A neurosurgeon diagnoses Joe Biden

Mid-stage Parkinson’s, with dementia

Following my post today, a neurosurgeon and Unreported Truths reader (yes, some of you are actually brain surgeons) wrote in.

For obvious reasons, he did not1 want his name used, but his email and answers to my follow-up question speak for itself. I’d urge you to read to the end, for the prediction he makes.

I simply wanted to give you a thumbs up on your diagnosis of POTUS.

He undoubtedly has Parkinson’s disease, and is increasingly suffering from Parkinson’s dementia.  The signs are unmistakable:

-his shuffling gait
-the absence of associated movements (facial expression, arm swinging). When he does swing his arms, it appears stilted - probably because his handlers have told him to swing his arms when he walks. It’s something we all do naturally, but it goes away in Parkinson’s disease
-gait instability
-soft voice
-ON and OFF periods - times when the medication seems to be working well, and when it isn’t (also explains how a good dose of Sinemet times right could get him more animated
-resting tremor is not prominent in Biden’s case, but this is true of many cases of Parkinsonism

His physicians UNDOUBTEDLY know this, and it is unconscionable that we do not know this about his health record.  I understand HIPAA issues, but this is worse than the Roosevelt secret - he couldn’t walk.  At least he had his mind about him!  Here we have someone with cognitive issues with his hand on the nuclear button.

I followed up with two questions:

1: Parkinson's is generally diagnosed clinically, not from brain scans or blood markers, right? The reason I ask is that if that's the case, his physicians could presumably keep an official diagnosis out of his records while prescribing him medicines for it, I imagine.

2: What is the life expectancy for someone with the symptoms Joe displays (assuming they are being managed to the extent possible, which seems like a fair bet). I know Parkinson's is a slow burn, but it accelerates near the end, right?

—

His answers:

1: Parkinson’s is largely a clinical diagnosis, meaning it is diagnosed from a neurological examination and history.  There are no blood tests.

2: So life expectancy is difficult to predict in Parkinson’s disease.  People can live many years and the disease can accelerate quickly near the end, or progress relatively slowly in its early stages...

My prediction is that the President will have increasing troubles walking over the next six months, eventually needing some sort of assistive device. His dementia will probably advance during that time as well.  We are not seeing the same Joe Biden of even a year ago.

This is obviously an educated guess on my part, but I’ve spoken to many colleagues who feel the same way about his appearance.  His gait and his expressionless face (called a ‘poker face’ in the Parkinson’s literature) are quite classic. (read more)