Columbia University – dwkcommentaries

Memory Issues for People in Their Eighties

Joe Biden, who just turned 80, will be 86 in 2028 should he be re-elected and serve another four-year term as U.S. President. This has prompted political speculation whether his age is or should be a disqualifying attribute for his seeking re-election. This issue was discussed in an interesting New York Times article about memory issues facing people in their 80’s in the U.S.[1]

The article starts with the following general comments:

“[W]hile the risk of life-threatening diseases, dementia and death rises faster with each passing decade of a person’s life, experts in geriatrics say that people in their 80s who are active, engaged and have a sense of purposecan remain productive and healthy — and that wisdom and experience are important factors to consider.”
“ Biden, . . . experts agreed, has a lot going in his favor: He is highly educated, has plenty of social interaction, a stimulating job that requires a lot of thinking, is married and has a strong family network — all factors that, studies show, are protective against dementia and conducive to healthy aging. He does not smoke or drink alcohol and, according to the White House, he exercises five times a week. He also has top-notch medical care.”
“His race is another [positive] factor. The life expectancy for the average white, 80-year-old man is another eight years, said Dr. John Rowe, a professor of health policy and aging at Columbia University. ‘And that’s the average,’ Dr. Rowe said. ‘A lot of those 80-year-olds are already sick; they are already in the nursing home.’”
“Scientists who study aging stress that chronological age is not the same as biological age — and that the two often diverge as people grow older. It is true that older people tend to decline physically, and the brain also undergoes changes. But in people who are active, experts say, the brain continues to evolve and some brain functions can even improve— a phenomenon experts call the ‘neuroplasticity of aging.’”
“’This idea that old age is associated with only declines is not true,’ said Dilip Jeste, a psychiatrist who has studied aging at the University of California, San Diego. ‘There are studies that have been done all over the world which show that in people who keep active physically, socially, mentally and cognitively there is increased connectivity among specific networks, and even new neurons and synapses can form in selected brain regions with older age.’”

Further comments were provided by five additional experts.

“Dr. Dan Blazer, professor emeritus and psychiatric epidemiologist at Duke University School of Medicine, who led a committee of experts that examined “cognitive aging” for the National Academy of Sciences in 2015, said, ‘Slippage of memory is something that is usual, but it is not a real deficit.’ He described such slippage this way: ‘They forget, they remember they have forgotten and they eventually remember what they have forgotten.’”

Another expert on aging, Dr. Gill Livingston, a psychiatrist at University College London, who led a commission on dementia in 2020, observed, ‘Once people reach 65, the risk of dementia doubles every five years. In general, she said, in high-income countries like the United States, dementia will affect 10 percent of people aged 80 to 84 and 20 percent of those aged 85 to 89.”

Lisa Berkman, a professor of public policy at the Harvard School of Public Health who studies health and aging, added a more nuanced view. ‘People in their 80s commonly experience declines; we shouldn’t be naïve about that. And at the same time, there is so much variability. People who are doing well and are in the top level of functioning, have the odds of going for another 10 years, of doing really well during this time and making very important contributions.’”

Jay Olshansky, an epidemiologist at the University of Illinois Chicago, names both Mr. Biden and former President Donald J. Trump, who is 76, as likely fitting the profile of “super-agers” — a ‘subgroup of people that maintain their mental and physical functioning and tend to live longer than the average person their age.’”

“Dr. Olshansky also says it is a misconception to think being president ages a person; in fact, former presidents tend to live longer, as an analysis he published in 2011 showed. Former President Jimmy Carter, who has been active well into his 90s, turned 98 last month. President George H.W. Bush was 94 when he died in 2018.”

“As the baby boom cohort ages, the number of octogenarians is growing into what experts have called a “silver tsunami.” In its 2020 Profile of Older Americans, the federal Department of Health and Human Services reported that the 85-and-older population was projected to more than double from 6.6 million in 2019 to 14.4 million in 2040.”

Reactions

On November 21, the Times published 583 comments on this article. Here are a few of them:

Jim K said, “If either party offers a younger candidate with a fresher and less polarizing vision/agenda for the nation, that party’s candidate will probably win the election. In my opinion, that is who the independents – the middle of the road types – would vote for.”
Joe Barnett said, “If he decides not to run, he can wait until the primaries and then endorse or just watch the Democrats pull from their wealth of talent to replace him.”
Northern D offered, “It will actually speak to Biden’s legacy if he knows when to leave and still be capable of helping his successor not matter who he or she is. In my estimation that should be sooner rather than later.”
Therion boston, “Step down Man! The United States needs a leader that is younger, fresher, and more vibrant. Our whole country needs to put forward a fresh face.”
MCM said, “The appropriate question is whether the United States can run the risk that he may not be. And the article suggests that while he has many advantages, that possibility exists.”
WHC says, “By their mid80s most individuals have some cognitive decline, and if there is one job where we don’t want the holder to have cognitive decline it’s president of the United States. Yes, decline is not guaranteed, but the odds are clearly rising, and shutting your eyes to it—or to declare legitimate worries ageism, as though he’s just a laid off fifty something—isn’t serving your readers.”

Although I voted for Mr. Biden in the 2020 election, I think he should not run for re-election because of concerns about the potential adverse effects of his aging during a second term and of some voters declining to vote for him for that reason. I also think that many of the younger voters, who turned out in great numbers in the 2020 election, would appreciate having a younger candidate to vote for. My recommendations: U.S. Senators Cory Booker or Amy Klobuchar.

As a mid-80’s white male, retired lawyer with three university degrees who is in relatively good health and active in various ways, I am glad to learn that my age does not automatically mean that I am destined to suffer significant physical and mental decline in the balance of my 80’s. However, I acknowledge that my short-term memory is not as sharp as it used to be. When I mentioned this issue to a friend of my generation, he loaned me a book, “Remember” that emphasizes forgetting is part of being human while some memories are built to last only a few seconds and others can last a lifetime. The book’s author, Lisa Genova, is a neuroscientist and acclaimed novelist. I look forward to reading this book and hopefully getting tips on improving my memory.[2]

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[1] Stolberg, The President Is Turning 80. Experts Say Age Is More Than a Number, N.Y. Times (Nov. 20, 2022),

[2] Author Spotlight: Lisa Genova, Harmony Books.

Other Opinions About the U.S. Electoral College

A prior post discussed the July 6 Supreme Court decisions about the “faithless electors’ in the U.S. Electoral College for electing the president and vice president and initial reactions to those Supreme Court cases. Here are some additional reactions to those cases as well as other commentaries about the U.S.’ complicated system for election of a president and vice president.

Jesse Wegman[1]

Jesse Wegman, a member of the New York Times editorial board and the author of a book about the Electoral College, rightly says these recent cases did not address the issue of the continued existence of that institution, which, he says,” is rotting American democracy from the inside out.” First, it potentially can award “the presidency to the candidate who earns fewer votes among the people as a whole — which violates the fundamental premise of majority rule.” Second, it violates “the constitutional mandate of ‘one person, one vote.’ In the presidential election, the value of your vote depends on where you live. If you live in one of the half-dozen or so ‘battleground’ states, it matters hugely. If you happen to live in a ‘safe state,’ as a vast majority of Americans do, it’s effectively irrelevant.”

The Electoral College was created in the late 18^th century Constitution because its “framers worried that most voters — who rarely ventured far from home and had no easy way of getting information quickly — couldn’t know enough about national candidates to make an informed decision.” However, Wegman says, the College has never worked that way with the immediate formation of national political parties.

As a result, Wegman argues, “there is no remaining rationale for the Electoral College. What remains is a system that serves no purpose other than to erase the votes of 100 million Americans every four years, making them bystanders to the most consequential election of all.” In short, amend the Constitution to eliminate the Electoral College.

Wall Street Journal[2]

A Wall Street Journal editorial also points out that these new cases do not “address the most controversial question about the Electoral College, which is whether the U.S. should have one at all.”

The editorial, however, does not address that issue either. Instead, it discusses the National Popular Vote Interstate Compact whereby some states agree to grant their electors to the winner of the nationwide popular vote and which presumably is valid under the Opinion of the Court. However, says the Journal, Justice Thomas in his concurring opinion, points out that the Constitution in the last clause of Article I, Section 8, states, “No State shall, without the Consent of Congress . . . enter into any Agreement or Compact with another State.”

In any event, that compact currently has 16 members (15 states and the District of Columbia) with a total of 196 electoral votes and by its terms would go into effect when enough additional states join to constitute a majority of the Electoral College (270 votes).

Richard L. Hasen[3]

Just before these Supreme Court decisions, Richard L. Hasen, a professor of law and political science at the University of California, Irvine and the author of a leading book on problems of the U.S. election system, noted several problems with that system.

First, it “features deep fragmentation of governmental authority over elections. Not only does the United States use a highly decentralized and localized election system that gives many powers over national elections to state and local bodies, but also, even within the approximately 10,500 bodies expected to run the 2020 election, there is sometimes disagreement over who has decision making authority over voting rights decisions.”
Second, “protection of voting rights in the United States is marked by polarized and judicialized decision making.”
Third, U.S. “ constitutional protections for voting rights remain weak. The U.S. Constitution contains no affirmative right to vote. It speaks of voting rights mostly in the negative: thanks to a number of constitutional amendments, it is now illegal to bar someone from voting on the basis of race, gender, age of at least 18, or through the use of a poll tax.”
Fourth, this “decentralized, federalist approach to voting rights has led to a self-perpetuating system of voting inequality, where in some places you may be disenfranchised even if you do everything right.”

Therefore, Hasen proposes the following short-term remedies. “All states need to expand opportunities for online voter registration in time” for this November’s presidential election. . . . Congress needs to adequately fund additional expenses related to running an election during the pandemic. . . . States need to form independent bipartisan task forces to conduct full and independent investigations into why areas with more poor voters and voters of color saw significant problems voting in person during the primaries.”

In addition, Hasen advocates for a new constitutional amendment that would “guarantee all adult citizens the right to vote in federal elections, establish a nonpartisan administrative body to run federal elections that would automatically register all eligible voters to vote, and impose basic standards of voting access and competency for state and local elections.

Wilfred Codrington III [4]

Last year Codrington, a Fellow at the Brennan Center for Justice at NYU School of Law, pointed out a racist motivation for the creation of the Electoral College at the Constitutional Convention.

“The populations in the North and South were approximately equal, but roughly one-third of those living in the South were held in bondage. Because of its considerable, nonvoting slave population, that region would have less clout under a popular-vote system. The ultimate solution was an indirect method of choosing the president, one that could leverage the three-fifths compromise, the Faustian bargain they’d already made to determine how congressional seats would be apportioned. With about 93 percent of the country’s slaves toiling in just five southern states, that region was the undoubted beneficiary of the compromise, increasing the size of the South’s congressional delegation by 42 percent. When the time came to agree on a system for choosing the president, it was all too easy for the delegates to resort to the three-fifths compromise as the foundation.”

This racial impact affected the election of 1800, when Thomas Jefferson defeated John Adams, 73-65 in the Electoral College and “metaphorically rode into the executive mansion on the backs of slaves,” according to a Yale Law School professor, Akhil Reed Amar.

In the 1876 presidential election, Democrat Samuel Tilden won the popular vote but not the Electoral College vote due to disputes about the status of some electors. An ad hoc commission ultimately awarded the disputed electors to Republican Rutherford Hayes with his agreeing to remove federal troops in the South that were intended to maintain order and protect black voters.

Max Boot[5]

Boot, an historian and Washington Post columnist, reports that he recently participated in a “war game” over a hypothetical narrow Biden victory in the Electoral College, 278-260, including narrow wins in three swing states—Michigan, Wisconsin and Pennsylvania—where Republicans control both houses of their legislatures. Although all three states have Democratic governors, who usually certify election results, there is nothing to prevent the legislatures from certifying different results, especially if Trump “will stop at nothing to avoid the stigma of being branded a ‘loser’” and if hypothetically he and his allies concocted allegations of election fraud in those three states. The resulting dispute over these three states and hence the results of the election could well end up in the Supreme Court, and who could predict how they might resolve the dispute, given what it did in the 2000 election contest between George W. Bush and Al Gore.

A related concern is whether local, state and federal funding for the expenses of conducting the upcoming election in this pandemic will be adequate. This especially is true for the U.S. Postal Service with the anticipated mailing of election ballots.

David Rothkopf[6]

A lot of these current issues about the Electoral College are prompted by the outrageous conduct of our current president, Donald Trump, who is the “embodiment of the Founders’ worst fears.” So says David Rothkopf, a former professor of international affairs at Columbia University, Johns Hopkins and Georgetown University, former CEO and editor-in-chief of Foreign Policy magazine and a senior official in the Clinton Administration.

Rothkopf continues, Trump “has invited our enemies to interfere with our elections to help him win, then sought to do it again. He has misused federal resources, inappropriately elevated his own family members, and enriched his own businesses. He has repeatedly attacked the First and the Fourteenth Amendments. He has had infants thrown in cages and denied relief to Puerto Rico in the wake of Hurricane Maria at the cost of thousands of lives. He has gutted environmental protections and attacked alliances that the US spent decades building and maintaining. And now he has mismanaged the worst public health crisis in a hundred years, overseen the greatest economic crisis since the Depression, and attempted to use the US military to crush legitimate protests on the streets of the capital.”

Moreover, “in the space of just a few days, . . . [Trump] was revealed to have endorsed concentration camps in China and to have again sought the assistance of a foreign adversary in winning a US election, was quoted as calling for the deaths and imprisonment of US journalists, defended the slave power traitors of the Confederacy, admitted that he suppressed testing during the pandemic because true data about the rate of infections would harm him politically, sought to fire more truthtellers in the administration and had his attorney general remove an official in charge of investigations into him and his supporters. He was reportedly briefed about a Russian scheme to place bounties on American and allied troops in Afghanistan, and not only did nothing about it but continued to act as an advocate for Putin. And so it goes on… before we even consider the many complaints about his character—his racism and misogyny, his ignorance and contempt for science and history, his lies, his narcissism, his vulgarity, his demagoguery. Has there ever been a public official in US history so unable to relate to others, show an emotion besides anger, or view the world through any means but his own self-interest?”

Conclusion

Support a constitutional amendment to abolish the Electoral College!

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[1] Wegman, Can We Please Pick the President by Popular Vote Now? N.Y. Times (July 6, 2020)

[2] Editorial, States and the Electoral College, W.S. J. (July 6, 2020); Kendall & Bravin, Supreme Court Rules States Can Prohibit Electors From Breaking Rank, W.S.J. (July 6, 2020); Astor & Stevens, Did the Popular Vote Just Get a Win at the Supreme Court? N.Y. Times (July 6, 2020); National Popular Vote, nationalpopularvote.com.

[3] Hasen, Bring on the 28^th Amendment, N.Y. Times (June 29, 2020). Since there are now 27 amendments to the U.S. Constitution, this article calls for a 28^th amendment even though an existing non-profit organization has drafted and is promoting what it calls the 28^th Amendment “to end the escalating influence of big money that dominates our elections . . . [by enabling} Americans to enact reasonable limits on campaign contributions and dark money political spending [and] reversing the 2010 Supreme Court Citizens United decision.” (American Promise, The 28^th Amendment.)

[4] Codrington, The Electoral College’s Racist Origins, The Atlantic (Nov. 17, 2019); 1800 United States presidential election, Wikipedia.

[5] Boot, What if Trump loses but insists he won? Wash. Post (July 6, 2020); Reuters, ‘Epic failure’: U.S. Election Officials Warn of November Chaos Due to Budget Crunch, N.Y. Times (July 10, 2020); McCarthy & Jameel, The Postal Service Is Steadily Getting Worse—Can It Handle a National Mail-In Election?, propublica.org (June 15, 2020). See also Will Upcoming U.S. Presidential Election Be Legitimate? dwkcommentaries.com (July 5, 2020).

[6] Rothkropf, “The Most Ignorant and Unfit’: What Made America’s Worst Ever Leader? N.Y. Rev. Books (July 3, 2020).

Cuban Scientists’ Assessment of Medical Problems of U.S. Diplomats

Science, a journal of the American Association for the Advancement of Science, on December 5 published an article about the results of a Cuban scientific committee’s study of the medical problems of 24 U.S. diplomats who had served at the U.S. Embassy in Havana. The Cuban committee’s 20 members are physicians, neurologists, acoustic scientists, physicists and psychologists.[1]

The Cuban study concluded that the diplomats probably suffered a “collective psychogenic disorder” [disorder having a psychological cause, not a physical cause] and not a deliberate ‘health attack.’” Stanley Fahn, a neurologist at Columbia University, who has seen a summary of Cuba’s report, agrees that “it could certainly be all psychogenic.“

Another U.S. neurologist, Alberto Espay of the University of Cincinnati, who has read the Cuban report, said, “The combination of sudden onset of hearing loss, tinnitus, headaches, vertigo, nausea, insomnia, anxiety, and memory problems would have to be related to multiple lesions in both brain hemispheres.” This comment coincides with the nearly simultaneous report of U.S. physicians who had treated some of the diplomats that their patients had abnormalities in the brain’s white matter tracts that normally let different parts of the brain communicate with one another.[2]

The committee lamentably was unable to obtain detailed medical data from the U.S. But it conducted audiometric tests on neighbors and domestic workers in the diplomats homes, examined environmental sounds and insecticides near the homes and recordings of certain sounds that were provided by the U.S.

One of the Cuban committee’s members emphasized that the findings were “provisional. If any evidence were available, they will be willing to revise their conclusions and they are eager to team up with U.S. scientists.

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[1] Stone, Stressful conditions, not ‘sonic weapon,’ sickened U.S. diplomats, Cuba panel asserts, Science (Dec. 5, 2017) Many previous posts to this blog have discussed the issues raised by the medical problems of some U.S. diplomats; they are listed in the “U.S. Diplomats Medical Problems in Cuba, 2017” section of List of Posts to dwkcommentaries—Topical: Cuba.

[2] Identification of Brain Abnormalities in U.S. Diplomats in Havana with Medical Damage, dwkcommentaries.com (Dec. 6, 2017).

Discovery of Brain Abnormalities in U.S. Diplomats in Havana with Medical Damage

A forthcoming article in the Journal of the American Medical Association describes brain abnormalities in U.S. diplomats who had been stationed at the U.S. Embassy in Havana Cuba and who have been suffering hearing, vision, balance and memory damage. The article is written by physicians at the University of Miami and the University of Pennsylvania who have treated the diplomats with input from the State Department’s medical unit and other government doctors.[1]

The abnormalities are in the brain’s white matter tracts that let different parts of the brain communicate with one another. But doctors still do not know how patients ended up with the white matter changes or how exactly those changes might relate to their symptoms.

U.S. officials also will not say whether the changes were found in all 24 patients. Most patients have fully recovered, some after rehabilitation and other treatment, officials said. Many are back at work. About one-quarter had symptoms that persisted for long periods or remain to this day.

U.S. officials have told the Associated Press that investigators have now determined:

The most frequently reported sound patients heard was a high-pitched chirp or grating metal. Fewer recalled a low-pitched noise, like a hum.
Some were asleep and awakened by the sound, even as others sleeping in the same bed or room heard nothing.
Vibrations sometimes accompanied the sound. Victims told investigators these felt similar to the rapid flutter of air when windows of a car are partially rolled down.
Those worst off knew right away something was affecting their bodies. Some developed visual symptoms within 24 hours, including trouble focusing on a computer screen.

Physicians are treating the symptoms like a new, never-seen-before illness. After extensive testing and trial therapies, they are developing the first protocols to screen cases and identify the best treatments.

Doctors still don’t know the long-term medical consequences and expect that epidemiologists, who track disease patterns in populations, will monitor the 24 Americans for life. Consultations with the Centers for Disease Control and Prevention are underway.

According to Elisa Konofagou, a biomedical engineering professor at Columbia University who is not involved in the government’s investigation, acoustic waves never have been shown to alter the brain’s white matter tracts.”I would be very surprised. We never see white matter tract problems” even though ultrasound in the brain is used frequently in modern medicine.

Apparently unconnected with this AP report, U.S. Secretary of State Rex Tillerson responded to a journalist’s question on this issue at a press conference at NATO headquarters in Brussels, Belgium on December 6.[2] The Secretary said the following:

“We are convinced these were targeted attacks. We have shared some information with the Cubans, and there are two restrictions I’ve placed on sharing information. One is respect for the privacy of individuals and their medical conditions, and the second is not to provide whoever was orchestrating these attacks with information that’s useful to how effective they were. What we’ve said to the Cubans is a small island, you got a sophisticated security apparatus, you probably know who’s doing it, you can stop it. It’s as simple as that. So that’s what we’ve asked the Cubans. We understand the Cubans don’t like the actions we’ve taken. We don’t like our diplomats being targeted.”

Conclusion

This medical report should at least eliminate Cuba’s recent assertion that the U.S. was lying about medical problems being experienced by some U.S. diplomats. The report also casts doubt on the notion that the cause was some kind of sonic attack. But the report leaves open the broader question of the cause and the perpetrator.

Secretary Tillerson’s comments are not very helpful. The reported U.S. physicians’ conclusion of observable brain abnormalities for at least some of the diplomats apparently was reached only recently and leaves other issues unresolved. Therefore, even if Cuba has a “sophisticated security apparatus,” it should not be surprising that Cuba has not uncovered a cause or a perpetrator.

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[1] Assoc. Press, Doctors Identify Brain Abnormalities in Cuba Attack Patients, N.Y. Times (Dec. 6, 2017) Many previous posts to this blog have discussed the issues raised by the medical problems of some U.S. diplomats; they are listed in the “U.S. Diplomats Medical Problems in Cuba, 2017” section of List of Posts to dwkcommentaries—Topical: Cuba.

[2] U.S. State Dep’t, Press Conference at NATO, (Dec. 6, 2017); Harris, Tillerson Suggests Cuba Could Have Stopped ‘Targeted Attacks’ on U.S. Diplomats, N.Y. Times (Dec. 6, 2017); Assoc. Press, The Latest: Tillerson says diplomatic people were ‘targeted,’ Wash. Post (Dec. 6, 2017).