Dementia is not an inevitable part of aging

Recent news that Texas Rep. Kay Granger, absent from Washington for months and not voting since July, has been in a Fort Worth senior living facility since July 2024 with “some dementia issues,” sent shock waves across the country and refueled ongoing discussions about the challenges of aging as more and more Americans are living longer.

President Joe Biden’s fitness to hold office due to his age has been questioned by both critics and supporters. Former California Sen. Dianne Feinstein, who reportedly exhibited failing cognitive health for years, faced similar questions before her passing in 2023.

Denial is an understandable human reaction when faced with devastating news. A diagnosis of a dementia-related illness such as Alzheimer’s disease is difficult to both deliver and accept. While Granger had already announced her decision not to seek reelection and relinquished her position as chair of the House Appropriations Committee, being more transparent with her constituents would have facilitated her receiving the understanding, respect, and compassion everyone living with dementia deserves. No one should be stigmatized because they are living with a cognitive impairment.

Her circumstances have also reopened a broader national debate on the health implications of aging, fueling public discussion about a mandatory retirement age for all elected officials or public servants.

What these commentaries reveal is ageism. Defining people based solely on their age rather than their abilities, experience, or contributions to society institutionalizes prejudice and excludes a large and dynamic portion of our population that still has much to offer. It also reinforces the misconception that developing dementia is a normal part of aging and will happen to everyone.

The fact that someone is old enough to have voted in the Kennedy-Nixon election of 1960 does not mean that individual has lost their cognitive standing. The elderly are not a monolith and do not share a common physical or mental state. In fact, the vast majority of older Americans are aging quite well. Health care authorities estimate that only 23% of the nation’s elderly are cognitively impaired.

Requiring sitting public officeholders to relinquish their office based solely on age would create a dangerous precedent, as would mandatory cognitive testing after a certain age as a condition of holding office. One needs to ask who interprets test results, what do political opponents do with that information, and whether any findings that determine cognitive health are protected under existing medical confidentiality laws. Unlike existing minimum age requirements (which vary by political office) designed to ensure elected officials have some degree of life experience before entering office, this would remove them from office solely for having too much of it.

Yes, someone living with dementia will be unable to perform their professional duties at some point during the disease’s progression. They must decide, together with their family and employer, when they’ve reached that point and need to retire. For elected officials entrusted by constituents to cast votes and make decisions impacting their lives and communities, it’s especially important. Making that decision is never easy. It’s unlikely this will be the last time a public official faces such a choice.

The solution to this difficult question should not be to require everyone of a certain age, regardless of their cognitive capabilities, to walk away. Ageism is no solution to eliminating the impact and stigma of dementia.

This guest essay reflects the views of Charles Fuschillo, president and chief executive of the Alzheimer’s Foundation of America.