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I am a doctor. Biden’s debate performance led me to a very different conclusion.

    Following the President Joe Biden's troubling presidential debate performance with Donald Trump has left Democrats consumed by a furious dispute over which candidate should replace Biden on the November 2024 ballot. But I came away from the debate with a different conclusion: How is the United States treating its aging population? Despite strides in diversity, equity, and inclusion initiatives, ageism remains one of the last socially acceptable biases, not-so-subtly embedded in our culture, media, and institutions.

    Age is inevitable. It happens to all of us, if we’re lucky. For those who don’t experience the symptoms of advanced aging themselves, they’re almost certainly influenced by a friend or family member who does. Yet, as a society, we portray aging as something to fear and avoid, reinforcing negative perceptions that contribute to the marginalization of older people—including our elected leaders. At the same time, society is committed to increasing longevity and life expectancy, evidenced by an entire industry built on the misconception that we can stave off old age with the right product, habit, or diet.

    Our treatment of older Americans reflects a bleak reality: We are unprepared for our aging population; the number of people 85 and older is expected to nearly quadruple between 2000 and 2040. By 2034, for the first time in history, older adults in the United States will outnumber children under 18. With this aging comes some significant societal dilemmas. Older adults have more chronic health needs, are more isolated, and are also more likely to be employed and face discrimination in the workplace because of their age. And as we age, we also rely on family members for help: 1 in 4 family members serve as caregivers, often unpaid. 1 in 6 older Americans experience discrimination while seeking employment, and 2 in 3 experience discrimination after they are hired.

    Biden’s symptoms displayed during the debate were a medical textbook of common findings for a geriatric population: slowed reaction time, trouble finding words, and so on. Combine that with little sleep and a viral illness or cold, and anyone over 40 would likely suffer from similar symptoms of hoarseness, slowed reaction time, and confusion.

    This is not a defense of the debate performance, but simply a reminder that both presidential candidates are, simply put, old. With such age comes an expected level of potential adversity; a bad cold, a hip fracture that could be fatal, a heart attack that lands you in the hospital. It is entirely misguided to also deny our society’s appetite for both ageism and our own amnesia regarding the effects of age.

    Historically, the age of American presidents has been a topic of debate and research, with concerns often raised about their physical and mental capacity to handle the rigors of the presidency. When Ronald Reagan In 1981, at age 69, he became the oldest president to be inaugurated. During his second term, which began when he was 73, questions about his age and cognitive abilities increased. Despite these concerns, Reagan completed his term and left office at age 77, setting a record as the oldest president to retire.

    Since the Reagan era, life expectancy for all adults, including white males, has increased by several years due to advances in medical technology, such as innovations in cancer treatment and heart medicine, even as Covid-19 is causing a setback in life expectancy. In short, we are living longer and longer thanks to science. Having two of the oldest people ever running for president is a sign of success and progress, even with the setbacks that come with it.

    Which brings us back to the age paradox: Our desire to live longer is hard to square with the way society treats those who do. Polls show that a majority of voters have reservations about the ability of older candidates to effectively handle the responsibilities of the presidency. A Pew Research Center survey found that only 3 percent of Americans believe the best age for a president is in their 70s or older, with the majority favoring candidates in their 50s. These concerns are not unfounded, as cognitive decline can affect decision-making, memory, and the ability to handle stress—all crucial aspects of presidential responsibility. But it’s also true that age brings experience and wisdom, undoubtedly valuable assets to a president.

    While there will always be an element of disagreement in debates, and the recent debate is no exception, a conversation about aging need not be another thing that divides us. Instead, it is an opportunity to think deeply and show great compassion for our elders, while also recognizing that we are intelligent enough to distinguish between showmanship and substance. Therein lies true common ground.

    This article was originally published on MSNBC.com