Are You As Cognitively Sharp As A Presidential Candidate?

It’s less than 90 days before the 2020 presidential election, and voters have lots of information-gathering to do in order to make an informed choice. It’s not only must the candidates’ positions on key issues which has to be ascertained, but the status of their cognitive abilities as well. With both Joe Biden and Donald Trump in their 70’s, so a decline in cognitive abilities is a real possibility, a huge concern where an individual is becoming president of the United States.

The issue of the state in which the candidates’ heads are came to a head recently when President Trump challenged his political opponent, Joe Biden, to take a cognitive assessment test. Is this a crazy notion? Considering that Biden is 77 and would be the oldest person to become president if sworn in on Inauguration Day, the concern seems reasonable. But Donald Trump, the current president, is no spring chicken himself. At 74, he currently holds the record for the oldest individual to assume the presidency. Let’s hear it for gray power!

At least for the Republican candidate, loss of basic cognitive abilities has not (yet) occurred. How do we know this? Because the Donald aced a cognitive assessment test achieving a perfect score. In 2018 this test was administered to him at Walter Reed Military Medical Center. And he hasn’t forgotten that he passed this with flying colors, confirming his memory is intact.

Just how is a decline in someone’s cognitive abilities detected? You can give them a MoCA. No, that’s not a coffee, it’s a paper and pencil test which is used to detect a decline in mental capabilities. President Trump was the first president to take the Montreal Cognitive Assessment Test for Dementia, commonly known as MoCA. Abnormal cognitive function can be determined by this relatively simple and brief test. MoCA, used in more than 200 countries worldwide, is the most sensitive test available for detecting Alzeheimer’s.

Given the presence of the word “Montreal,” in the test’s name, it should come as no surprise that the test was developed at a public research university in Montreal, Canada. The purpose of the test is to detect cognitive impairment. According to the assessment’s creator, neurologist Zrad Nasreddine, MoCA was not meant to measure IQ or intellectual skill. 

Dementia is more prevalent with age. Thus, Nasreddine himself agrees that the status of a candidate’s cognitive abilities is a “pertinent question” when that candidate is over age 70. Joe Biden, however, bristled at the suggestion he take an assessment test. His test-y response was, “Why the hell would I take a test?” Um, perhaps because voters want to know if you are losing it before they cast a vote for you to become the leader of the free world? Backing up Biden was DNC Chairman Tom Perez who characterized a reporter’s asking Biden if he’d take an assessment test as “a stupid question.” Sorry, sir, but my momma told me that there was no such thing as a stupid question. And, if I may be so bold, isn’t it more stupid NOT to want to know if a candidate’s cognitive abilities are declining?

Assuming a candidate’s cognitive abilities need to be assessed, how does MoCA work? Well, it doesn’t take much time. MoCA consists of 30 questions which take about 10-12 minutes to complete. Thirty is the highest score which can be obtained. President Trump achieved a perfect score of thirty out of thirty. A score of 26 or up is considered normal. Mild cognitive impairment (MCI)  is denoted by a score between 18-25 and can help predict dementia. Do we really want someone running our country who is “impaired” and possibly on the road to being demented?

The MoCA test questions relate to different parts of the brain and assess different cognitive domains. One such domain is orientation. An individual must be able to state the date (month, year, day), place, and city. With people stuck at home due to COVID-19, it’s not necessarily a sign of cognitive decline not to know what day it is. Don’t the days all just blend together when quarantined or working remotely?

Language abilities are another domain which is assessed. A couple of sentences must be repeated correctly and a list of all the words beginning with the letter “F” that can be recalled have to be listed. Hmm. This question might make the presidential debates more fun. Who can repeat a tongue twister twice without making a mistake? And what “F” words  can the debaters identify related to government or American history? Let’s see–Founding Fathers, Franklin, Filibuster, Felix Frankfurter, Freedom, etc.

MoCA tests abstract reasoning because that function is often impaired in dementia. Thus, a test taker must explain how two things are alike. A tough question might involve how Republicans and Democrats are alike.

A fun challenge in MoCA is to identify three animals which are pictured. If the test is to be given to presidential candidates, donkeys and elephants should surely be included. Inability to recognize the animal symbolizing one’s political party is definitely cause for concern about cognitive abilities.

MoCA may, however, need to be updated to be in synch with current practices. Test takers have to draw a clock face showing a specified time. Today, digital is in. No one may really know what time it is if we go back to looking at a a clock face.

As tests go, MoCA seems rather harmless in that it is short and fairly straightforward. While no one wants to take a test, taking it anyway has certain benefits. The stakes are high when it comes to running our country. Does it really hurt to take 30 minutes of time to assure not only the voters but yourself to rule out that declining cognitive abilities won’t impede your ability to carry out presidential duties?

Why not have both candidates take MoCA prior to the election? President Trump hasn’t taken the test since 2018. Things may have changed between then and now; the rest of the world sure has. Joe Biden is approaching 80. If he makes it to the White House, he’ll have his plate full of things to deal with. Let’s make sure in advance that declining cognitive abilities of the Commander in Chief isn’t one of them.

Sure we want to have someone who is cognitively sharp running our country. But don’t we want those electing them to also be with it?  And by with it, I don’t mean simply oriented as to date, place, and time; I mean voters should be informed on what the issues are and what the candidates’ stances on those issues are. MoCA tests ability, but voting should utilize knowledge. Let the candidates take MoCA while voters drink a mocha and get informed on the candidates and issues.

Just WONDER-ing:

When voting, do you ever consider the candidate’s mental health? Does it concern you that both presidential candidates are in their 70’s? If you were running for a political office, would you be willing to take MoCA and have the results released publicly? How much health information about a candidate is the voting public entitled to have? How informed are you on current issues and the candidates’ position on them?

 

 

 

 

 

 

 

 

 

 

 

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