By Jason Karlawish
Sept. 16, 2026
As the sweltering heat of summer gives way to the crisp air of autumn, the American political landscape is reaching a fever pitch. With the midterm elections looming on November 3, the national conversation is dominated by the usual heavy hitters: the volatility of the economy, the complexities of healthcare reform, and the perennial friction surrounding immigration policy. Yet, beneath these macro-level issues lies a silent, creeping crisis that remains dangerously misunderstood and improperly addressed.
That issue is dementia.
While 7.1 million Americans are currently navigating the profound challenges of living with dementia, and 12 million family members are shouldering the immense, often invisible burden of caregiving, our political discourse has failed to evolve. Instead of treating cognitive health as a matter of urgent public policy, our leaders—from both sides of the aisle—have chosen to deploy the word "dementia" as a schoolyard taunt. In doing so, they are not only trivializing a devastating medical reality but are also distracting from the structural failures that will soon bring millions of American families to a breaking point.
The Facts: A Silent Crisis at Our Doorstep
Dementia is not merely a "senior issue"; it is a demographic tidal wave that threatens the stability of the American social contract. According to the latest reports from the National Institutes of Health (NIH), the number of people living with neurodegenerative conditions is climbing, and the infrastructure to support them—financially, emotionally, and medically—is woefully inadequate.
The economic ripple effects are staggering. Caregiving involves more than just emotional labor; it is a full-time, often life-altering profession for millions of spouses, children, and friends. The "costs" associated with this work are multifaceted:
- Direct Out-of-Pocket Expenses: Medical bills, specialized care facilities, and home modifications.
- Opportunity Costs: The loss of wages for caregivers who must exit the workforce or reduce their hours to attend to loved ones.
- Mental and Physical Toll: The skyrocketing rates of burnout, depression, and physical decline among family caregivers who lack the institutional support necessary to balance their lives.
Despite these clear, quantifiable metrics, the national political platform remains largely devoid of a substantive strategy to address the looming surge in Alzheimer’s and related dementias. We are staring down a future where the "silver tsunami" will overwhelm our healthcare system, yet our politicians are more interested in questioning their opponent’s cognitive processing speed than in debating the future of long-term care insurance or federal research funding.
Chronology of a Rhetorical Decay
To understand how we arrived at this point of degradation, one must look at the recent history of political rhetoric. The use of cognitive status as a weapon of war did not happen overnight; it is the culmination of years of political polarization.
- The 2022 Precedent: During the 2022 campaign cycle, the term "dementia" began appearing with alarming frequency in viral social media posts and aggressive campaign ads. Candidates were frequently accused of "senility," turning medical diagnoses into political scarlet letters.
- The 2024 General Election: The presidential race of 2024 acted as a catalyst. As political temperatures reached an all-time high, both Democrats and Republicans engaged in a race to the bottom, with both camps accusing the other of suffering from cognitive impairment. This was not a nuanced discussion about presidential fitness or stamina; it was an act of deliberate dehumanization.
- The 2026 Midterm Season: We are now in a phase where this behavior has become normalized. Recent headlines from across the country—including incidents involving high-profile governors and national figures—demonstrate that the "dementia card" is now a staple of the political playbook. Rather than pivoting toward policy, the discourse has solidified into a pattern of name-calling that treats a diagnosis as a punchline.
The Data: Behind the Rhetoric
The disconnect between political rhetoric and scientific reality is vast. When a politician calls an opponent "demented," they are utilizing a medical term as a shorthand for "incompetent" or "weak." This is medically inaccurate and ethically reprehensible.
Dementia is a clinical diagnosis characterized by a decline in cognitive function severe enough to interfere with daily life. It is not a synonym for poor judgment, memory slips, or the natural slowing of processing speed that comes with aging. By conflating the two, politicians are stigmatizing a condition that already suffers from a lack of public understanding.
Furthermore, the data suggests that the burden of this stigma falls heaviest on the families of those suffering from the disease. Research published in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association confirms that the social isolation experienced by patients is exacerbated by the public’s casual, derogatory use of the term. When society treats a medical condition as an insult, patients are less likely to seek early screening, and families are less likely to seek support, fearing the societal shame associated with the label.
Official Responses: The Silence of the Policy Makers
When asked to comment on the usage of these terms, campaign spokespeople often deflect, claiming that voters "deserve to know" about a candidate’s mental acuity. However, this is a hollow defense. There is a profound difference between a legitimate, physician-led evaluation of a public official’s health and the weaponized, non-medical speculation that characterizes modern campaign rhetoric.
Medical experts and advocacy groups, such as the Alzheimer’s Association, have repeatedly issued statements condemning this trend. They argue that:
- Stigma Prevents Care: Public discourse that mocks cognitive decline discourages the millions of Americans who are currently experiencing symptoms from coming forward to see a doctor.
- It Undermines Policy: When the conversation is focused on mocking an opponent, there is no "airtime" left to discuss the bipartisan solutions needed for Medicare expansion, caregiver tax credits, or increased federal research funding for neurodegenerative diseases.
- It Dehumanizes the Vulnerable: Using a condition that strips individuals of their agency as a weapon of political power is a moral failure that trickles down, fostering a culture that views the elderly and the cognitively impaired as burdens rather than as members of our community who deserve dignity and support.
The Implications: A Cost We Cannot Afford
The consequences of this rhetorical war are far-reaching. As we approach November 3, we must recognize that the failure to address dementia as a public health priority is a failure of governance.
If we continue to use dementia as a cudgel, we ensure that the next generation of leadership will remain ill-equipped to handle the demographic reality of an aging America. We are effectively choosing to ignore a looming social crisis in favor of political theatre.
The implications are clear:
- Healthcare Infrastructure: We will continue to lack the beds, home-health workers, and specialized medical facilities required to support the 7.1 million people already living with dementia.
- Economic Stagnation: Without a national policy on caregiving, we will see a continued decline in the labor force participation rate as millions of Americans are forced to leave their jobs to act as full-time caregivers.
- Erosion of Empathy: Perhaps most dangerously, we are eroding the collective empathy required to support the most vulnerable among us. A society that views cognitive decline through a lens of derision is a society that has lost its moral compass.
A Call to Action
The midterm elections are not just about which party controls the House or the Senate; they are a litmus test for our national character. It is time for voters to demand more from their representatives. We must reject the use of medical conditions as political ammunition. We must ask candidates what their specific plans are for supporting caregivers, for funding breakthroughs in research, and for building a healthcare system that treats those with dementia with the respect and urgency they deserve.
The summer is fading, and the political season is burning bright. Let us hope that before the ballots are cast, our leaders find the maturity to stop the name-calling and start the work of governing. The millions of Americans living with dementia—and the millions more who love them—are watching, and they deserve far better than a schoolyard bully.
Jason Karlawish is a professor of medicine, medical ethics, health policy, and neurology at the University of Pennsylvania’s Perelman School of Medicine, co-director of the Penn Memory Center, and executive producer of the "Age of Aging" podcast. He writes "Neurotransmissions," a STAT column about the new era of dementia.
