Micah Loewinger: When it comes to answers about his capacity to serve another four years, most of us don't have the expertise even to make an educated guess. Steven N. Austad, professor of biology at the University of Alabama at Birmingham does. He holds the university's Protective Life Endowed Chair in Healthy Aging Research. He's been reviewing footage of Biden and actuarial data, medical records released by his administration, and scientific literature about how the geriatric body and brain change. He says he hasn't seen proof that Biden is unfit for a second term.

Steven N. Austad: There's no indication that his age is affecting his performance. Now, if he had had some episodes that made us question his mental acuity, I think that would be different, but he hasn't had any episodes like some others have had.

Micah Loewinger: Okay, but he has been filmed falling and tripping multiple times over the last year and a half. Does that not count for anything?

Steven N. Austad: It does, but I think it counts in a different way than most people think. He tripped over a sandbag once. Think to note about that is he didn't hit his head, he didn't get injured. People fall all the time, but the older the people get, the more likely they are to be injured. For instance, Senator McConnell fell and got a concussion and all, but Biden was notable. He did not hit his head, he caught himself and he was relatively uninjured. I think if a 45-year-old senator had fallen, no one would've paid any attention to it. Somebody that's President's Biden age today is not like someone that age 20, 30, 40 years ago.

Micah Loewinger: Just because the science and healthcare for older people has improved?

Steven N. Austad: Exactly. One of the things that is interesting about this presidency is that you can go get his full medical report from this year online and it's very detailed. You can find out all the medications he's taking, and I do think that health transparency is important because we would want to know if he had some serious illness. We've had presidents in the past that had very serious illnesses that the public was kept from knowing about.

Micah Loewinger: I did look at the most recent report issued by the White House and his physician. I saw a lot of medications. I saw references to his stiffened gait and other ailments that I'm sure his doctors are watching very closely. I'm not studied in this, so I couldn't tell if this was just transparency theater, the White House trying to make it seem as if he's healthy. I know that when President Trump was in office and his administration issued updates about his health, it seemed selective. It didn't seem all that credible. In your professional opinion, are Biden's doctors telling us the full story?

Steven N. Austad: I thought it was very detailed and very honest. There were blood chemistry values, there was no glossing over his back problems that he has. It seemed to me like a very credible medical report. What caught my eye is that he's taking cholesterol-lowering medication, which is good. His cholesterol values, his blood pressure is excellent. To me, he's in remarkably good health for a man his age, which you would expect for someone that's had his health closely monitored for years.

Micah Loewinger: In an interview you did with New York Magazine, you acknowledged that Biden's speed and confidence in debates and really all his public speaking has deteriorated over time. The reporter you spoke with, Benjamin Hart specifically referenced the difference between Biden's 2012 debate against Paul Ryan-

Joe Biden: That's a bunch of malarkey.

Paul Ryan: Why is that so?

Joe Biden: Because not a single thing he said is accurate. First of all-

Paul Ryan: Be specific.

Joe Biden: I will be very specific

Micah Loewinger: -and his more recent speaking engagements.

Joe Biden: The best way to get something done if it holds near and dear to you that you are likely to be able to-- anyway.

Micah Loewinger: Is this type of aging, the kind that we as voters can easily pick up on? Is it indicative of his ability to lead, make important decisions?

Steven N. Austad: We do lose processing speed as we get older, the speed with which our brain processes information, but that's not really a critical component of the thing that I think presidents should be doing. They should not make staff decisions and they often don't have to. What they do is they listen to a lot of advisors and synthesize what they hear and come up with measured decisions. The changes that we've seen in Biden over the last decade don't seem to me to have anything to do with his ability to do exactly that.

One of the things that you have to consider is that aging makes people different. To a first approximation, all 25 and 30-year-olds are the same from a health perspective. That's not true when you get older. There are 80-year-olds that are running marathons and there are 80-year-olds that can't get out of a chair unassisted, and that's the same for mental properties. I think the best indication of someone's decision-making ability is the recent decisions that they've made and we're not privy to a lot of the decisions that the president makes. I don't see any obvious changes in that property over the last terms he served. If you look at Biden's history, I mean, he grew up with a terrible stutter. He's always misspoke at times.

Micah Loewinger: A recent study conducted by the Rand Corporation, which was partially funded by the Pentagon found that as the average age of our politicians continues to increase, dementia is a "emerging security blind spot" for the federal government. Looking at Mitch McConnell, Dianne Feinstein, other high-ranking officials that maybe aren't even in the public eye as much, how severe of a risk does our aging leadership and dementia in particular pose to our country?

Steven N. Austad: Politicians are getting older, that the world is getting older. We're living longer than we ever have in the 300,000-year history of our species right now. We are going to have more and more politicians and more and more people exhibiting dementia because it doubles in probability every five to six years. This goes back to my point about the transparency of medical records. I think that ought to be mandatory for anybody in a national office.

Micah Loewinger: Does the science in your opinions suggest to us that our government would be safer and more effective if we capped the age at which politicians can serve.

Steven N. Austad: I don't believe that there should be. There are some people that are idiots at 40 and they should not be serving. 2,500 years ago in ancient Sparta, you had to be 60 years old to be on a governing council. 60-year-olds, 2,500 years ago was a very different 60-year-old than today. One of the early researchers in aging actually said that voting rights ought to be taken away from people after the age of 50 because they no longer were sensible.

Micah Loewinger: You're talking about Raymond Pearl in the 1920s.

Steven N. Austad: Also, Noah Webster of dictionary fame thought that no one should be able to hold public office until they were at least 50 years of age. There's dramatic historical differences of opinion.

Micah Loewinger: You seem confident that Biden has what it takes to remain healthy enough to serve another four years and be a competent leader. That said, are there signs we should be looking for to determine a more substantial decline that would make him unfit for office?

Steven N. Austad: I think as a window into someone's health and mental competence, the stress and strain of a presidential campaign is likely to be very revealing. If he melts down repeatedly during the presidential campaign, then I would say that's something to be concerned about. That's also the case of his opponent, whoever that might be.

Micah Loewinger: The way his public appearances are already selectively edited and mined by some in the news media, and I'm thinking of Fox News in particular. We would be led to believe that every time he speaks, he's verbally wandering and having to be yanked off the stage or protected by his staff. It seems like the reason we're even speaking about this topic at all is that Biden has lost his gift of gab if he ever had it.

Steven N. Austad: That's the thing. I think he's always had these speech lapses, but they've never turned into reasoning lapses that I know about. This is something that has been with him his entire career. People used to make jokes about how often he misspoke and anything that he says will be magnified because of his age, but I don't think that's really indicative unless it becomes a lot more of an issue than it currently is. Unless he can't keep his thoughts straight on a debate stage, for instance.

Micah Loewinger: Steven, thank you very much.

Steven N. Austad: It's been a pleasure talking to you.

Micah Loewinger: Dr. Steven N. Austad is the Protective Life Endowed Chair in Healthy Aging Research at The University of Alabama at Birmingham.

Brooke Gladstone: Coming up, what do you do when you have a doppelganger making mischief in the world? You learn from it.

Micah Loewinger: This is On the Media.

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