President Trump reiterated a series of claims that rival Joe Biden was too weak to serve as commander in chief while dwarfing his own obscure health history by embellishing speculation and then refuting that he had a stroke last year could.

Trump has fueled the kerfuffle about the president's fitness himself in large part by denying he had a "series of mini-strokes" and then trying to turn the narrative around by suggesting without evidence that it might be his opponent who former Vice President Biden, had suffered a stroke.

Trump, who boasted of having taken a cognitive test, usually done to detect early signs of decline, also reiterated unsubstantiated claims that Biden had dementia.

With his barrage of tweets and aside notes, the president has once again brought age and its impact on the mental and physical functioning of the campaign to the fore. Experts say this is a subject that has no obvious use to either the 74-year-old president and the 77-year-old challenger – while dangerous landmines are being planted. Both would be the oldest people ever elected to the presidency.

The video of Trump's apparent misstep as he took a stage in New Hampshire last week attracted endless attention, like an NFL touchdown replay (did he almost fall or was he joking as the campaign said?) Along with the hashtag # TrumpIsNotWell. Biden's stopping description of the death toll from the COVID-19 pandemic appeared more than once on Trump's Twitter stream.

The president's health has always been a fascinating subject, as has the tendency of experts and the general public to extrapolate from minimal evidence. This can lead to misinterpretation rather than more informed judgments resulting from evaluating executives based on their performance, according to scholars who have studied the issue.

Claims of stroke and poor mental performance – with such limited evidence – are both "alteristic" and "ridiculous," said Stuart Jay Olshansky, a professor of public health at the University of Illinois who researched the president's longevity.

"When you describe someone as weak or cite something they did wrong, you are describing attributes of almost anyone over 60 or 65," said Olshansky. "When the candidates insult one another, they are also insulting the entire (older) US population, many of whom have to vote for them to be elected."

Joe Biden puts on his face mask after speaking to the media in Wilmington, Delaware on Friday.

(Associated Press)

But missteps and false statements live on forever on video. A five-second GIF can make a deeper impression than a lifetime of work. This is a truth that even one of America's foreign opponents is trying to exploit, according to news reports.

In early July, the Department of Homeland Security had evidence of a Russian program to promote "allegations of poor mental health" from Biden, ABC News and the New York Times reported last week. A network of intelligence agencies warning the state and local law enforcement agencies about the system has been withheld by senior Homeland Security officials, the network reported.

The health problem occurred in a roundabout way. In a new book, New York Times reporter Michael S. Schmidt wrote about an incident in November when aides took Trump to the Walter Reed National Military Medical Center. Schmidt reported that Vice President Mike Pence was put on standby "to temporarily take over the powers of the presidency if Trump had to undergo an anesthetic procedure."

CNN expert and former Clinton administration spokesman Joe Lockhart, taking advantage of this revelation, wondered on Twitter whether Trump might have had a stroke that he was "hiding from the American public". The Trump administration has claimed that the November unscheduled hospital visit was for the president's annual physical visit.

On Tuesday, Trump tweeted: “It never ends! Now they are trying to say that your favorite president, I, went to Walter Reed Medical Center after suffering a series of mini-strokes. Nothing has ever happened to this candidate – FAKE NEWS. Maybe they are referring to another candidate from another party! "

This created confusion as no major news station or commentator had reported any "mini-dashes" claim until Trump brought up the issue. The rumor gained more fuel on Tuesday through a headline in the Drudge Report, a conservative news site whose publisher opposes Trump: "Trump denies a mini-stroke took him to the hospital."

Trump countered via Twitter and suggested that Matt Drudge or Biden had suffered strokes: "His report of fake news about mini-strokes is wrong. Possibly think of yourself or the other party's “candidate”. "

White House Doctor Sean P. Conley followed up with a statement that Trump “has not mistakenly experienced or assessed a cerebrovascular accident (stroke), transient ischemic attack (mini-stroke), or acute cardiovascular emergency as in the EU was reported to the media. "

Trump continued to tweet, saying the Walter Reed visit was "to complete my annual physical exertion".

However, this was inconsistent with the government's statement at the time Trump's visit was supposed to begin and not complete his physical. And Pence didn't specifically deny Schmidt's coverage in an interview with Fox News, saying he doesn't remember being put on emergency standby. The net result: many journalists and voters focused again on Trump's health.

Trump has long wondered about his own health and strength. At the end of July, he boasted of his “perfect score” on a cognitive test. He told an interviewer how he successfully remembered a series of words from the start of the exam to the end – "person, woman, man, camera, television".

In recent months, he has also shown his reluctance to wear a face mask amid the pandemic and his willingness to hold personal rallies. The president has repeatedly made fun of Biden for taking advice from public health experts and avoiding personal campaigns for “hiding” in his basement. Trump tried on Wednesday to use a new nickname: "Joe Hiden".

But when it comes to detailed medical information, Trump has provided fewer records than other major presidential candidates, including Biden.

During his campaign in 2015, he did not publish specific health records, but instead issued a letter from his doctor, a gastroenterologist based in Manhattan. It stated, "If he is elected, Mr Trump will, as I can clearly say, be the healthiest person ever elected to the presidency." Dr. Harold Bornstein later told CNN, “He dictated this whole letter. I did not write this letter. "

In 2018, then White House Doctor Ronny Jackson stated in the briefing room that the President was in "excellent" health at 6 feet 3 and 239 pounds. Jackson praised Trump's "great genes" and said "if he had a healthier diet for the past 20 years, he could live to be 200".

Months later, Trump named Jackson Secretary of Veterans Affairs, despite the doctor retiring from the exam and now a Republican candidate for Congress in Texas.

Trump's team went to great lengths to protect his personal medical information. In 2018 – not long after Bornstein acknowledged Trump's longstanding use of baldness treatment – the doctor said his office had been "raided". The President's bodyguard and attorneys stormed in unannounced and left with his medical records. (The White House described the action as a standard requirement for important records.)

In 2008, Biden published 49 pages of records while pursuing the vice presidency. Last December, his campaign published a three-page summary of his medical history, including a doctor's statement that he was a "healthy, vigorous" 77-year-old who was able to take on the role of president.

The abstract showed that Biden had been treated for irregular heartbeat, occasional allergies, and gastroesophageal reflux. The report also said that scans taken when he was 65 showed no permanent damage from brain aneurysms he suffered in his 40s.

The report put the 6 foot tall Biden at 178 pounds and his blood pressure at 128/84. A June report from Trump's doctor said the president weighed 244 pounds. Body mass index charts categorize 6-foot-3-inch men who weigh 240 pounds or more as obese.

But Trump has tried to focus the fitness debate on Biden. Last week, he twice posted a video of Biden's hesitant attempts to round up the death toll from the COVID-19 pandemic. “COVID has lasted more than 100 years this year, exactly since the outbreak. Look, this is life, it's just like that, "Biden says hesitantly in the video that Trump posted. But the clip leaves out the more conclusive ending to Biden's statement: "I mean, think about it: more lives this year than any other year in the last 100 years, more than 180,000 lives in just six months."

On Tuesday, Trump casually claimed that in a somewhat awkward conversation with reporters, Biden "doesn't know he's alive".

Biden campaign spokesman Michael Gwin said Trump's statements showed that he is "an undisputed expert at projecting his own insecurities and weaknesses onto others".

Biden supporters don't hesitate to recall Trump's mistakes when he pronounced the name of one of America's most famous national parks as "Yo-Semite" and Thailand as "Thigh Land". And they distributed videos of the president's preliminary steps on a ramp after speaking at West Point, where he raised a water glass to his mouth with two hands.

Katherine A.S. Sibley, director of the American study program at St. Joseph's University in Philadelphia, said such events should not create liability for Trump unless "it becomes a cumulative thing," adding, "If it is literally there are enough missteps then it could. " become a problem. "

But Trump and his team don't seem afraid to get involved with the health problem. As of July, the campaign's largest television advertising spend in 2020 went to a location where Biden was accused of lacking "the strength, persistence and mental strength to run this country".

Democrats countered with an ad that aired during the Republican National Convention that showed Biden cycling, running, and hurrying his day-to-day business. “Some people are always in a hurry. They run when they can run, run up stairs when others take it slow, "said the ad, switching from footage of a swimming Biden to a shuffling Trump. "If Joe Biden is president, America just has to keep up."

Historian Sibley said Biden had to demonstrate that kind of energy in the last two months of the presidential race.

"It's very important for him to get out of there," said Sibley. “At 77, he has to confirm that he can be out and about to do this very big job. If you get locked away for whatever reason, it will hurt you. "

Olshansky, the longevity researcher, said the aging debate is unlikely to be a brilliant moment for either the incumbent or the challenger.

"The problem for them is that whatever one of them says about the other could also apply to them."

The Times staffer, Melanie Mason, contributed to this report.

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