Verbal Gaffe or Sign of Trouble? Mixing Up Names like Biden and Trump Have Done Is Pretty Common

Any parent who's ever called one of their children by the other's name – or even the family pet's name – likely could empathize when President Joe Biden mixed up the names of French leaders Macron and Mitterrand.

The human brain has trouble pulling names out of stuffed memory banks on cue. But when are those and other verbal stumbles normal, and when might they be a sign of cognitive trouble?

"When I see somebody make a flub on TV, I'm really not all that concerned," said well-known aging researcher S. Jay Olshansky of the University of Illinois at Chicago. "What science will tell you about flubs is that they're perfectly normal, and they are exacerbated by stress for sure."

Biden, 81, has a decadeslong history of verbal gaffes. But they're getting new attention after a special counsel this past week decided Biden shouldn't face criminal charges for his handling of classified documents – while describing him as an old man with trouble remembering dates, even the date his son Beau died.

That prompted a visibly angry Biden to lash out from the White House, saying, "My memory is fine." As for his son's 2015 death from brain cancer, "Frankly, when I was asked the question, I thought to myself, it wasn't any of their damn business," Biden said.

Biden is not the only candidate making verbal slips. Former President Donald Trump, Biden's likely opponent in the November presidential election, has also. Last month the 77-year-old Trump confused his major opponent for the GOP nomination, former U.N. Ambassador Nikki Haley, with former House Speaker Nancy Pelosi, D-Calif.

Health experts caution that neither verbal gaffes nor a lawyer's opinions can reveal whether someone is having cognitive trouble. That takes medical testing.

But certain glitches are common at any age.

"To easily recall names, right in the moment, is the hardest thing for us to do accurately," said Dr. Eric Lenze of Washington University in St. Louis, a geriatric psychiatrist who evaluates cognition in older adults.

Some studies have suggested that everyday "misnaming" may occur when the brain has names stored by category – like your family members or perhaps in Biden's case, world leaders he's long known – and grabs the wrong one. Or the miss may be phonetic, as the names of France's current president, Emmanuel Macron, and former President Francois Mitterrand both begin with "M." Mitterrand died in 1996.

As for dates, emotion may tag certain memories but not run-of-the-mill ones, such as the special counsel's questions about when Biden handled a box of documents.

"Attaching a calendar date to an event is not really something that the human brain does at any age," Lenze said. It's "not like a spreadsheet."

Whether it's a name, date or something else, memory also can be affected by stress and distractions – if someone's thinking about more than one thing, Olshansky said. And while everybody's had an "it's on the tip of my tongue" lapse, flubs by presidents, or would-be presidents, tend to be caught on TV.

Olshansky watches recordings of his presentations at science meetings and "there isn't a single time I don't make a mistake," he said. "I'm 69 years old, which I do not consider to be old, but I made the same mistakes when I was 39."

It's reasonable for people to wonder if leaders in their 70s and 80s remain sharp, Lenze said. What's reassuring is if overall, what someone says is overall accurate despite a verbal gaffe.

Some cognitive aging is normal, including delay in memory retrieval. People's brains age differently, and heart health, blood pressure and physical activity play a role in brain health.

And while Trump often brags about passing a screening-style memory test several years ago, Lenze said the best assessment includes rigorous neuropsychological testing.

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