Biden Aides Decided Against a Cognitive Test in Early 2024, Book Says

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His White House advisers considered giving him such a test to prove his fitness for a second term, but they worried it would draw new attention to his age, according to a forthcoming book.

President Biden walking out of Walter Reed National Military Medical Center in Bethesda, Md., in February 2024, flanked by other people.
A few weeks before former President Joseph R. Biden Jr.’s final White House physical exam in early 2024, his aides decided against having him undergo a cognitive test.Credit...Pete Marovich for The New York Times

Reid J. Epstein

May 4, 2025, 5:01 a.m. ET

Months before President Joseph R. Biden Jr. was forced to abandon his re-election campaign, his top White House aides debated having him undergo a cognitive test to prove his fitness for a second term but ultimately decided against the move, according to a forthcoming book.

The account illustrates the degree to which Mr. Biden’s top aides harbored deep fears about how voters viewed his age and mental acuity. The book, “2024: How Trump Retook the White House and the Democrats Lost America,” by Tyler Pager of The New York Times, Josh Dawsey of The Wall Street Journal and Isaac Arnsdorf of The Washington Post, is set to be released in July.

Mr. Biden’s aides were confident that he would pass a cognitive test, according to the book, but they worried that the mere fact of his taking one would raise new questions about his mental abilities. At the same time, Mr. Biden’s longtime doctor, Kevin O’Connor, had told aides he would not take the 81-year-old president’s political standing into consideration when treating him.

The discussion took place in February 2024, a few weeks before Mr. Biden’s final White House physical exam and a period preceding some of his most damaging public episodes.

A representative for Mr. Biden declined to comment.

The same month that Biden aides considered the cognitive test, Robert K. Hur, the special counsel who investigated Mr. Biden’s handling of classified documents, released a report concluding that the president was “a sympathetic, well-meaning, elderly man with a poor memory.” Mr. Biden held a late-night news conference to deliver an angry response in which he referred to the president of Egypt as the president of Mexico and declared, “My memory is fine.”

By then it was becoming obvious that former President Donald J. Trump would be the Republican nominee. Mr. Trump, three years younger than Mr. Biden, had bragged during his first term about having passed a cognitive test, though details were sketchy. His repetition of a five-word sequence he had been asked to memorize — “person, woman, man, camera, TV” — became a running joke in Washington political circles in 2020.


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