Cognitive Decline in Congress

I’m just going to say it: not having dementia is a low bar to set for a political leader….no matter your political party.

In the last couple of years, we’ve seen the increasing age in our political leaders and many calling out their age, assigning a casual “diagnosis” of dementia, but then still re-electing them. In contrast, there have been some congressmembers who have proposed legislation to make sure that we aren’t doing so. In 2023, Representative Scott DeJarlais proposed a cognitive screening requirement for the President and Vice President and in 2025, Representative Marie Gluesenkamp Perez introduced an amendment that called for cognitive screenings for members of congress. Neither of these proposals went forward- interesting, given the large focus on the age of government officials in the media and other conversations.

But let’s break it down here…

When testing for dementia, a clinician will start with a screening that asks about orientation to time and space (e.g., what year is it? what floor of the building are we on?), ability to follow simple instructions (e.g., close your eyes- and then watch as the individual does this task), and simple memory recall for words (e.g., remember pen, watch, and apple for 2-3 minutes). Sometimes more complex tasks will be added, where individuals are asked to replicate a picture of a clock from memory or copy a set of shapes. These are basic cognitive functions to help determine if this person is capable of simply living alone without assistance. That is, can they do their own laundry, make their own meals, dress and feed themselves, etc.?

In my opinion, this is the bare minimum. We wouldn’t ask this little of any other professional. Need a mechanic? Just make sure they can draw a clock. Or, what if we break our leg? Make sure your doctor can tell you what year it is and can remember three simple words. This is not enough. The American people need and deserve more than this. Our mechanics need to pass written and practical exams. As do our doctors. Teachers. Lawyers. Mail carriers. So then why are we only asking for a cognitive fitness test for our lawmakers? And truly not even asking for that because the proposed legislation hasn’t passed.

What’s worse about this is that people often slip into assuming that if they are older, they must be experiencing cognitive decline, but most people do not ever develop dementia. Rates are reported that roughly 10-12% of individuals over the age of 65 will develop Alzheimer’s disease (the most common type of dementia). And, while that is a high number, it is far from universal. And, what’s more, research shows that if people are experts in their field, their expertise will buffer any diminishing cognition that they may be experiencing. What this means is that people who are 70 or 80 years old, even in the face of mild cognitive decline, may actually do their job better than their younger counterparts because they’ve had a lifetime of building the knowledge and wisdom to do so.

So, yes, cognitive screening is a good idea (let us please at least pass legislation for this)… no matter the age of the representative. But expertise and capability in the field of lawmaking is also necessary- possibly more necessary and more valuable to us than cognitive screening. I’d argue that we could do well to add written exams covering the basic operations of our country’s governmental systems too.

When we make a call to require a cognitive test, let us consider what we are really asking for. Are we setting the bar so low that we just need our leaders to know how to draw a clock? Or do we want more? I vote for more… We deserve leaders who can think clearly but also have expertise to do the job we are hiring them to do.

Sara J. Margolin, Ph.D. is an associate professor of psychology and neuroscience with expertise in cognitive aging. Her research has appeared in journals such as Aging, Neuropsychology, and Cognition, Experimental Aging Research, and Educational Gerontology, and she has published a textbook on the psychology of aging. Her writing has also appeared in the Buffalo News, the Rochester Democrat and Chronicle, the Albany Times Union, and Crunchy Tales—all discussing various aspects of the aging process. You can find her on Instagram (@drsaramargolin) and Facebook (Sara Margolin) providing insight into the positive aspects of aging every day.