Fact Check

Biden Is the 1st US President To 'Refuse' a Cognitive Test?

On Feb. 28, 2024, the 81-year-old U.S. president completed his annual physical exam as scrutiny concerning his memory intensified.

Published Feb. 29, 2024

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U.S. President Joe Biden is the first president to skip a cognitive test during an annual physical exam.

Biden did not take a cognitive test as a part of his annual physical exam on Feb. 28, 2024. However, presidents are not legally required to take such a test. In fact, no president has publicly acknowledged taking such a test or made the results public except former President Donald Trump.

On Feb. 28, 2024, U.S. President Joe Biden completed a 2.5-hour annual physical examination at Walter Reed Medical Center. In a six-page memo, his physician, Dr. Kevin O'Connor, reported that "President Biden is a healthy, active, robust 81-year-old male, who remains fit to successfully execute the duties of the Presidency, to include those as Chief Executive, Head of State and Commander in Chief."

Reporters and social media users raised questions in the weeks leading up to the physical about whether Biden would take a cognitive test as a part of the exam, and many online posts claimed that he was the first president to "refuse" such a test. This claim is false, and, to provide context, we looked into both whether he skipped the test and whether he was the first president to do so.

Did Biden Take a Cognitive Test?

He did not. Within hours of Biden's physical, White House Press Secretary Karine Jean-Pierre responded to a question about the president taking a cognitive test?as part of the annual exam by saying that Biden "doesn't?need a cognitive test" according to his?doctor?and neurologist?(beginning at 31:13 in the video below):

Jean-Pierre also doubled down on the position she took on Feb. 12, 2024,?when asked a similar question, which was that Biden "proves every day how he operates, how he thinks by dealing with world leaders, by making really difficult decisions on behalf of the American people."

The transcript of the question and Jean-Pierre's answers from Feb. 12 are as follows:

Reporter: Does the White House think that the idea of the president taking a cognition test, a cognitive test, as a part of this physical is a legitimate idea, particularly just on the heels of the special counsel's report, more polling as my colleague Selina just mentioned, showing that many American people have concerns about that?

Jean-Pierre: Look, I got this question last week as well, and I'm just going to say what Dr. O'Connor said to me about a year ago when the report came out last year, obviously, on his physical, which is the president proves every day how he operates, how he thinks, right, by dealing with world leaders, by making really difficult decisions on behalf of the American people whether it's domestic, whether it's national security. And so he shows it every day in how he thinks, how he operates, and so that is how Dr. O'Connor sees it and that's how I'm going to leave it.

Reporter:?What do you think about the idea of taking that kind of a test?

Jean-Pierre: …?I believe you're asking me my personal opinion. He is sharp, he is on top of things, when we have meetings with him, with his staff, he's constantly pushing us trying to get more information, and so that has been my experience with this president. Anything else outside of that I just shared with you what Dr. O'Connor said to me and so I'll just leave it there.

The special counsel's report mentioned by the reporter, released on Feb. 5, 2024, detailed Biden's handling of classified documents. It found that the president's memory was "significantly limited"; he could not recall when he was vice president or, within several years, when his son Beau died.

Biden previously?showed an unwillingness to take a cognitive test. In 2020, when asked about it?by?CBS News correspondent Errol Barnett, Biden stated: "No, I haven't taken a test? Why the hell would I take a test?"

Was Biden the 1st President to Skip the Test?

Several posts on X (formerly Twitter) claimed Biden was the first U.S. president to refuse a cognitive test, a claim that requires context.

A cognitive test designed to detect signs of Alzheimer's is not a legally required element of a president's annual physical. Former President Donald Trump was?the first president to make public his request of one, as well as his results.

The Montreal Cognitive Assessment — the test?taken by Trump in 2018?—?is the most sensitive test available for detecting Alzheimer's disease,?the MoCA Cognition website?claims.?It consists of 30 questions?that include (in Version 8.2 of the test below) labeling drawings of animals and drawing a specific time on a clock.?

(via championsforhealth.com)

Although it is traditional for presidents to have an annual physical exam and release an assessment to the public, it is not legally?required. The choice as to what portions of an assessment to release or whether to release it at all is up to the president and the administration's discretion. However, failing to be transparent about a president's or a presidential candidate's medical information has historically been a matter of controversy, as explained in a 1995 New England Journal of Medicine article.?

When former President Ronald Reagan was diagnosed with Alzheimer's disease in 1994, just five years after leaving the White House, critics accused his physicians of covering up early symptoms. Dr. Lawrence C. Mohr, one of Reagan's doctors, said in a 1997 interview with The New York Times that ''there was never anything that would raise a question about his ability to function as president" and that his ''cognitive function, belief structure, judgment, ability to choose between options, behavior and ability to communicate were totally and completely intact.''

The only law in place to prevent a president with physical or mental conditions rendering him?or her unable to serve from staying in office is the 25th Amendment, which was adopted in 1967 and states that, should a president be "unable to discharge the powers and duties of his office," the vice president would assume the role of presidency.

In summary, posts claiming that Biden "skipped" or "refused" a cognitive test are misleading given that a cognitive test is not required, and it is unclear whether any presidents other than Trump have ever taken such a test.


| About. https://mocacognition.com/about/. Accessed 27 Feb. 2024.

'Biden Angrily Pushes Back at Special Counsel's Report That Questioned His Memory, Handling of Docs'.?AP News, 8 Feb. 2024, https://apnews.com/article/biden-hur-garland-classified-documents-836b99fe9cbef9ba7d32602f4928efec.

'Biden on Cognitive Test: "Why the Hell Would I Take a Test?"'?AP News, 5 Aug. 2020, https://apnews.com/article/election-2020-joe-biden-donald-trump-politics-970ebab7e7a7f848f4153a9282600014.

'Https://Twitter.Com/FinanceLancelot/Status/1757389159348805788'.?X (Formerly Twitter), https://twitter.com/FinanceLancelot/status/1757389159348805788. Accessed 28 Feb. 2024.

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Joe Biden Refuses to Take Cognitive Test at His next Medical Exam.?www.youtube.com, https://www.youtube.com/watch?v=cr61qRl1Gtk. Accessed 28 Feb. 2024.

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Shear, Michael D., et al. 'Trump Has Perfect Cognitive Test Score, White House Physician Says'.?The New York Times, 16 Jan. 2018.?NYTimes.com, https://www.nytimes.com/2018/01/16/us/politics/trump-health-exam-doctor-cognitive-test.html.

'Special Counsel Alleged Biden Couldn't Recall Personal Milestones. His Response: "My Memory Is Fine"'.?AP News, 8 Feb. 2024, https://apnews.com/article/biden-memory-age-special-counsel-report-doj-f4232bc8316e556ed467185b67c3e0a8.

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Taija PerryCook is a Seattle-based journalist who previously worked for?the PNW news site Crosscut and the Jordan Times in Amman.