Proposed Legislation Would Mandate Mental Fitness Exams for Older Lawmakers

Aging Leaders and Rising Concerns

The U.S. Congress is getting older. Nearly 120 members are 70 or older, prompting questions about whether cognitive tests should be required for lawmakers. Rep. Marie Gluesenkamp Perez introduced the idea earlier this year, proposing a neutral process to determine if any member suffers from serious cognitive issues. Although the amendment did not pass, many Americans remain uneasy about entrusting major decisions to officials who might face cognitive decline.

Should Lawmakers Face Cognitive Tests?

Cognitive decline often accompanies old age, but the proposed tests aimed to assess process, not age. Supporters argue that such exams could rebuild trust in Congress. Critics worry they could be politically manipulated or clash with constitutional rights.

Many insist voters, not medical exams, should decide who governs. Lawmakers counter that mandatory testing could infringe on privacy. Legally, implementing such a requirement is complicated. The Constitution sets the qualifications for Congress, and new laws cannot override them. A constitutional amendment would be needed—a challenging feat.

Currently, Congress can discipline or expel members for misconduct. However, expulsion requires a two-thirds vote, and incapacity alone rarely triggers action.

How Other Countries Handle Mental Fitness

Globally, cognitive requirements for officials are uncommon. In Singapore, officeholders must be of “sound mind,” though no routine tests exist. Medical panels may intervene if a mental issue arises.

Communist Party leaders undergo internal cognitive and health evaluations, though details are limited. Similarly, Vatican City expects leaders to be of sound mind, and incapacity can disqualify a candidate.

Would Cognitive Tests Be Effective?

Even if Congress required tests, selecting the right tool is tricky. Clinical tools like the MMSE and MoCA were not designed to evaluate a person’s fitness for office. Results can be affected by education, language, and culture.

Set the bar too low, and serious issues may be overlooked. Set it too high, and officials could be wrongly disqualified. Alternatives include greater transparency from candidates about health or testing only when credible concerns arise.

The Bottom Line

Democracy relies on voters to choose leaders. Mandatory cognitive tests remain politically and legally difficult. Still, options exist to boost trust: transparency about officials’ health and fair processes to address serious concerns.

A constitutional amendment would be required for mandatory testing—a rare and difficult path. Meanwhile, hiding cognitive or physical decline becomes harder as symptoms become visible. Public debates, like those involving President Biden and former President Trump, have highlighted these challenges. Sudden changes in an official’s condition can leave voters shaken and disillusioned.

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