Haley’s mental competency tests could rock Washington — but would be hard to implement

Former Ambassador Nikki Haley’s presidential campaign proposal to impose mental competency tests for politicians aged 75 and older has reignited debates about how to decide who is fit to lead.

It puts the spotlight on calls for generational change sure to be front and center during the 2024 campaign cycle and on battles over whether those calls constitute a form of ageism. 

(AP Photo/Charlie Neibergall, File)

The proposal was a dig at President Biden, who will be 82 by the time of the next presidential inauguration — though former President Trump would be 78 — but it would also have implications for the rest of Washington, where nearly 10 percent of Congress is at least 75 years old.

That includes some of the top leaders and decision-makers in both parties.

Psychiatric and aging experts warn that it would be difficult to create and implement a fair and effective test to measure politicians’ mental competency, and drawing a line in the sand at age 75 to require such a test doesn’t necessarily make sense. 

Photo by: Greg Nash

“I’ve encountered individuals in their 80s, 90s or hundreds, who are much more mentally flexible and aware of current world events and the interaction of such things than are some of the 20- and 30- and 40-year-olds that I’ve worked with,” said Dr. Bennett Blum, an expert in mental capacity and legal issues affecting the elderly.

The proposal from Haley, 51, has been met with some sharp criticism from those who would be subject to it. 

Sen. Bernie Sanders (I-Vt.), 81, pushed back on the idea on CBS’s “Face the Nation” last week, calling it “absurd” and ageist. Haley fired back by tweeting that is “exactly what a career politician and socialist would say,” charging that the “Washington establishment is afraid of the people finding out some of our leaders aren’t fit to serve.”

Annabelle Gordon

Trump, for his part, expressed support for the idea, writing on his website Truth Social that “ANYBODY running for the Office of President of the United States should agree to take a full & complete Mental Competency Test.”

The age of Congress

(AP Photo/Patrick Semansky)

An NBC News analysis of data from the @unitedstates Project found that the average age of members of Congress has steadily climbed since the 1980s. 

In the 118th Congress that started in January, the average age in the Senate is 63.9 years and 57.5 years in the House. Right now, 16 Senators and 36 members of the House are 75 or older.

Some of those individuals have powerful positions. House Minority Leader Mitch McConnell (R-Ky.) is 81. Senate Democratic Whip Dick Durbin (D-Ill.) is 78. House Appropriations Committee Chair Kay Granger (R-Texas) is 80, and the committee’s Ranking Member Rosa DeLauro (D-Conn.) is 79.

Photo by: Greg Nash

Until they stepped down at the end of the last cycle, House Democrats long-time leaders — former Speaker Nancy Pelosi (D-Calif.) and former House Majority Leader Steny Hoyer (D-Md.) — were both over the age of 80.

Several news articles have questioned the mental fitness of 89-year-old Sen. Dianne Feinstein (D-Calif.), who is not running for reelection in 2024, with reports of memory lapses. 

Photo by: Annabelle Gordon

Shortly after she announced her retirement, she appeared momentarily confused when a reporter asked her about the decision.

Feinstein has defended her mental fitness.

“I meet regularly with leaders. I’m not isolated. I see people. My attendance is good. I put in the hours. We represent a huge state. And so I’m rather puzzled by all of this,” Feinstein told the San Francisco Chronicle’s editorial board last year.

Calls for generational change 

It’s common for younger candidates to argue that it’s time for older leaders to pass the torch to a new generation. And imposing an upper age limit on politicians is popular among voters.

An August 2022 CBS/YouGov survey found 73 percent support among U.S. adults for imposing a maximum age limit on elected officials. And a November 2022 Reuters/Ipsos poll found 67 percent of Americans said that there should be upper-age limits on the president and members of Congress.

It is not unheard of to require age limits on public officials. Most states set mandatory retirement ages for judges.

But opponents of age limits argue that it can take years to develop the type of institutional knowledge and relationships that allow them to most effectively work for their constituents.

And the public’s opinions on the matter are also complex. The Reuters/Ipsos poll found 55 percent support for allowing lawmakers to stay in office as long as they are in good health, regardless of age, and 61 percent said older leaders should not be discounted just because of their age.

Measuring mental competency can be difficult

Dr. Tracey Gendron, Chair for the Virginia Commonwealth University Department of Gerontology and the Executive Director of the Virginia Center on Aging, said age alone is not a good predictor of health or ability.

“Aging is not a homogenous, linear experience; there are no milestones or expectations to make comparisons. Sweeping, blanket statements about using age as a barometer for ability is dangerous and misguided,” Gendron said.

(AP Photo/ Evan Vucci)

Gendon said that “crystallized” intelligence or ability, representing cumulative skills and memories, continues to improve well into later in life. “Fluid” intelligence, the ability to process new information, is known as to decline with age, but that perceived reduction “dissipates or disappears when attentional factors like concentration or perceptual speed are considered.”

But even if every politician were required to take a cognitive test regardless of age, it would be difficult to come up with a metric to assess those abilities.

“Our society would have to figure out what specific cognitive abilities are required, what specific knowledge levels required, what specific ability regarding emotional control is required. And those have not been enumerated,” said Blum.

Press releases from the Haley campaign point to the Montreal Cognitive Assessment, or MoCA, a brief screening tool used when screening for cognitive impairment related to Parkinson’s disease, dementia, Alzheimer’s, and other conditions. Trump boasted in 2020 that he “aced” that cognitive screening.

But that test, experts said, can give false positives or negatives, and would likely require further testing.

“It looks at different cognitive domains. It looks at your attention and concentration, executive function, or the more complex problem solving ability, memory, language, looks at visual spatial skills, calculations,” psychiatrist Karen Reimers said.

“It doesn’t tell you things that might be really pertinent for somebody’s ability to function. As a politician, you know, things like age-associated experience or wisdom can be very important,” Reimers said.

Blum called Haley’s assessment suggestion “a blatant negation of anything that involves sophistication, or understanding of context, or of treating adults as adults.”

(AP Photo/Carolyn Kaster, File)

“Our societal system has built into it the … ability to look at a person’s behavior and render an opinion as to whether that person is fit to be in the position that they are in,” Blum said. “And I think that’s a good method. It’s different than giving someone some type of a test so that you get a numeric score … But it’s a much more sophisticated nuanced method of evaluating people that we entrust with power at any level that comes with power and responsibility, that takes into account much more than any simple test ever could.”