The absurdity of an 80something president

Fact: Over the 230 years that the USA has had a president, 220 of those years have featured a POTUS who was less than 70 years old. The ten other years consist of almost all of Reagan’s two terms, all of our current nightmare, and the last three months of Eisenhower’s second term. That’s it. Only the last half of Reagan’s second term featured a 75+ year old president, and that time frame also brought us White House staffers openly speculating with each other about whether the president’s deteriorating mental condition might justify invoking the 25th amendment.

Now, with Joe Biden and Bernie Sanders leading the early polling for the Democratic nomination, the prospect of an 80something president is suddenly very much on the horizon. (Sanders would be 79 upon taking office, while Biden would be a year younger. Not to mention, though I will, that if Trump should get re-elected he would spend the second half of his second term as the oldest president in US history, assuming the nation survives to that point.)

The most obvious risks of electing a super-geriatric person to the most powerful office in the world is that the person will die or become demented in office. What are the risks either of these things would happen to Biden or Sanders?

Obviously the answers to those questions are, empirically speaking, highly individual. Just as obviously, the only way to make any real estimate of those probabilities is to look at population-wide statistics.

Let’s start with the easiest one: Probability of death, adjusted for age and sex. (These stats don’t adjust for high SES, which correlates inversely with mortality risk. On the other hand, most 80somethings don’t hold jobs, let alone one that features the 24/7 stress of being POTUS, at least if you’re doing right, as opposed to yelling at the TV, tweeting about what you just saw on it, and playing golf. So let’s call those two factors a wash).

Probability of Biden dying within four years of election: 20.7%

Within eight years of election: 44.5%

Probability of Sanders dying within four years of election: 22.8%

Within eight years of election: 48%

Now the real fun starts.

Risk of developing dementia by end of first presidential term:

Biden: 7%

Sanders: 9%

Risk of developing dementia by end of second presidential term:

Biden: 12%

Sanders: 16%

These are admittedly rough cut estimates. They are based on lots of studies that show that in geriatric populations the risk of dementia doubles every five years with age, so that while approximately 2% of 70 year olds are demented, around 32% of 90 year olds have achieved this mental state.

But I’d say this is close enough for government work. Now it’s not completely valid, statistically speaking, to just add these probabilities up, given that one sort of confounds the other (dead men don’t have dementia), but again, close enough for our purposes.

Electing Biden means electing someone who has well over a 50% chance of being either dead or demented by the end of a second term. For Sanders the combined odds of these two outcomes are close to two thirds!

ETA: It’s true that these are very rough estimates, that don’t take into account various relevant individual factors. But the point is that even if the actual risks these two men face are half of these estimates, which seems wildly optimistic, that risk would still be too high under the circumstances.

And this doesn’t even account for perhaps the scariest risk factor of all, which is dementia statistics are based on clinically diagnosed instances of the disease. They don’t take into account sub-clinical dementia, which often precedes the clinical version of the disease by many years (Hi Ronnie and Donnie!). What happens when creepy Uncle Joe or shouty Uncle Bernie starts to seem not exactly all there any more, at least some of the time, but is still miles away from a formal Alzheimer’s diagnosis? I don’t think we want to find out the answer to that question.

In short, the idea electing a man about to turn 80 to the presidency is flat-out nuts. Not nearly as nuts as electing Donald Trump of course, but we’re not grading on a curve here, especially when there are plenty of perfectly acceptable alternatives that don’t carry anything like this particular set of risks. (If you’re wondering, dementia among women seems to have about the same prevalence rate as among men when people are in their 70s, and then becomes higher than among men in their 80s, even when you adjust for the fact that more women than men live into their 80s. So electing an 80-year-old woman wouldn’t make any sense either, not that anyone would ever consider doing that. FWIW, I think Warren is on the very edge of acceptability in terms of age for a first-term presidential candidate).

Part of the problem here is that people tend to think in linear terms about exponential phenomena. 80 is 14% older than 70, but the risk of dementia for an 80-year-old isn’t 14% higher than for a 70-year-old: it’s 300% higher.

I also suspect that another reason we’re even talking about this is that once you’ve elected Donald Trump president then what would otherwise seem like absurd risks suddenly seem relatively benign. But they aren’t, and we shouldn’t take them, especially when, again, there’s absolutely no good reason to do so.