Often sharp and focused, but sometimes confused and forgetful

WASHINGTON — President Joe Biden’s behavior behind closed doors, in the Oval Office, aboard Air Force One and in meetings around the world is being described in the same two ways by those who regularly see him in action.

He is often sharp and focused. But there are times, especially delayed at night, when his thoughts seem disjointed and he stops mid-sentence or seems disoriented.

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Biden’s occasional trouble concentrating may not be unusual for someone his age. But at 81 and with another four years in the White House ahead of him, his moments of weakness have taken on new meaning after his disastrous debate performance with Republican Donald Trump.

The June 27 showdown worried Democrats and his financial backers in part because Biden seemed so much worse than he did in his almost routine moments of less sharpness. And it raised questions about whether he was prepared for a campaign that would only get nastier and whether he would be able to govern effectively for another four years if he won.

“We understand the concerns. We understand that,” White House press secretary Karine Jean-Pierre said this week. But she insisted Biden has no intention of walking away from the campaign.

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The article is based on interviews with about two dozen people who met privately with the president, some of whom were granted anonymity so they could discuss interactions not intended for public consumption.

What he is like in private life, is often like in public life – unequal

How Biden conducts himself in private, according to regular observers, often reflects how he comes across in public. In both situations, he can command one day and hold back the next.

A day after his debate mishap, Biden’s voice at a rally in North Carolina was firm, his eyes alert, his delivery confident. Cheers filled the room as he spoke.

“I give you my word as Biden. I would not run again if I didn’t believe with all my heart and soul that I could do this job,” he told supporters. “Because, quite frankly, the stakes are too high.”

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Throughout all this, public concern about Biden’s ability to serve another four years in office has been persistent. In an August 2023 poll by The Associated Press-NORC Center for Public Affairs Research, a full 77% of U.S. adults said Biden was too old to be effective for another four years. Not only did 89% of Republicans say that, but 69% of Democrats did as well.

Strategy shift to boost Biden’s presence

Biden’s aides have long aggressively deflected questions about his age. But they now acknowledge that Biden’s slowdown is undeniable. The debate has forced the president to more openly acknowledge the limitations of his age, a position he had largely downplayed before.

After an internal campaign discussion, the White House announced a public campaign blitz Tuesday: Biden will sit down for an interview with ABC’s George Stephanopoulos on Friday. The president added a trip to Wisconsin on Friday and will travel to Philadelphia on Sunday. And he will hold a news conference at the NATO summit in Washington next week.

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Biden allies fear that another inevitable setback — even if it is not as major as the debate debacle — would revive voters’ concerns about the president’s fitness for office.

Exhausting foreign travel

Three French officials who helped organize Biden’s visit to France earlier this month said their American counterparts’ reactions to proposals for a state visit to Paris and D-Day commemorations in Normandy led them to believe the president’s health was delicate.

After a Group of Seven summit in Italy, where Biden appeared pale and sluggish, he flew across nine time zones to Los Angeles for a glitzy Hollywood fundraiser. One person who spoke with Biden at the event was struck by how tired the president seemed in backstage conversations.

How Biden is doing at work

Many members of the White House believe the president is in control both on domestic issues and on key foreign policy issues.

“Over the last 3 1/2 years, I have been with the president many times as he makes the most important decisions about life, death or peace,” said Brett McGurk, a senior National Security Council official who has worked for both Republican and Democratic administrations.

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“And what I’ve seen repeatedly — repeatedly and consistently — from the first week of the administration to now — is a president who prepares for these actions, who has very detailed and comprehensive summaries of these actions, and then implements the actions, and then very actively monitors them.”

Dissatisfied with the explanations

Democrats have so far been largely dissatisfied with the explanations for Biden’s debate performance, offered by White House staff, his campaign and the president himself. And there is a deeper frustration among some who believe the president should have addressed it much earlier, and he put them in a difficult position by staying in the race.

Another problem for Democrats is that because there has been so much focus on Biden, there has been less attention paid to Trump, whose debate performance was riddled with lies about the Jan. 6, 2021, Capitol riot, Democrats’ views on abortion rights and his own revisionist comments about his response to a 2017 neo-Nazi rally.

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Only Biden’s doctors can really answer

In fact, only Biden’s personal physician can answer questions about the president’s cognitive abilities, and given the level of public concern, he should, said aging researcher S. Jay Olshansky of the University of Illinois at Chicago.

Biden’s physician, Dr. Kevin O’Connor, deemed the president fit to serve after a February checkup that included a neurological evaluation. White House officials at the time said Biden did not receive a special cognitive test because O’Connor and a neurologist determined it was unnecessary.

Olshansky emphasized that one bad TV appearance is not enough to judge someone’s cognitive abilities, “even for those of us who study aging professionally.”

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