A recent poll from YouGov/CBS News showed that 77% of respondents said that there should be a maximum age limit for elected officials, with the most popular cutoff being 70 years old. The idea of an age limit for the presidency or Congress isn’t entirely new; Jimmy Carter even endorsed the concept in 2020. But the prospect of a mandatory political retirement age seems newly relevant with protests over our “gerontocracy” filling news outlets seemingly daily.
These pieces inevitably focus on President Joe Biden (80), former President and current candidate Donald Trump (77), Senate Majority Leader Mitch McConnell (81), and, until her recent death at the age of 90, Sen. Dianne Feinstein. In San Francisco, where I live and where the gratitude for Feinstein’s service runs deep, the remembrances of her have thankfully focused on honoring her greatness and her actions. The news has finally shifted from any mention of her public decline as a reason for championing age limits.
As a geriatrician, I think that the idea of maximum age for politicians is terrible. It won’t help America — and it might hurt us.
And yes, it’s because the very concept is rooted in ageism. Conflating age and health or age and ability cannot actually help us discern who’s truly fit for office and who’s not.
Older adults, those 65 and older, are the most heterogeneous group for a given age with regard to health and abilities. As Louise Aronson, author of “Elderhood” and a geriatrician colleague of mine at UCSF, pointed out in a Salon article discussing Biden as the first octogenarian president, “There is a legitimate increase in risk of disease, disability, and death with advancing age and that risk varies tremendously among octogenarians depending on their health, opportunities, and function.” Aging is a heterogenous, unpredictable process mitigated by old-fashioned advantages in life and luck.
In some jobs, there are policies of mandatory retirement at a particular age. Commercial pilots have to retire at age 65 (it used to be 60). This is presumably to balance the risk of more pilots having health conditions or changes in their abilities that affect their performance in a job where there is a very low tolerance for errors. This profession chose a general assessment of these factors on a population level — e.g., the decline in motor skills is on average X%, and that is beyond what the field considers an acceptable risk. But other jobs take a more case-by-case approach: A school bus driver can be any age over 18 but can’t have an uncontrolled seizure disorder, for instance.
Our older politicians may have a more diverse profile of health conditions than their younger colleagues because of the heterogeneity of aging. But like their younger colleagues, they have their own set of unique experiences and accumulated wisdom and we should feel lucky they wish to devote their time to being a public servant. Age diversity could be seen as more of an asset to be cultivated.
And, again, age is different for everyone with regard to health. Jay Olshansky and colleagues directly tackled the question of the health and longevity of the presidential candidates Joe Biden and Donald Trump before 2020 by reviewing all their public medical records. They concluded that both Biden and Trump appeared to be superagers, a term for people who tend to maintain their mental and physical functioning in older age.
Of course, if there are concerns that someone is struggling in their job, asking whether they are fit for work may be fair — after all, we are their employers. And this plays a role for some in deciding to leave office, though not always as soon as observers and constituents might prefer, as was the case with former Sen. Thad Cochran.
But we need to be on guard for when we’re confusing a reasonable concern over someone’s health seriously affecting their job performance, whether they recognize it or not, and plain old ageism. After Mitch McConnell froze for a second time, NPR’s Ron Elving showed how public discourse about public officials’ health issues is reinforcing ageism: “Aging is an equal opportunity agent, and it spares no one. No party, no individual,” he said.
Elving is right in a literal sense. Aging is exactly equal for all of us — it is happening in the same amounts, measured in seconds, minutes, years. What he expects us to understand — because of ageism — is that aging means a loss of health and abilities that obviously will affect performance.
But age doesn’t obviously affect performance in a job like McConnell’s. (Notably, his doctor released a statement saying the senator does not have a condition that impairs him to work.) For example, Sens. Chuck Grassley and Bernie Sanders are both older than McConnell. But coverage about the need for age limits in Congress or the White House tends not to acknowledge that Grassley and Sanders are performing well at advanced ages.
Some suggest that there can be universal criteria for the job, specifically giving cognitive testing and physical fitness tests to all those who would like to serve who are over 50 or all people running for office. (As far as we know, current leading presidential candidates have passed their most recent cognitive tests with flying colors.) On the face of it, cognitive tests may seem fair. But the most common screening tools for a condition like dementia are not in and of themselves diagnostic of anything. You need a full medical evaluation to determine whether something is wrong.
So maybe you would want to do even more extensive cognitive testing. Well, both screening tests and cognitive batteries are often biased against people with lower educational attainment and from minority backgrounds, among other factors. It’s also unclear how physical requirements relate to these jobs, and the suggestion of them quickly invites ageism’s close companion, ableism, into the conversation (though most of the time it’s already racing to join the discourse).
These ageist conversations actually create harm. They make us look down on older people, no matter our age, and on our older selves. Yale professor Becca Levy, author of “Breaking the Age Code,” led a longitudinal study that shows the impact of internalized negative beliefs about aging and one’s own longevity. On average, those with more positive views on aging in middle age lived 7.5 years longer than those with more negative beliefs. And ageism is pervasive: In one study, 93.4% of older adults ages 50-80 reported daily experiencing “everyday ageism,” defined as seeing ageist messages, interpersonal ageism, and internalized ageism. The more everyday ageism respondents reported experiencing, the more physical and mental health conditions they had. Though it was a cross-sectional study, which limits our ability to draw conclusions from it, that is a troubling association.
Across the globe, there is evidence of the negative impacts of ageism in health care — at the individual and structural level — via reduced access to health care and services, more physical and mental illness among older adults, and reduced longevity.
I beg political commentators and reporters, my fellow medical professionals, and voters: Stop dismissing politicians by saying someone is “too old.” It’s an undefined concept. There is plenty to debate with regard to their actual work, their record, their policies, and their proposals.
It may be that we need to further debate the accumulation of power for people who are allowed to be in high political jobs for many years. That’s fair. But that’s a debate about term limits, not age maximums.
As Ashton Applewhite, anti-ageism activist and author of “This Chair Rocks,” has pointed out more than once, “Generalizations about the capacities of older people are no more acceptable than racial or gender stereotypes. Period.” Let’s race on the real debates.
Anna Chodos, M.D., MPH is an associate professor of clinical medicine in the Division of Geriatrics and the Division of General Internal Medicine at Zuckerberg San Francisco General Hospital in the Department of Medicine at UCSF and a practicing geriatrician in the San Francisco Health Network.
