump, Biden’s biggest threat in the presidential election, at 77-years-old, has also faced criticism over his mental acuity as he has shown signs of poor memory, giving inaccurate facts and slipping up in public remarks, allowing both Democrats and Republicans to attack their political foe over mental sharpness.

Some who attended the meetings with Biden blamed his slip-ups on his speech impediment and tendency to be long-winded. People who expressed concern about the president said the behavior they observed suggested unevenness, rather than a confused leader that some of his political opponents have described. The White House said the president’s doctors have found him fit to serve, and that his recent annual physical showed no need for a cognitive test.

Members of the administration provided several examples of other instances they say showed the president was sharp and engaged, including long hours in the Situation Room in April during and after Iran’s missile attack on Israel, and late nights on the phone with lawmakers from the White House.

Voters’ concerns about the mental acuity of Biden and Trump are shaped largely by their speeches and other public appearances.

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During a campaign event in Detroit last month, Biden suggested he was vice president during the COVID-19 pandemic, which started during the Trump administration. The following day, during a Rose Garden event celebrating Jewish American Heritage month, Biden initially said one of the U.S. hostages held in Gaza was a guest at the White House event before correcting himself.

In January, Biden mixed up two of his Hispanic cabinet secretaries, Department of Homeland Security Secretary Alejandro Mayorkas and Health and Human Services Secretary Xavier Becerra.

At a February fundraiser in New York, he recalled speaking to German Chancellor Helmut Kohl at the 2021 Group of Seven meeting, despite the fact that Kohl died in 2017. During a different fundraiser that month, he said that during the 2021 G-7 summit he had spoken to former French President François Mitterrand, who died in 1996.

Trump, meanwhile, mixed up then-Republican presidential opponent Nikki Haley with former House speaker Nancy Pelosi, a Democrat congresswoman from California, during a speech in January. During a rally in Virginia in March, Trump mixed up Biden with former President Obama when commenting on Russian President Vladimir Putin’s opinion of U.S. leadership. At his criminal hush money trial in New York last month, he closed his eyes for extended periods of time.

Following the Jan. 6, 2021, riot at the Capitol, concerns about Trump’s mental state led some of his cabinet officials to discuss whether there should be a greater check on his power and at least one considered invoking the 25th Amendment to remove him from office.

A spokeswoman for Trump told The Wall Street Journal he is “sharp as a tack.”

Concerns about Biden’s mental state were amplified in February when Special Counsel Robert K. Hur, who interviewed him for roughly five hours over two days in October during an investigation into his handling of classified documents, wrote that the president’s memory had been “significantly limited.” Biden addressed Hur’s report in a news conference, saying “I know what the hell I’m doing.”

Americans have had limited opportunities to observe Biden in unscripted moments, as he has shown a reluctance to give media interviews. By the end of April, he had given fewer interviews and press conferences than any of his recent predecessors, according to data collected by Martha Joynt Kumar, an emeritus professor at Towson University. His last town-hall-style meeting with an independent news outlet was in October 2021.

Biden has had fewer small meetings with lawmakers as his term has continued, according to visitor logs. During his first year in office, he held more than three dozen meetings of fewer than 20 lawmakers in the West Wing, even with pandemic restrictions. The number dipped to roughly two dozen in his second year, and about a dozen in his third year.

The Wall Street Journal contributed to this report.