With the United States’ presidential race between a 74-year-old incumbent and a 77-year old-challenger, Americans are starting to weigh the health of both candidates – and it has not been edifying.
While Democrat Joe Biden’s mental dexterity has been under the microscope for some time, Donald Trump is now facing questions.
The President opened the door to increased media scrutiny about his health after tweeting an overly defensive response to concern about his slow descent of a ramp at a West Point graduation ceremony.
Earlier, Mr Trump appeared shaky when drinking a glass of water and slurred his way through the graduation speech, asking many commentators to wonder aloud if the President was sick.
It also prompted a new ad from The Lincoln Project, a lobby group of conservatives and Republicans who oppose Mr Trump’s re-election on the basis that he is an unfit commander in chief.
The renewed speculation on social media under the Twitter hashtag #Trumpisnotwell has clearly grated on the President, who explained that his careful walk down the ramp was due to it being slippery and the need not to fall in front of the media.
The President also raised eyebrows when he said he was taking the malaria drugs hydroxychloroquine and chloroquine as part of his unproven plan to ward off the coronavirus.
He has also staunchly refused to wear a mask when out in public, contrasting his stance with Mr Biden, who has maintained strict isolation and social distancing protocols.
Apart from controversial commentary about the President’s mental health, there has been continuing speculation about Mr Trump’s unscheduled visit to Walter Reed military hospital in November 2019.
The White House said at the time the visit was part of Mr Trump’s routine annual checkup, but reporters claimed it was unusual that the visit happened out of the blue.
In the UK’s Independent newspaper clinical professor of neuropsychiatry at George Washington University School of Medicine James Merikangas was quoted saying he had noticed problems with Mr Trump’s movements.
“My reaction to that was that he’s got a problem with his balance and with his posture,” Dr Merikangas told journalist Andrew Feinberg.
“You’ll notice that when the President sits in his chair, for instance, he doesn’t lean back against the chair – he always is sort of crouching, leaning forward. With his legs spread apart, this abnormal posture is something you see in people who’ve got a neurologic problem, though I can’t say specifically which.
“His problem with balance with his gait is also something that happens with people who have some sort of degenerative brain problem, usually in the frontal lobes of the brain … it certainly is suspicious, the way he was walking.”
Given the power of the presidency, there has been a long history in the US of keeping health issues under wraps.
Famously, 1930s and ’40s president Franklin D Roosevelt was paralysed, but photographers were often stopped from picturing him in a wheelchair, with the result that many Americans were not aware of the severity of his condition.
Along with his wartime back injuries, president John F Kennedy kept a secret that he suffered from Addison’s disease, a life-threatening adrenal gland condition that was exacerbated by stress.
The fear was that opponents would make use of the pair’s conditions to hamper their electability. And it has been no different in recent elections.
Throughout his run for president, Mr Trump made much of his opponent’s health, questioning Hillary Clinton’s stamina after a bout of pneumonia in 2015 and regularly referring to Mr Biden as “sleepy Joe” after his regular verbal slips.
Social media accounts linked to the Trump campaign have recently stepped up their attacks on Mr Biden’s memory lapses.
Mr Trump famously provided only the barest of health details when he was seeking the presidency in 2016, releasing a letter from his personal physician in 2015 to assure the public.
The letter included the line: “If elected, Mr Trump, I can state unequivocally, will be the healthiest individual ever elected to the presidency … His physical strength and stamina are extraordinary”.
With opponents comparing Mr Trump’s appearances on the campaign trail in 2015 to this past week, it seems clear that the presidency has taken a toll – on the nation, if not the man himself.