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Medical News & Perspectives
Quick Uptakes
September 11, 2019

How Old Is Too Old to Be President?

JAMA. Published online September 11, 2019. doi:10.1001/jama.2019.14329

Plato is quoted as saying that whoever is “of a calm and happy nature will hardly feel the pressure of age…” Easy for Plato to say—he never ran for president of the United States. The current crop of Democratic and Republican 2020 presidential candidates includes 5 who would be aged 70 years or older on inauguration day in January 2021. The pressure-packed life of a US president has raised the question: how much of a factor should age be as voters size up the candidates for next year’s election? A recent white paper from the American Federation for Aging Research explains why age shouldn’t be “a relevant criterion.”

Collecting the Data

In an ideal world, candidates would release their personal medical information for voters to evaluate potential health pitfalls. But that’s unlikely, so the report’s authors used data from the Social Security Administration (SSA) and the National Health Interview Survey (NHIS) to estimate 27 candidates’ life expectancy, healthy life span, disabled life span, and the probability of surviving for 4 years after inauguration day in both 2021 and 2025. The 2017 NHIS data the authors used are based on the white, college-educated population. Disability was defined as needing help with at least 1 activity of daily living such as bathing or dressing.

[Editor’s note: Several candidates left the field after the white paper’s release but are included in the analysis. The numbers and percentages in this article reflect data for the 27 candidates studied unless otherwise indicated.]

“Ecological Fallacy?”

That’s how the white paper describes using generic, population-based life tables like the SSA’s to estimate how long any 1 person in the population will live. But that doesn’t necessarily apply to presidential candidates, the authors contend. Candidates vying for the Oval Office usually are highly educated and financially well off, and they have access to the country’s best health care. After elected, they’ve generally lived longer than other US men who were their same age on inauguration day. In this case, population-based data may actually represent a conservative estimate.

The Numbers
Age

  • The candidates’ average age is 58.4 years. The youngest is South Bend, Indiana, Mayor Pete Buttigieg at 37 years; at age 78 years, Sen Bernie Sanders (I, Vermont) is the oldest candidate still in the running. (Among the candidates who have dropped out is 89-year-old former Sen Mike Gravel [D, Alaska], whose age skews the averages upward.)

  • Seven candidates in the analysis who would be aged 70 years or older on inauguration day 2021 have an average age of 75.6 years. They would have to live to an average age of 81.2 years to reach the end of a first term, or second term in President Donald Trump’s case.

  • On inauguration day 2025, the average age of the remaining 26 candidates would be 63.4 years. Nine of the candidates would be older than 70 years, 3 would be older than 80 years, and 1 would be older than 90 years. They would have to live to an average age of 82.7 years to complete a second term.

Projected Life Span

  • On inauguration day 2021, the candidates’ average projected life span would be 23.1 years. But it would drop by more than half, to 10.7 years, for the 7 who would be older than 70 years. The projected life span for the 7 youngest candidates would be 35 years.

  • By the start of a second term on inauguration day 2025, the candidates’ average projected life span would be 20.5 years. For the 9 who would be 70 years or older, it would be 9.9 years.

Healthy and Disabled Life Span

  • All of the candidates could expect to live another 22.5 years disability free by inauguration day 2021. For most, only the last 6 months to a year of their lives would be spent with a disability. However, the authors noted that as age increases, so does the amount of remaining life span that’s expected to be affected by disability.

  • By the 2025 inauguration, the candidates’ projected disability-free life span will decline by slightly less than 4 years and their expected life span with a disability also will decline slightly because of selective survival to an older age.

Projected Survival Probability

  • If they live to see inauguration day 2021, the candidates have an average 92% likelihood of living until that term ends. For the 7 who would be older than 70 years, the collective probability of surviving until the end of the term is 79.2%.

  • The candidates have an average 89.4% chance of living to the end of a second term that begins in 2025. For 8 of the 9 oldest candidates aged 70 years or older (excluding outlier Gravel), the probability of surviving a second term is 81.4%.

Does Age Matter?

The authors suggested a few age-based considerations that voters might weigh to rule out a candidate for the presidency: an estimated life span shorter than the term in office, less than a 50% chance of surviving the term, and greater than a 50% chance of developing a disability while in office. But according to their analysis, none of the current candidates fit those categories.

“[A]ging often has unpredictable effects on mind and body, but for now, empirically derived forecasts bode well for everyone,” the authors wrote. Although age is an established risk factor for fatal or disabling health conditions, it’s impossible to know how individual candidates will fare over time.

Voters and legal scholars could discuss whether candidates or a sitting president should disclose medical records, the authors noted, but wrote that given the candidates’ favorable health and longevity forecasts, “there is reason to question whether age should be used at all in making judgments about prospective presidential candidates.”

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