As Nikki Haley kicked off her presidential campaign this week, stressing the need for “generational change” in politics, she said she would make sure lawmakers over 75 years old would be subject to “mental competency tests.” It was a not-so-subtle dig at President Joe Biden and former President Donald Trump, who are 80 and 76 years old, respectively. Her remarks also came after 89-year-old Sen. Dianne Feinstein, the longest-serving member of Congress, announced she will retire at the end of her term.
But are these kinds of screenings actually a good idea? I spoke to three experts in geriatric medicine who didn’t think so. Not only were Haley’s comments ageist, they said, but mental competency tests are not necessarily a useful tool to assess a person’s leadership ability.
The logistics of administering a competency test can be complicated, since some can be done in five minutes while others require up to four hours. “Cognitive tests, a lot of them, are timed, and we know that neurological processing slows with age. So you can come out looking impaired, even if you’re not really,” said Carolyn Aldwin, gerontologist and director of the gerontology program at Oregon State University. David Nace, chief of geriatric medicine at University Pittsburgh Medical Center, agreed. “Those don’t necessarily determine that you have capacity,” he said.
The tests can measure memory, personality, the ability to manipulate information, speech, visual spatial skills and more—but it can’t measure leadership skills or abilities. Nace explained to me that there isn’t a single person or validated tool that could measure an intangible quality like leadership.
The experts I spoke to also said that designating 75 as the age when tests become mandatory was arbitrary and not rooted in science. “Maybe she should talk to my patient who’s 95 years old and published a book a year and a half ago,” said David Reuben, division chief of geriatric medicine at University of California, Los Angeles Center of Health Sciences.
It’s also important not to generalize, since the aging process doesn’t look the same for everyone. “There are huge individual differences in how people age. Some are sharp as a tack at 90 or 100, some have cognitive impairment in their 50’s,” Aldwin said.
Aldwin, Reuben and Nace also felt Haley’s suggestion could easily be flipped, opening the door to questioning younger politicians’ mental fitness. Should we implement mandatory testing for lawmakers that checks for alcoholism or gambling and sex addictions?
“If you’re gonna start down that road of saying people are unfit for office because of a personal issue, why limit it to age?” Reuben said. “Whether a poor decision is made because of intellectual capacity, or it’s because of a disease like alcoholism, then the poor decision stands either way.”
Aldwin also felt Haley was introducing a “slippery slope,” that could extend beyond presidential candidates. ”Do we start testing Supreme Court justices, mayors and governors?,” she told me.
One thing is clear: Haley is using age as a political strategy because her two biggest opponents in the race for president happen to be pretty old. If her opponents were, say, 50 years old, Haley may not have made such a bold suggestion.
“This is a wonderful soundbite because it gets at her political aim, which is: separate myself from the other candidates,” said Nace.
She is also not the first politician to lean into ageism. In 2020, Trump ran television ads that claimed Biden lacked the stamina and mental fortitude to lead the country, and digital ads that said he “is old and out of it.” Democrats have also indicated discomfort with Biden’s age. Rep. Dean Phillips, for example, told Politico that he has concerns about Biden running for reelection. “If he were 15-20 years younger, it would be a no-brainer to nominate him.”
