Arizona’s Presidential Preference Election is Tuesday. Both President Joe Biden and former President Donald Trump have won enough delegates to become their party’s presumptive nominees, which could take a little of the air out of Tuesday's contest. But Arizona is widely expected to be a swing state again this fall, meaning both campaigns will be paying a lot of attention to us here.
And more and more of the conversation about this race seems to focus not on the candidate’s policies, but rather on their ages. And more specifically, whether they’re up for the job of president. Critics of both candidates point to instances where the other has mistaken names or slipped up in a speech or in response to a question.
All of this has led to charges of ageism in our politics. With The Show to talk more about this is Dr. Jordan Karp, professor and chair of the Department of Psychiatry at the University of Arizona College of Medicine in Tucson. He’s also clinical service chief for behavioral medicine for Banner University Medical Center and Group and an adult and geriatric psychiatrist.
Full interview
MARK BRODIE: Dr. Karp, what goes through your mind when you hear the frequency and content of all the conversations that have been happening over the last several months about the ages of some of our elected leaders in this country?
DR. JORDAN KARP: Well, well, I mean, it's, I think it's a nature of being at the top of the political system in the United States, is that it's, it's mostly going to be older adults. So people in their 60s and 70s and maybe even into their 80s who are going to be as suitable for this, for this role. I've been troubled to hear about the, the ageist remarks and concerns that so many journalists and people have made. Ageism, I think, is one of the few remaining acceptable forms of discrimination that we as a society still deal with. I do think that ageism is damaging, and there is evidence that older adults who are exposed to ageism, whether it's a sort of micro- or macro-aggression, have worse measures of of health and maybe hastened morbidity.
BRODIE: Do you find that those, those negative outcomes are both physical and sort of in the mental emotional realm or, or does one tend to suffer more when somebody is a victim of ageism?
KARP: No, that's a great question mark. [There is] evidence that there are both psychological negative effects as well as health negative effects. And I mean, you could take it one step further that if somebody feels bad because they experience ageism when they leave their house or they, they feel that they are not in an age-friendly environment, maybe they don't leave their house as frequently as they could or used to. So they're not as active as they are or they used to be, their diabetes and their cardiac disease gets worse, and then they could have worse physical outcomes.
BRODIE: Why do you think it is that so many people seemingly are maybe a little nervous about having people the ages of at least the two presumptive major party nominees are going to be?
KARP: I think that there's well, let, let's face it. The primary concern is really about cognitive decline and and dementing illnesses. And so, you know, we can remember what happened with Ronald Reagan, that he most likely had early signs of dementia later in his tenure as president of the United States and his communication had changed, his memory had changed, and he was relying more and more on his family and aides to to make it through his responsibilities. So that's a concern is that somebody is gonna have some cognitive deterioration, and they're not gonna be a successful leader for the United States, but I think it goes deeper than that. And we don't as a society respect older adults as much as we used to. There's a part of us, part of the human condition is to fear aging and the lack of vigor and vitality. So I think it's, it's a lot of these conscious and unconscious biases and worries that really contribute to our concerns about having an older adult in the most senior political position in the United States.
BRODIE: So understanding that just because somebody is in their 70s or 80s doesn't mean that they will have cognitive decline. Both President Biden and former President Trump have had instances that could be argued that might be showing signs of memory loss or maybe something more. So, what is the most appropriate way do you think for voters to try to discern whether or not that was just a simple slip-up or maybe, you know, these people just have so many names, so many things in their head that, you know, everybody makes these kinds of mistakes vs. the idea that maybe it could be something more serious than that.
KARP: So, you know, I think it's useful just for maybe a little education about what, how to conceptualize the aging brain. So there, there are normal age-related brain and cognitive changes. It's like we lose muscle mass, we live, we lose bone density. Our brain function also slows down as we age, but that's not necessarily pathological. There's also something called mild cognitive impairment, or MCI, which is sort of the, the bridge between normal memory age associated decline and dementia. And so that may be noticeable to people, but it doesn't really interfere that much with their function. And then there is dementia, which we can, you know, we, we criteria or we categorize as mild, moderate or severe. And we also have to remember that when we see these public figures, they are in high stress situations.
So their brains are having to do a lot of things, look good, communicate effectively, appear strong, respond to challenging questions. And so I think in many instances, it's a normal experience to have some slips of the tongue. And I don't think that that necessarily suggests that somebody is demented, but I would say that it's just part of being an aging human, that people in their 70s and 80s, their brains are maybe working a little slower than somebody who is a younger adult. And the corollary, I do want to mention that we don't discuss enough about wisdom that people also can accrue as they get older. And whether or not they may have some other slowing of their brain, these are important leadership skills that they can bring to these senior positions.
BRODIE: What kind of impact does this kind of conversation about political figures have on sort of the, the rest of us in terms of, you know, maybe the patients with whom you work or the population that you try to help? I mean, does the fact that we're having all these conversations about the cognitive health of these two political leaders, does that impact treatment or the way that sort of society as a whole looks at older Americans?
KARP: I hope so. I hope that people see this as inspiring, that older Americans and older people can still be vibrant and be effective leaders with incredibly busy schedules and having a positive, hopefully positive impact on the nation and the world. I hope that it also makes people think about the importance of cognitive and brain health across the lifespan and ways that they can prevent cognitive decline by managing their cardiovascular health, not smoke, don't drink too much alcohol, exercise. If you're depressed, get the depression treated, because these are all modifiable risk factors for cognitive decline and dementia. And if we take care of these, we can maybe prevent or delay the onset of cognitive decline later in life.
BRODIE: That is interesting. All right. That is Dr. Jordan Karp, professor and chair in the Department of Psychiatry at the University of Arizona College of Medicine in Tucson. Jordan thank you so much for the conversation. I really appreciate it.
KARP: That was really fun to talk to you. Thanks, Mark.
