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U.S. President Joe Biden delivers remarks in the Diplomatic Reception Room of the White House on Feb. 8, in Washington, DC.Nathan Howard/Getty Images

Devastating, discreditable, demeaning and not easily dismissed, a special counsel’s assertion this week that Joe Biden was an “elderly man with a poor memory” has elevated an undercurrent of the American presidential campaign into an unavoidable issue with vast implications.

It raises inescapable questions about the mental acuity of the President, at 81 already the country’s oldest chief executive and whose decades-long proclivity for astonishing gaffes has only deepened since he entered his ninth decade. It provides irresistible, damaging fodder for the campaign of former president Donald Trump.

At the same time, it adds focus to Mr. Trump’s mental slips such as his insistence that former governor Nikki Haley, who has never served in Congress, was responsible for security gaps during the Jan. 6, 2021, riot at the Capitol. It gives credibility to Ms. Haley’s claim that both Mr. Biden and Mr. Trump are too out of touch, and too mentally infirm, to serve as president.

And it shifts remorseless attention to Vice-President Kamala Harris, who would ascend to the presidency if Mr. Biden were deemed medically unfit to conduct the responsibilities of his office. It also raises the stakes of Mr. Trump’s selection of a running mate, who would similarly assume presidential powers if the 77-year-old were elected and rendered incapacitated.

Meanwhile, the conclusions by special counsel Robert Hur prompted questions about whether an attorney with an English literature degree from Harvard and graduate study in philosophy at Cambridge University is qualified to render a diagnosis on the mental fitness of the President.

It also prompts reflection on how politicians regularly cite memory lapses when they would prefer not to answer questions; former mayor Rudy Giuliani, for example, issued 17 variations of “I do not recall” during a 2005 deposition on his crackdown on New York City taxicab drivers.

All the American presidential nominees from George H.W. Bush in 1988 to the two contenders in the 2016 race between Mr. Trump and former secretary of state Hillary Clinton have been fit and fuelled with the “vigor” that John F. Kennedy argued was an essential element of presidential leadership. Mr. Kennedy, though, was sickly, had four back surgeries and suffered from Addison’s disease, a rare but serious disorder of the adrenal glands.

The health and mental-acuity issue first became a public element of American presidential politics when Ronald Reagan, until Mr. Biden the oldest president, faltered during his initial 1984 debate with former vice-president Walter Mondale, then 56 years old.

Mr. Reagan, who after he left the White House acknowledged that he suffered from Alzheimer’s disease, dismissed the concerns by asserting at the next debate, “I am not going to exploit for political purposes my opponent’s youth and inexperience.” It was at that moment, Mr. Mondale said later, that he knew that his campaign was doomed.

And yet presidential health has been an occasional legitimate issue in American politics. Woodrow Wilson suffered a stroke in 1919 and was incapacitated for nearly a year and a half, a period when his wife and close aides secretly conducted the work of the presidency. Dwight Eisenhower’s 1955 heart attack focused fresh attention on his vice-president, Richard Nixon, then only 42 and widely considered intemperate. And Franklin Roosevelt, who successfully minimized the effect of the polio from which he suffered, died of a cerebral hemorrhage shortly after beginning his fourth term.

“One of the most irresponsible things FDR did was to go for that fourth term when he knew he was mortally ill and unlikely to serve out the four years,” said David Kennedy, a Stanford University historian who is an expert on that period. “It was especially irresponsible that he took an oblique interest in the selection of a vice-president when he all but knew that that person would succeed him.”

The persistent concerns about Mr. Biden’s health, physical and mental, puts inevitable attention on Ms. Harris, whom Republicans almost certainly will target in the fall campaign. It would be an offensive with double dividends: a way of exploiting her low ratings – the NBC News Poll released this week showed that a majority of Americans disapprove of her performance in office – while simultaneously being a means of emphasizing the fragility of Mr. Biden’s health.

For his part, Mr. Biden immediately defended his powers of memory, saying of the special counsel, “How in the hell dare he raise that?” and asserting, “I know what the hell I’m doing.” But already the Trump team had pounced on the comments of the special counsel.

It didn’t help Mr. Biden’s case when, in the same appearance, he referred to Abdel Fattah el-Sisi, as the “President of Mexico” instead of the leader of Egypt.

Ms. Haley on Friday said that Mr. Trump “has his own mental deficiencies,” and “would get crushed by a Democrat.”

The context of this development was Mr. Hur’s decision not to pursue legal action against Mr. Biden for possessing government documents, an issue that arose after the disclosure that Mr. Trump had taken top-secret materials when he left the White House and resisted relinquishing them.

Mr. Hur said he declined to press forward with felony charges against Mr. Biden in part because of the difficulty of proving that a man “well into his 80s” was guilty of an act that “requires a mental state of willfulness.”

It was that judgment that Mr. Biden’s team is assailing. Ms. Harris on Friday dismissed the diagnosis as “gratuitous” and said Mr. Hur’s report “could not be more wrong on the facts and clearly politically motivated.” The special counsel was named by U.S. Attorney-General Merrick Garland but was appointed by Mr. Trump in 2018 to be the chief federal prosecutor in Maryland until he resigned in February, 2021.

William Thomas, the gerontologist who co-founded ChangingAging, an effort to address American ageism, said he “put no stock” in Mr. Hur’s assessment.

“This is an opinion by someone who has no basis for making judgments on mental acuity,” he said. “The interview that the special counsel had with the President was not an assessment for drawing that conclusion. I have no basis for disputing the special counsel’s judgment on the documents but he’s not an expert on the mental capacity of another person.”

In coming months, the two campaigns likely will be trading anecdotes about the mental capacity of their rivals.

Mr. Trump – who last month in New Hampshire said, “I think cognitively I’m better than I was 20 years ago” – and his aides are sure to cite the special counsel report. Conversely, Mr. Biden’s team will remind Americans that Mr. Trump warned that the President would lead the country into “World War II,” which began three years before Mr. Biden was born, and that Mr. Trump believed he had defeated Barack Obama, and not Ms. Clinton, for the White House eight years ago.

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