WASHINGTON (AP) — If he wins next month’s election, Donald Trump would be the oldest person in U.S. history to be elected president. Yet the 78-year-old Republican candidate is refusing to reveal fresh details about his physical or mental well-being, breaking decades of precedent.
There have been circumscribed snapshots of Trump’s health over the past year. After surviving an assassination attempt in July, Texas Rep. Ronny Jackson, a staunch supporter and his White House doctor, wrote a memo describing a gunshot wound to Trump’s right ear. And last November, Trump’s personal physician, Dr. Bruce Aronwald wrote a letter describing him as “excellent” and having “extraordinary” cognitive tests. He noted that “all cardiovascular exams were normal and cancer screening tests” were negative. Trump has also “reduced his weight.”
But those communications did not address more fundamental questions about Trump’s health, including his blood pressure, his exact weight or whether he continued to take previously prescribed medication for high cholesterol – or even what tests he had undergone. His campaign has also not disclosed whether Trump was diagnosed with any illnesses or received psychiatric care after the attack.
This gives his political opponents, including Democratic rival Kamala Harris, an opportunity to raise questions about his age and his ability to carry out presidential duties into his 80s.
“You wonder, ‘Why does his staff want him to hide?’” Harris asked recently as she lambasted Trump for withholding medical records, refusing to allow another debate and skipping an interview with CBS’ “60 Minutes.” “You have to ask yourself: Are they afraid that people will realize that he is too weak and unstable to lead America? Is that what’s going on?”
Trump’s doctors have long been vocal about his health, such as when his White House team initially downplayed the severity of his hospitalization for COVID-19 in 2020.
His representatives ignored multiple requests from The Associated Press to provide more detailed information about his status for this story.
Drawing a contrast to Trump
To provide a contrast with Trump, Harris released a letter from her doctor on Saturday that went into far more detail about her medical history, including a list of tests and results. The letter said she had no heart, lung or neurological diseases, that her risk of heart disease was low and that her cancer screenings were up to date. She takes medication for allergies and hives. She wears contact lenses and her only surgery was at age 3, when she had her appendix removed during an intestinal procedure.
Although the letter did not specify her weight, it stated that the 59-year-old vice president was in “excellent health” and had “the physical and mental stamina” required to serve as president.
Sensing an opportunity to put Trump on the defensive, the Harris campaign on Monday released a letter from more than 250 doctors and other medical professionals calling on Trump to release his medical records.
Still, it’s unclear whether age will be an critical factor for voters. Polls found that voters were significantly less worried about Trump’s mental performance and physical health than they were about President Joe Biden’s when he was still in the race. Since Harris replaced Biden on the ticket, Trump’s advantage on the issue has shrunk.
And so far, the Lincoln Project is among the few anti-Trump groups to spend money on ads that focus on Trump’s age. An ad titled “An Old Man” describes Trump as “weak, impotent, forgetful, rapidly declining mentally.”
Such messages are designed to anger Trump as much as they turn voters against him, said Rick Wilson, co-founder of the Lincoln Project.
“We’re doing these ads because Trump hates them,” Wilson said.
This vigorous is ironic for Trump, who for years denounced the 81-year-old Biden’s age and portrayed him as fragile and unable to handle the challenges of the presidency. After a disastrous debate in June, Biden’s fellow Democrats began openly voicing similar concerns, which ultimately led to his decision to withdraw from the race and support Harris.
There is no requirement for candidates to disclose health information. But presidential candidates traditionally share their medical records voluntarily because of the demands of the office, particularly when there are concerns about their age.
In 2008, Republican candidate John McCain opened more than 1,000 pages of medical documents to the public. At 72, he would have been the oldest president elected to a first term. When Biden, then 77, came under scrutiny for his advanced age in 2019, he released a three-page note from his doctor.
“At a time when more and more older people are running for president or becoming president, it honestly seems to me less acceptable” to have so little information, Dr. Eric Lenze from Washington University in St. Louis. a geriatric psychiatrist who assesses cognition in older adults.
The last detailed report on Trump’s health came in 2019, when he was still president. At that exam, he was classified as obese, weighing 243 pounds and having a body mass index of 30.4, which increases the risk of heart disease, diabetes and other problems. This report also revealed increased dosages of high cholesterol medications. Although Trump does not drink alcohol or smoke, he has long avoided playing any sports other than golf and loves speedy food.
As for his family history, his father suffered from Alzheimer’s disease, a potential risk factor, overdue in life.
Trump’s allies point to his vigorous public lifestyle as evidence that he is not in decline.
Trump is a regular golfer and an engaging host at social events. He takes questions from the press far more often than Harris. At his rallies he often speaks for more than 90 minutes, standing the entire time and often ignoring the teleprompter.
Trump often waffles during his public appearances
Still, Trump’s public appearances are often characterized by chatter. He regularly messes up schedules, events and people.
At a town hall-style forum in Fayetteville, North Carolina, Trump appeared to have no recollection of meeting a seriously injured veteran and his family. The veteran’s wife noted that “you visited him often” and “you only saw him this summer.”
Trump has also confused Republican rival Nikki Haley with former Democratic House Speaker Nancy Pelosi. He confused the location of a vast military base. He incorrectly said that Hungarian Prime Minister Viktor Orbán was leading Turkey.
During a convoluted press conference in August filled with false and misleading statements, Trump recalled being a passenger in the helicopter with former San Francisco Mayor Willie Brown when he made an emergency landing.
Brown later said he never shared a helicopter with Trump. Instead, it was likely a Los Angeles city councilman, also black, who experienced a rocky helicopter ride with Trump decades earlier.
And recently, at a rally in Wisconsin, he appeared to squint at teleprompters as he veered from topic to topic. He described the country as a “third world hellhole.” He then told his audience, “Remember, there’s a hat that’s selling like crazy,” before interrupting himself to comment on a fly.
“Oh, there’s a fly, I wonder where the fly came from. You see, two years ago I wouldn’t have had a fly up here. “They’re changing quickly,” Trump said.
He begins to brag about his “beautiful body” and describes his often long-winded speeches as “flawless.”
Trump regularly answers questions about his age and health during public appearances. On Sunday in Arizona, Trump mocked critics who called him “cognitively impaired” because he “mispronounced a word.”
“They say he’s cognitively impaired!” Trump teased. “No, I’ll let you know when I’ll be there. It will be me one day – it will be all of us one day. I’ll be the first to tell you.”
The AP consulted several medical experts, but none would comment specifically on Trump’s overall health or cognitive abilities without examining him or having access to current medical records.
John R. Beard, director of the International Longevity Center at Columbia University, has identified what could be warning signs of cognitive problems as we age, including unusual speech patterns and ramblings.
“People can jump from one thought to the next without there being a logical connection between them, and then tend to dwell on a topic at length without really connecting it to the main argument,” Beard said. But some people may have exhibited such traits for years, raising the question of whether they are worsening or affecting performance, he added.
Earlier this year, the science news organization STAT asked a handful of aging experts to analyze excerpts from Trump’s speeches. They reported several worrying changes since 2017, including an escalate in confused word order, repetition and so-called “all-or-nothing thinking.”
Lenze and Beard called on every presidential candidate, regardless of age, to provide a detailed medical report to make it clear how robust they really are.
Lenze said that at a certain age, perhaps 70 or 75, this should include a full neuropsychological examination that lasts several hours. It’s far more intensive than rapid, snapshot-in-time screening tests like the Montreal Cognitive Assessment, or MoCA, which Trump often boasted about passing in 2018.
“Someone can have a perfect score in MoCA and still be impaired,” Lenze said. “The level of cognitive integrity and ability to lead the presidency is, in my opinion, quite a bit higher than what is required to graduate from MoCA.”
Without further information, the basic life expectancy of the average American man shows that Trump has about a 79% chance of surviving a four-year term, said aging researcher S. Jay Olshansky of the University of Illinois at Chicago, who studies the president’s health and this confirms request for candidates’ medical records. The younger Harris has a nearly 97% chance of surviving a first term, he said.
When it comes to the presidency, “it’s not about age, it’s about position,” Olshansky warned.
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Völker reported from New York. Associated Press writer Michelle L. Price in New York contributed to this report.
