The White House endured a sleepless night following President Joe Biden's stutter-filled and challenging performance in the presidential debate in Atlanta on Thursday night. Within the Democratic Party, calls for Biden's resignation have surfaced, and rumors are spreading globally about his deteriorating cognitive function and the possibility of dementia.
According to estimates, although it is not possible to know for sure just by watching the debate, Biden does not meet the criteria for dementia and is experiencing cognitive decline consistent with his age – 81 and a half years old. With the increase in life expectancy, the prevalence of cognitive impairment also rises due to the thinning of brain tissue.
This can be demonstrated in a simple test by a specialist doctor, which includes questioning, physical examination, task requests, and the cognitive test. The most popular one is MoCa, which Donald Trump also took and reportedly passed successfully.
This is a test translated into many languages, including Hebrew. It lasts about ten minutes and is easy to understand. The test is scored from zero to thirty and allows for the identification of early signs of dementia or cognitive impairment.
Here are the parameters examined in the test:
1. Short-term memory: The examinee is asked to repeat words and remember them after about five minutes. The examiner should note the level of attention during the word learning, but it does not receive any score. The examinee is asked to remember five words in total, with one point given for each word.
2. Spatial perception: This is tested through a clock drawing test where the examinee is asked to draw and receives a total of three points: one point for drawing a circle, one for the placement of numbers, and one last point for the direction of the hands at 11:10. Additionally, the examinee is asked to draw a three-dimensional cube for which they receive one point.
3. Executive function: The examinee is asked to draw a continuous line between all the numbers and letters in a specific order. The examinee does not receive any hints, only a general instruction to complete the line according to the order shown in the illustration. This section is scored with one point.
4. Abstraction: The examinee is asked to find similarities between two words. Initially, the examinee is asked about the similarity between two types of fruits (e.g., apple and pear). If they fail to reach the correct answer, the examiner explains that they are fruits and moves to the next test. Each correct answer in the abstraction test awards one point – a total of two points. The fruit question is not included in the calculation, and partial answers, such as “wheels” for the question about train and bicycle, or “numbers” for the question about clock and ruler, are not considered correct.
5. Attention and concentration: The examinee is asked to identify a specific letter from a list of letters read by the examiner and tap on the table upon hearing the specified letter. They receive one point if they make less than two mistakes.
6. Serial subtraction of 7 from 100: The examinee receives three points for 4-5 correct answers in the series 93-86-79-72-65, two points for 2-3 correct answers, one point for only one correct answer, and zero points if there are no correct answers. Repeating the number series forwards and backwards grants two points.
7. Language skills: This is tested by naming three animals shown in an illustration: a lion, a rhino, and a camel. Each correct name earns the examinee one point, for a total of three points. Additionally, the examinee is asked to repeat two complex sentences, totaling two points.
8. Speech fluency: The examinee is asked to mention as many words as possible starting with a specific letter within one minute. Eleven or more words earn one point.
9. Orientation in time and place: The examinee receives points if they correctly mention the location of the test, the city, the time, the day, the month, and the year.
10. In years of education: Since it is assumed that more educated examinees are likely to have a better cognitive function, an examinee with 12 years of formal education receives an additional point. A final test score of 26 or higher is considered normal.