For Biden and Trump, Age Is Just a Number

From a Wall Street Journal story by Josh Zumbrun headlined “For Biden and Trump, Age Is Really Just a Number”:

Either Donald Trump or Joe Biden would be the oldest person to win the presidency if they prevail in next year’s election. At age 77 and 80, respectively, both are already past the U.S. life expectancy of 76.4 years.

It’s become a major source of voter concern and media attention. In a CBS News poll, only 34% of respondents thought Biden would complete a second term and only 55% thought Trump would.

It isn’t just the presidential contenders. Last week, California Sen. Dianne Feinstein died at age 90, long after her health had clearly declined. Senate Minority Leader Mitch McConnell, 81, twice went strangely silent in public during the summer. Nancy Pelosi, who until the beginning of this year was speaker of the House, is 83.

Yet the concern that their age somehow disqualifies them from public office doesn’t really align with the state of aging in the year 2023. There’s biological truth to the adage that age is just a number. Americans on average are healthier in old age than before. Many of the factors that predict longer life favor Biden and Trump, based on publicly released information about their health.

“There’s a lot of armchair gerontologists who are wearing glasses through which they see what they want to see,” said Jay Olshansky, a professor of epidemiology and biostatistics at the University of Illinois, Chicago. “The suggestion that everyone who is old is feeble, experiencing loss, decline and decay—this completely ignores the radical transformation in the last 20-30 years of the population that’s survived to older ages.”

What is usually referred to as life expectancy typically means life expectancy at birth: how long a hypothetical newborn would live if current age-specific death rates prevailed through her entire life. For older individuals, we care more about how long someone their age can expect to live, which can be calculated with the Actuaries Longevity Illustrator.

That tells us a nonsmoking male with Biden’s birthday, in good health, would be expected to live nine more years after next year’s Election Day, while for one with Trump’s birthday, it would be 11 years.

That basic expectation is a median, meaning half of individuals would live longer, and half less. Would Biden and Trump live longer or less than the median?

First, the median includes people who drink alcohol. Regular drinking of two or more drinks, three or more times a week, shortens life expectancy by about seven years. Both Trump and Biden are teetotalers, in addition to being nonsmokers.

“Those are two of the biggest killers right there,” said Bradley Willcox, a professor and research director at the Department of Geriatric Medicine at the University of Hawaii. “When you eliminate excessive alcohol intake and smoking, one thing you’re left with is genetics.”

Here, Trump and Biden picked their parents well. Trump’s mother lived to 88 and his father to 93, though late in life he developed Alzheimer’s disease. Biden’s mother died at 92—living long enough to see her son become the sixth-oldest vice president. Joe Biden Sr. died at 86. That’s even more impressive than it sounds: When those four individuals were born, life expectancy was around 50.

Biden and Trump are each highly educated at a time when the life-expectancy gap between the educated and uneducated has been growing. They are wealthy, also a strong predictor of longer life. They receive excellent healthcare. Willcox notes that both men have been tested for C-reactive protein, which helps predict heart disease. He says it’s an example of a useful screening that many people might not get.

Median life expectancy is just that, the middle. Nonsmokers and nondrinkers, who are educated, wealthy and have long-lived parents and good medical care, are generally going to outlast the median quite a bit, which is why many people are not only reaching their 80s but continuing to thrive.

“Many people who are 80 years old now have more in common with people a couple generations ago who were 60,” said Willcox.

To this point in 1985, when Ronald Reagan began his second term as president just shy of his 74th birthday, a man his age could expect to live nine more years, comparable to Biden and Trump now.

This is why, despite politicians’ advancing average age, so few die in office. In the past 10 years, just two U.S. senators have: Feinstein and Arizona’s John McCain. From 1903 to 1913, 31 died in office. Like Biden and Trump, senators tend to be educated and wealthy and have good medical care. Men the age of McConnell and women the age of Pelosi can expect to live seven more years.

Geriatricians are increasingly seeking ways to measure not just how many years someone will live but how many healthy years, sometimes called healthspan. Here too, the evidence for Trump and Biden is favorable. The University of Connecticut’s Healthy Life Expectancy Calculator suggests (again, based on what’s publicly known) that Trump and Biden are likely to not only be alive, but in good health, for at least 10 years.

Neither is in perfect health. Both have had problems walking—Trump at West Point and Biden at the Air Force Academy, in incidents widely amplified by partisan media. In 2019, a White House doctor gave Trump’s weight as 243 pounds, which would put his body-mass index just above the line for obesity. (He seems to have lost weight since.)

Despite speculation about the mental acuity of the two men, nothing in their publicly shared medical records suggests the doctors who evaluated them have concerns about cognitive function, Olshansky said.

Putting together all the known data, Olshansky said that Trump’s extra weight probably cancels out the benefit of his slightly younger age. But he estimates that Trump and Biden would likely have at least an 80% chance of completing their terms in good health, far better than voters think. He suggests voters worry less about the candidates’ ages and more about their values and policies.