WASHINGTON — When President Biden leaves Tuesday night for a four-day swing through the Middle East, he will presumably be more rested than he would have been had he followed the original plan.
The trip was initially tacked onto another journey last month to Europe, which would have made for an arduous 10-day overseas trek until it became clear to Mr. Biden’s team that such extended travel might be unnecessarily taxing for a 79-year-old president, or “crazy,” as one official put it.
Aides also cited political and diplomatic reasons to reorganize the extra stops as a separate trip weeks later. But the reality is that managing the schedule of the oldest president in American history presents distinct challenges. And as Mr. Biden insists he plans to run for a second term, his age has increasingly become an uncomfortable issue for him, his team and his party.
Just a year and a half into his first term, Mr. Biden is already more than a year older than Ronald Reagan was at the end of two terms. If he mounts another campaign in 2024, Mr. Biden would be asking the country to elect a leader who would be 86 at the end of his tenure, testing the outer boundaries of age and the presidency. Polls show many Americans consider Mr. Biden too old, and some Democratic strategists do not think he should run again.
It is, unsurprisingly, a sensitive topic in the West Wing. In interviews, some sanctioned by the White House and some not, more than a dozen current and former senior officials and advisers uniformly reported that Mr. Biden remained intellectually engaged, asking smart questions at meetings, grilling aides on points of dispute, calling them late at night, picking out that weak point on Page 14 of a memo and rewriting speeches like his abortion remarks on Friday right up until the last minute.
But they acknowledged Mr. Biden looks older than just a few years ago, a political liability that cannot be solved by traditional White House stratagems like staff shake-ups or new communications plans. His energy level, while impressive for a man of his age, is not what it was, and some aides quietly watch out for him. He often shuffles when he walks, and aides worry he will trip on a wire. He stumbles over words during public events, and they hold their breath to see if he makes it to the end without a gaffe.
Although White House officials insist they make no special accommodations the way Reagan’s team did, privately they try to guard Mr. Biden’s weekends in Delaware as much as possible. He is generally a five- or five-and-a-half-day-a-week president, although he is called at any hour regardless of the day as needed. He stays out of public view at night and has taken part in fewer than half as many news conferences or interviews as recent predecessors.
When Mr. Biden fell while dismounting a bicycle last month, White House officials ruefully noticed that it was among the top stories of the week — never mind that the president works out five mornings a week, often with a physical trainer, or that many men his age hardly ride bikes anymore.
Mr. Biden himself has said questions about his fitness are reasonable to ask even as he reassures Americans that he is in good shape. Even for some admirers, though, the question is whether that will last six more years.
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“I do feel it’s inappropriate to seek that office after you’re 80 or in your 80s,” said David Gergen, a top adviser to four presidents. “I have just turned 80 and I have found over the last two or three years I think it would have been unwise for me to try to run any organization. You’re not quite as sharp as you once were.”
Everyone ages differently, of course, and some experts put Mr. Biden in a category of “super-agers” who remain unusually fit as they advance in years.
“Right now, there’s no evidence that the age of Biden should matter one ounce,” said S. Jay Olshansky, a longevity specialist at the University of Illinois Chicago who studied the candidates’ ages in 2020. “If people don’t like his policies, they don’t like what he says, that’s fine, they can vote for someone else. But it’s got nothing to do with how old he is.”
Still, Professor Olshansky said it was legitimate to wonder if that would remain so at 86. “That’s the right question to be asking,” he said. “You can’t sugarcoat aging. Things go wrong as we get older and the risks rise the older we get.”
The White House rejected the idea that Mr. Biden was anything other than a seven-day commander in chief. “President Biden works every day and because chief executives can perform their duties from anywhere in the world, it has long been common for them to spend weekends away from the White House,” Andrew Bates, a deputy press secretary, said after this article was published online.
The president’s medical report in November indicated he had atrial fibrillation but that it was stable and asymptomatic. Mr. Biden’s “ambulatory gait is perceptibly stiffer and less fluid than it was a year or so ago,” the report said, and gastroesophageal reflux causes him to cough and clear his throat, symptoms that “certainly seem to be more frequent and more pronounced.”
But overall, Dr. Kevin C. O’Connor, the president’s physician, pronounced him “a healthy, vigorous 78-year-old male who is fit to successfully execute the duties of the presidency.”
Questions about Mr. Biden’s fitness have nonetheless taken a toll on his public standing. In a June survey by Harvard’s Center for American Political Studies and the Harris Poll, 64 percent of voters believed he was showing that he is too old to be president, including 60 percent of respondents 65 or older.
Mr. Biden’s public appearances have fueled that perception. His speeches can be flat and listless. He sometimes loses his train of thought, has trouble summoning names or appears momentarily confused. More than once, he has promoted Vice President Kamala Harris, calling her “President Harris.” Mr. Biden, who overcame a childhood stutter, stumbles over words like “kleptocracy.” He has said Iranian when he meant Ukrainian and several times called Senator Mark Warner, Democrat of Virginia, “John,” confusing him with the late Republican senator of that name from Virginia.
Republicans and conservative media gleefully highlight such moments, posting viral videos, sometimes exaggerated or distorted to make Mr. Biden look even worse. But the White House has had to walk back some of his ad-libbed comments, such as when he vowed a military response if China attacks Taiwan or declared that President Vladimir V. Putin “cannot remain in power” in Russia.
Mr. Biden was famously prone to gaffes even as a younger man, and aides point to his marathon meetings with families of mass shooting victims or his working the rope line during a trip to Cleveland this past week as evidence of stamina.
Mike Donilon, a senior adviser who began working for Mr. Biden some 40 years ago, said he did not see any change. “On the way back from long trips when the staff is wiped out, he’ll want to spend four hours planning for how we hit the ground running on domestic policy, when all much younger staff want to do is sleep,” he said.
Mr. Biden is not the first president to confront questions of age. The issue came up repeatedly under President Donald J. Trump, who is four years younger. Mr. Trump’s diminished vocabulary, tendency to meander, sometimes incoherent remarks, light office schedule and struggles to process information led critics to conclude that he was in decline.
Until now, the oldest president was Reagan. When a poor debate performance in 1984 briefly threatened his re-election, he recovered in his next encounter by joking that he would not exploit “my opponent’s youth and inexperience.”
“Reagan understood this issue, both intuitively and he had thought it through,” said the biographer Lou Cannon. “And he told me, ‘Age will be an issue if I act old and it won’t if I don’t.’”
By Reagan’s final years, a new set of aides secretly assessed whether he might have to be removed from office under the 25th Amendment’s disability clause, but ultimately concluded he was still fit. (Five years after leaving the White House, he was diagnosed with Alzheimer’s disease.)
Still, aides tried to limit his schedule, monitored sharply by the first lady, Nancy Reagan. “That’s one of the first lessons we had, to not overschedule,” recalled Tom Griscom, one of those aides. Nor should they send excessive briefing papers at night. “After a couple weeks,” he said, “a message came back down from Mrs. Reagan asking us not to send so much up in the evening because he would read it all,” staying up late.
Mr. Biden’s advisers say he resists such management and pushes in the other direction. “He’s driving additions to his schedule all the time, whether it’s new C.E.O. calls or night meetings with members,” said Jennifer O’Malley Dillon, the deputy chief of staff who oversees his calendar.
But aides are cautious about exposing him to the coronavirus. Aides are tested once a week and wear colored wristbands on the day of their test; if they plan to attend a meeting with the president on another day, then they must test that morning, too, and wear N95 masks.
The White House seems equally determined to guard Mr. Biden against unscripted interactions with the news media. He has held just 16 news conferences since taking office, less than half as many as Mr. Trump, Barack Obama and George W. Bush had by this stage and less than a third as many as Bill Clinton and George H.W. Bush, according to Martha Joynt Kumar, a longtime scholar of presidential media strategy.
Likewise, Mr. Biden has given just 38 interviews, far fewer than Mr. Trump (116), Mr. Obama (198), the younger Mr. Bush (71), Mr. Clinton (75) and the older Mr. Bush (86). Mr. Biden has been more accessible taking a few questions informally after a speech or other event, which he has done 290 times, compared with 213 by Mr. Trump and 64 by Mr. Obama.
During his European trip last month, foreign leaders followed his lead while protectively treating him like a distinguished elderly relative. At a photo opportunity, Chancellor Olaf Scholz of Germany gently pointed Mr. Biden in the direction of the cameras. Just before a meeting, a reporter twice shouted a question about getting grain out of Ukraine. When Mr. Biden could not hear the question, Boris Johnson, the British prime minister, rescued him. “We’re working on it,” Mr. Johnson responded.
At times, Mr. Biden kept a packed schedule. On the day he flew to Madrid for a NATO summit, he met with multiple leaders and finished with a dinner hosted by King Felipe VI and Queen Letizia of Spain. On another day, though, he skipped evening festivities with other leaders, and his public schedule finished with a 3:30 p.m. event.
But aides said he was busy and stayed up working late each night of the trip out of view — just as they say they expect him to in the coming week as he hits the road again in Israel and Saudi Arabia.
Jim Tankersley, Michael D. Shear and Katie Benner contributed reporting.