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    Spotify’s Daniel Ek Wants to Democratize Full-Body Scans

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    In conversations with colleagues, fellow entrepreneurs and even musicians over the past decade, Daniel Ek would often abruptly shift the subject to something that really bugged him: health care. “I was like adamant to fix it,” Mr. Ek, the Spotify chief, told DealBook. He saw the industry as a bloated and inefficient colossus in need of disrupting.The problem: Mr. Ek had neither a plan, nor the time or money to do much about it. He was busy taking on Apple, YouTube and Amazon Music in the streaming wars. In his spare time, Mr. Ek pored over medical journals. And he routinely measured his vital statistics with a Fitbit, an Apple Watch or Wii Fit tracker — the more data, the better to see how his body held up against the rigors of running a business. He thought that such tracking might hold some clue to living longer and healthier. “I was just toying around with ideas in health care,” he added.That all changed in 2018. Spotify went public, making Mr. Ek a billionaire. It was time to turn his side focus into his next venture, he decided. He knew whom to contact: Hjalmar Nilsonne, a Swedish tech entrepreneur who Mr. Ek had met the year prior at the Brilliant Minds event, an annual gathering Mr. Ek started. Mr. Nilsonne was passionate about upending the status quo, too. At the time, he was focused on climate change and his start-up, Watty, which aimed to strip waste out of the energy grid.At first, Mr. Nilsonne rebuffed Mr. Ek’s proposition. But Mr. Ek eventually won him over. (It helped that Watty was running out of money, and it was eventually sold to a German company.) Mr. Ek, a former computer coder, and Mr. Nilsonne, an engineer, zeroed in on building a better diagnostic tool. Their aim: disease prevention, and prolonging life. The company they founded, Neko Health, opened its doors in Stockholm last year, and it is set to open in London, its second market, this summer.Longevity has become a kind of obsession with tech moguls. Sam Altman, Peter Thiel and Mr. Ek are among those who believe bright ideas, the right tech and bundles of capital can help humans live longer. Mr. Ek, 41, has invested millions personally and through his investment firm, Prima Materia, in such start-ups around Europe. Neko Health is the only one for which he’s taken the title of founder.An exam room at a Neko Health clinic in central Stockholm showing a full-body scan chamber.David B. Torch for The New York TimesWe are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      What Is VO2 Max?

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      VO2 max has become ubiquitous in fitness circles. But what does it measure and how important is it to know yours?Fitness is full of numbers meant to help you become faster and stronger. There’s your mile run time, your resting heart rate and measures of strength and flexibility. But perhaps the gold standard is VO2 max.A handful of years ago, the test — which tracks how much oxygen your body absorbs — was an obscure tool mainly used by elite athletes. Today, it’s touted by fitness professionals and wellness experts like Peter Attia as being a useful measure for all exercisers.But getting an accurate number requires an expensive and exhausting lab evaluation. And estimates provided by wearable devices might not tell you much. So how useful is it to invest time and money in the full work-up, and how important is knowing your VO2 max?For everyday people who want to be healthy and live a long time, the measurement is “the best piece of empirical information we have on health and longevity,” said Kate Baird, a clinical exercise physiologist and the coordinator of running and metabolic services at Hospital for Special Surgery in New York.The key, she said, is acting on what the data tells you.What is VO2 Max?“VO2 max” is a two-digit number that expresses how effectively your body metabolizes oxygen. The measurement itself is the milliliters of oxygen consumed in a minute per kilogram of body weight.As you exercise, your body needs ever more oxygen. The more you can efficiently consume, the more energy your muscles will have, increasing the time and intensity you can exercise. Generally speaking, someone with a higher VO2 max will be able to sustain a run or an aerobic activity at a given pace longer than someone with a lower VO2 max.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      Power of Older Women? Extinct G.O.P. Moderates? It’s Time for the Mailbag.

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      We’re answering reader questions on polling and elections, including the underexplored area of longevity.Women live longer than men on average, meaning they can vote more often on average. Arin Yoon for The New York TimesWatch out: Women outlive menI’m 79, and women my age remember when abortion was illegal. Many of us either had a back-alley abortion, or had friends who had one. We are determined that neither our daughters nor our granddaughters have to experience this. Many of the elderly men I know still vote for Republicans. But watch out: We outlive you! — Mary LeonhardtYou may be partly joking, Mary, but this is probably a minor reason Democrats do a bit better among older voters than people might guess!Why? American women, who tend to support Democrats, live almost six years longer on average than men. Women make up 55 percent of registered voters over age 65 — including 58 percent of those over age 80 — according to data from L2, a political data firm. In comparison, women are 52 percent of registered voters under 65.I know all of this is a little morbid, but longevity strikes me as an underexplored dimension of electoral trends nowadays. We know higher life expectancy is correlated with socioeconomic status and tends to be higher in Democratic-leaning areas. Could this be a factor in why Democrats are performing better among older voters than usually thought? I think so.Are you sure these people exist?“You refer to ‘relatively moderate, highly educated Republicans.’ You could have listed all of them … it wouldn’t have been a long list. — Jeff DavisIt would be a longer list than you might think. More than 20 million people with a college degree voted for Donald J. Trump in 2020. In our last New York Times/Siena College poll, 13 percent of likely Republican primary voters were self-identified moderates or liberals with a college degree.There’s a bigger lesson here: A small percentage of a huge group can still yield a large number of people. To take another example: There are more Republicans in California than in any other state. There are more Republicans in Brooklyn than in Wyoming, the state where Mr. Trump fared best.If not Biden, who?Pundits keep saying people don’t want Biden. Who do they want? — R. GribbonWell, they’re not sure. In an open-ended survey question, no alternative candidate earns any meaningful amount of support from Democratic voters. And I don’t think that’s entirely unreasonable, given there aren’t any mainstream Democrats running against President Biden.To me, the interesting question is whether many of these voters would wind up preferring Mr. Biden if alternatives like Gov. Gretchen Whitmer of Michigan or Gov. Gavin Newsom of California actually ran. It seems quite possible.Just forget about national polling?I find national polling to be particularly misleading. Please focus on state-by-state polling. I’ll be watching PA, WI, MN, GA, AZ, VA, and NV. — Tim OliverI’m sympathetic to the general sentiment here, Tim. Over the years, we’ve done many more Times/Siena polls in the battleground states than nationwide.But I wouldn’t go so far as to say that national polling is misleading. The difference between the national vote and the battleground states isn’t that large — and might even be shrinking.There are advantages to national polling as well. There are more historical questions for comparison. It’s much less expensive than battleground polling: It might take six state polls to get a decent picture. And there are plenty of cases — say, a Republican presidential primary or a battle for control of the House — where the national picture is much more relevant than the core battlegrounds.Polling and nonbinary peopleI was wondering about the inclusivity of the demographic charts. I noticed that the gender category was very binary, with someone only being able to select male or female. Were there any nonbinary people interviewed in this poll, or did someone have to select male or female? As a nonbinary person, I would love to advocate for queer folx to be able to fully participate in these polls. Thank you so much. — Melissa DaileyIt’s worth adding some historical context. First, most pollsters typically asked whether someone was male or female — which is to say someone’s “sex,” not gender. That’s what the Census Bureau does as well, and pollsters generally find it advantageous to have their questions align with the census for comparison or even statistical adjustment. And as someone who loves historical data, I’m also always loath to lose a consistent measurement of something over time.Second, you might be surprised to learn that many telephone pollsters haven’t actually been asking about the sex or gender of respondents. Instead, many have relied on the interviewer to record the respondent’s sex or gender based on voice. That might seem strange, but many respondents find it strange or even offensive to be asked if they’re a man or a woman.Nonetheless, this is an area where survey research is evolving. In the last decade or so, many pollsters have started asking about gender. A smaller number of pollsters have offered respondents options beyond “male” or “female” or “man” or “woman,” though this is complicated in its own right. Respondents could identify in any number of ways, whether as transgender, non-cisgender, nonbinary, gender fluid, queer or something else. They could identify as a “man” or a “woman” to reflect a gender that does not align with the sex they were assigned at birth.There’s another issue with adding small categories: measurement error. If one in every 300 respondents is trolling, or if one in 300 interviewers mistakenly clicks the wrong gender button, this mismeasured 0.3 percent of the sample will have no discernible effect on our results among men and women. But it could make up a huge share of the tiny number of transgender respondents.In our most recent Times/Siena poll, “male” and “female” were the only explicitly listed options when we asked about gender. But if respondents said they identified in some other way, the interviewer would record it. In the end, we had three respondents who said they were transgender or nonbinary. This sample was too small for us to report. I’m not sure whether we — or anyone else — is handling this exactly right; I expect the industry to continue to experiment and evolve.Woe WisconsinI am a Wisconsin voter who is a Democrat. However, we do not have to declare a party. How did you fit that into your analysis? — Nancy EschenburgIf you’re looking for a niche explanation for recent polling errors in Wisconsin, this is an interesting place to start.Unlike with most states, pollsters have very little data on the partisanship of Wisconsin respondents, making it much harder to ensure an unbiased sample.The absence of party registration is the best example, but the issue runs deeper. We don’t have data on whether our respondents participated in a partisan primary (like voting in a Republican presidential race). In most of the states without party registration, this primary participation data is a decent alternative.The results by precinct aren’t very helpful, either. Outside of Madison and Milwaukee, very few voters live in overwhelmingly blue or red precincts. Even the most Republican counties in Wisconsin aren’t so Republican that we can be especially confident that an individual respondent will be a Trump supporter.One of our major goals in recently collecting more data in Wisconsin was to improve our ability to estimate whether someone was a Democrat or a Republican, based on the relatively limited data at our disposal. I wouldn’t say we’ve found anything revolutionary: There’s just no substitute for knowing whether someone is registered as a Democrat or a Republican.Don’t forget ArizonaHere in very hot Arizona we will have some very “hot” political races. Of course we are a critical presidential swing state. Biden vs. Trump (or another Republican) will be very close again.And our U.S. Senate race (with Senator Sinema now an independent) will be fascinating. Ruben Gallego & Kari Lake & perhaps Sinema — that will be very entertaining. And the race will be critical regarding Senate control.So I plead with you to increase your polling in Arizona. We are just as important as other swing states like Wisconsin, Michigan, Pennsylvania and Georgia. — Chris HerstamChris, I think we deserve a little bit of credit! In 2020, Arizona was one of our core six battleground states in Times/Siena polling. We surveyed it five times during the cycle, tied for the most of any state. We surveyed it in 2018 and 2022 as well, something that can be said only of Arizona and Nevada.Heading into 2024, Arizona remains in the top tier. We’ll poll it just as much as Wisconsin, Michigan, Pennsylvania and Georgia.Six kinds of Democrats?Loved your “Six Kinds of Republicans.” Please do the same with Dems. — Walter B. ShurdenI’d like to see the same article written about Democrats … We all know there is a big difference between a conservative Democrat and someone like A.O.C. — Craig WilsonYou’ll most likely have to wait until 2028! In the meantime, consider reading our breakdown of Democratic voters from 2019. There were five types of Democrats in that analysis, based on data from the Hidden Tribes project: progressive activists, traditional liberals, passive liberals, moderates and the politically disengaged.Another option to get you through until the next Democratic primary: Pew Research’s 2021 typology, which identified four Democratic-leaning groups: progressive left, establishment liberals, Democratic mainstays and the outsider left. More

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      What Older Voters Say About Biden 2024: From ‘He’s Fine’ to ‘Oh, God’

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      In interviews, dozens of left-leaning older Americans wrestled with the prospect of a president in his mid-80s, reflecting on their own abilities and changes to their lives — and even their mortality.Over the last three decades, Americans have chosen presidents who felt their pain and channeled their anger, who shattered historical barriers or seemed like enjoyable beer-drinking companions.But if voters often desire leaders who reflect themselves and their struggles, President Biden’s potential bid for a second term, which he would conclude at the age of 86, is prompting exceptionally complicated feelings among one highly engaged constituency: his generational peers.Three years after older voters helped propel Mr. Biden to the Democratic presidential nomination, embracing his deep experience and perceived general-election appeal, his age is his biggest political liability as he moves toward another presidential run, which he could announce as soon as Tuesday. It is a source of mockery and sometimes misinformation on the right — though the now-indicted Donald J. Trump, the Republican presidential poll leader who faces a morass of legal troubles, is just a few years younger — and one of widespread anxiety among Democrats.The issue is particularly personal, however, for older voters who are inclined to like Mr. Biden, but often view his age through the prism of their own experiences.They are aging. He is aging. They are not the president of the United States.Dr. Ruth Westheimer, the sex therapist, encouraged Mr. Biden to run again. But, she said, “one has to know one’s limitations.” Gabby Jones for The New York TimesIn interviews with about three dozen voters, political veterans and prominent Americans between 67 and 98 years old, broaching Mr. Biden’s age prompted not only electoral analysis, but also wide-ranging discussions of their own abilities and adjustments to their lives. Some bluntly wrestled with questions of mortality, and others veered into grandparent mode, admonishing the president to take care of himself.“I’m 72 and I’m a young whippersnapper here in The Villages,” said Diane Foley, the president of The Villages Democratic Club at the Republican-tilted mega-retirement community in Florida, who encouraged Mr. Biden to run again. “There are incredibly energetic, active people well into their 80s, and some 90s.”“One has to know one’s limitations,” advised Dr. Ruth K. Westheimer, 94, the famed sex therapist. She keeps busy these days with a project on the grandparent-grandchild relationship, but prefers to take meetings from home.“I would say the president should run again, but he should also not run up to a podium,” she added. “I don’t want him to fall.”And former Representative Charles B. Rangel of New York, who at 92 has a dark sense of humor about his future — “at my age, I don’t buy green bananas” — signaled that he would support a Biden run. But he is eager for a new generation of leaders.“Maybe I’m feeling so strongly because I’m leaving relatively soon and I want to see what’s going to follow,” Mr. Rangel said in an interview. “I truly believe that we should have more candidates, more than two old white men.”Former Representative Charles B. Rangel of New York, who is 92, said he wanted to see a younger generation step into political leadership. Johnny Milano for The New York TimesParty leaders overwhelmingly plan to support Mr. Biden if he runs. But recent polling has shown that while many Democratic voters rate him favorably, they also have reservations about another bid. An Associated Press/NORC poll released Friday found that poll respondents were concerned about his age.Other surveys found that older Democratic voters were more likely to favor another Biden run than younger Democrats, even as roughly 30 to 50 percent of Democrats over 60 preferred that he step aside.“I can’t go on television and say, ‘Let’s not talk about this, let’s pivot to the real issues,’ because people think age is a real issue,” James Carville, 78, the Democratic strategist, said last month.It was top of mind for several people who milled around a community center recently as a canasta game ended in Plantation, Fla.Doreen W., 78, a Democrat who declined to share her last name on the record, citing fear of causing problems for her husband at work, said she hoped Mr. Biden would run again. But she worried about whether he was up to it.“I know how tiring it is for me, and I’m not doing anything but retire,” she said. “I’m aware of his age and I’m concerned about that.”Informed that Mr. Biden was not 78, as she had thought, but 80, she groaned, “Oh, God.”“If I could just keep him at age 80 and active the way he is, I’d be more than happy,” she said.Nursing a canasta defeat nearby, Jacque Deuser, 67, said the way Mr. Biden sometimes walked reminded her of her late husband, who had dementia.“It kind of looks like he’s going to fall down,” said Ms. Deuser, who voted for Mr. Trump in 2016, backed Mr. Biden in 2020 and is inclined to support him again if Mr. Trump or Gov. Ron DeSantis of Florida win the Republican nomination.Mr. Biden’s doctor recently reported that he was a “healthy, vigorous 80-year-old” fit to serve, while acknowledging that Mr. Biden had a “stiffened gait,” citing factors including arthritis. But the doctor said there were no findings “consistent with any cerebellar or other central neurological disorder.”Mr. Biden works out at least five days a week and does not drink or smoke, and his recent travel, including a covert trip to Ukraine, impressed some of his peers.Mr. Biden made a long trip to Ukraine in February, meeting with President Volodymyr Zelensky in Kyiv.Daniel Berehulak/The New York Times“I don’t know if I could have been on my feet going to Ukraine and taking a 10-hour train ride,” said Peggy Grove, 80, the vice chair of the Pennsylvania Democratic Party. But his public appearances have been uneven. While Mr. Biden has long been gaffe-prone, he has made several striking misstatements as president, and he can sound halting. Moments like a stumble on a stairway or a fall off a bike have attracted attention.“I enjoyed working with him. I watch him from a distance now and I get concerned,” said former Senator Judd Gregg of New Hampshire, a 76-year-old self-described “not a Trumpian” Republican. “He’s lost a little of his sharpness.”The White House did not directly respond to Mr. Gregg.Several voters said Mr. Biden’s running mate would be important — and many Democrats have privately expressed concerns about Vice President Kamala Harris.But while health is unpredictable, some aging experts have said there are signs Mr. Biden could be a “super-ager.”Dr. John W. Rowe, a former president of the International Association of Gerontology and Geriatrics and a professor of health policy and aging at Columbia, said “super-agers” tend to live more of their lives without functional impairment. Dr. Rowe also said age could bring unexpected benefits.Older people, he said, are often better at resolving disputes, and “are less likely to do something imprudent.”“If you have, on the one hand, a super-ager, with no obvious evidence of something bad happening right now, and they bring along these other characteristics, I would feel pretty comfortable for the next four years,” he said, adding that he did not know Mr. Biden.Dr. Rowe, 78, a former head of Aetna, said he, too, had encountered occasional questions about retirement.“I do not feel that I’m functioning any less well than I was a couple years ago,” he said.He stressed that unlike 30-year-olds, older people vary greatly in their abilities.Some Democrats pointed to the differences in aging between Presidents Ronald Reagan and Jimmy Carter.Mr. Reagan, who announced in 1994 that he had Alzheimer’s disease and died a decade later at 93, long faced questions about his cognitive functioning. Mr. Carter — now in hospice care at 98 — remained active until recently.“I just try to always look at the individual, factor in age as one of many considerations,” said Gloria Steinem, the women’s rights activist, 89. “For myself, retrieval time is longer, but the choice of what to retrieve is richer.”As for Mr. Biden, she said, “I feel fine about re-electing President Biden, depending on both the alternatives and his health.”Mr. Biden and his allies stress his legislative accomplishments, including on issues affecting older Americans.Andrew Bates, a White House spokesman, said Mr. Biden had inherited and helped the country overcome “the worst crises in decades,” and was “now bringing manufacturing back from overseas, rebuilding our infrastructure, empowering Medicare to lower drug prices and standing up for the rights and dignity of every American.” He emphasized Mr. Biden’s experience, judgment and values in office.A recent gathering of the Broward Democratic Senior Caucus at a pub in Plantation, Fla. Many attendees said they were unworried about Mr. Biden’s age.Melanie Metz for The New York TimesAt a recent gathering of the Broward Democratic Senior Caucus at a pub in Plantation, attendees dismissed concerns about Mr. Biden’s age.“If his head is working, he’s fine,” Muriel Kirschner, 94, pointedly told a reporter. “My head is still working, honey.”Patti Lynn, who will turn 80 this year, retired after having a heart attack, deciding it was “time to have some fun.” But Ms. Lynn, whose phone background was a picture of herself with Mr. Biden, did not think he should do the same just yet.“Does he stumble and forget and have to get his words? I understand that perfectly,” she laughed. “Been there, done that. Oh well, I’m having a senior moment. But he’s respected worldwide, he is stable.”“How do you put him down — because he is old?” she added. “He worked hard to get that old. Me too. I worked hard to get this old.” More

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      Joe Biden’s Greatest Strength Is Also His Greatest Vulnerability

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      In February 2020, just before the world shut down, I was waiting for Joe Biden to speak on a Friday night in Henderson, Nev. The next morning I watched Bernie Sanders rally a fairly young, largely Latino crowd in a packed Las Vegas high school cafeteria. The Biden event, held when it looked as if he would not win the nomination, was smaller and more subdued. On the other side of a rope separating media from attendees, a group of Biden supporters were talking about how stressful it would be to be president at their and Mr. Biden’s age. As I remember it, one of them said, “But he feels he has to do it.”Not much has changed about the substance of their conversation since then, other than three long years: Mr. Biden, at 80, is the oldest U.S. president ever. If and when he announces a re-election campaign, he will put into play the idea of an even older president, eventually 86 years old. “Is age a positive thing for him? No,” Nancy Pelosi recently told Maureen Dowd, before adding that age is “a relative thing.” For reasons ultimately only Mr. Biden can know, it seems he feels he has to do it.There’s a straightforward dimension to the problem: The effects of age can get beyond your control, and it’d be a safer bet to leave office before the risk probability elevates to a danger zone. Barney Frank decided well in advance that he would retire from Congress at 75, then did so in his early 70s. You could feel that would be the right choice for Mr. Biden or any other leader over a certain age threshold, and be done with this topic. But age and health knot together different contradictions in America. Everything’s so weird now. Tech types, athletes and people of means are spending millions to keep their bodies youthful, and to defeat decline, if not death. We live in this society where people frequently talk about their resentment of older leadership — and elect and re-elect older leaders.Donald Trump would also, were he to win and serve out a second term, turn 82, and you could view the final days of the first Trump White House through this prism. Nearly a quarter of the Congress was over 70 last year, Insider found, up from 8 percent in 2002. Senator Charles Grassley, a Republican and Iowa’s senior senator, won re-election at age 89 last fall. Two of the most powerful and defining congressional leaders of most of our lives — Mitch McConnell and Ms. Pelosi — are in their 80s, and until the recent hockey line change in House leadership, much of the Democratic congressional leadership was over 70. The Treasury secretary is 76. Two Supreme Court justices are in their 70s; in the last decade, death changed the ideological balance of the court.If he runs for this second term, squarely in this space of all these contradictions, Mr. Biden is making the same ask as he did during the 2020 election — to trust him, to trust that he will be proven right about himself. Qualitatively, Mr. Biden represents familiarity and stability, which both derive from his age and sit in uneasy tension with it.Mr. Biden premised his 2020 campaign on his singular ability to win the presidency, when a good number of people in politics and media didn’t think he could win even the nomination. He predicted a level of congressional function that many people found nostalgic to the point of exotic. This skepticism was, on a deep level, about his age and whether his time had passed and whether he was too distant from the political realities of the 2020s. The thing is: Mr. Biden was right before. He did win the nomination. He did win against Donald Trump. The first two years of the Biden presidency did involve a productive and occasionally bipartisan U.S. Congress. On some level, people like me were wrong. This whole presidency originated with Mr. Biden being right about himself, and therefore his age.And maybe he will be right again! That’s a real possibility, under-discussed in these conversations. Age is relative, as Ms. Pelosi said. Medical science keeps improving, and people keep living longer, healthier lives. Presidents can focus on the big picture and delegate the rest. Mr. Biden’s own parents lived to 86 and 92. Having purpose, professional or otherwise, can rejuvenate all our lives. He looked pretty lively during that State of the Union earlier this month, and certainly in Ukraine and Poland.A generation of old men, from Clement Attlee to Konrad Adenauer, rebuilt Europe after the catastrophic 1930s and 1940s, back when people lived much shorter lives. Mr. Adenauer, the first leader of West Germany, actually served until age 87. We haven’t lived through anything like World War II, but as we convulse through two decades of staggering technological change, that might explain the resurgence of some older and familiar leaders over the last decade. Maybe rather than resenting this generational hold on power that Mr. Biden represents, some segment of people is relieved by the continuity that he offers, and by his distance from our daily lives.It’s complicated to leave office when you have real power. If you were Mr. Sanders (81) or Mitt Romney (75), why would you walk away? Mr. Sanders and Mr. Romney retain their essential selves as public figures — they don’t seem especially changed by age. Neither has said whether he’s going to run again. But if they still feel vital and able, and they are in a position of actual agency and responsibility, then it’s hard to see why they should leave public life.The risk, though, registers at a different pitch with the presidency. Even if we’re not expecting the president to catch a bullet in his teeth or something, we have 100 senators and one president. Hundreds of federal judges, and nine Supreme Court justices. Some stuff matters more than others.This was a problem even at the very beginning of the country’s history. During the Constitutional Convention, a proposal arose about how to proceed if the president were unable to serve. According to James Madison’s notes, the delegate John Dickinson asked “What is the extent of the term ‘disability’ & who is to be the judge of it?” Nobody’s ever precisely resolved this dilemma, even with the 25th Amendment.Mr. Biden could be wrong. He could lose the election because of the way voters perceive his age, or he could make it to a second term only to suffer a serious illness in office. Would the country default to a discomfort with visible age and slant one way on Mr. Biden, or take a more nuanced view?In the fall, while thinking over some of these concerns, I saw Senator John Fetterman speak to a large Saturday afternoon crowd in an indoor sports complex in Scranton, Pa. Mr. Fetterman isn’t old — he’s 53 — but he did suffer a stroke and begin recovery while campaigning for office.That day in Scranton, though he moved fluidly and alertly, he struggled some with the cadence of his speech, which was mostly one-liners about Dr. Mehmet Oz. But the event opened up into a gentler moment when he asked, “How many one [sic] of you in your own life have had a serious health challenge? Hands. Personally. Any of you?” Tons of hands went silently up from the synthetic grass. “How many of your parents?” Nearly all the remaining hands went up and stayed up while he ticked off a few other close relations. Though this eventually segued into another joke about Mr. Oz, the silent, serious quality of this call-response was not how the campaign often played online and in the media, where Mr. Fetterman’s condition became a weapon to be bashed over him. The politics of health and age can be brutal.Last week, Mr. Fetterman entered Walter Reed medical center to treat depression. Annie Karni reported that Mr. Fetterman’s recovery has continued to be challenging as he adjusts to new accommodations and limitations. Though he initially faced criticism for not disclosing enough about his condition, over the last several months he has been public about the changes he has gone through and the accommodations he requires, and about depression, something millions of people face but politicians have rarely disclosed.Aging is different than depression or stroke recovery; but like those experiences, there is no shame in aging, and there’s also no suggesting that everything’s easy about it. The choice for Mr. Biden is only an elevated version of the one many people deal with: When will you know it’s time to retire or step back, and when to keep going? All of us are aging, gaining and losing capacities in ways we may not even be aware of.There’s no automatic test that will prove someone is “too old,” and even if there were, nobody would want to take it.You can drive yourself crazy with war games about the ways an election could go. What if Mr. Biden were to run and face a much younger candidate, instead of Mr. Trump? What if he stepped aside in favor of a younger potential successor who then lost to Mr. Trump, invalidating the entire premise of Mr. Biden’s 2020 presidential campaign?All that there is, in the end, is Mr. Biden’s request — to trust that he is right about himself. He’s been right before, and may well be right again. But the reason this question lingers is the unstable ground of the answer: The source of what makes people worry about the president is also the source of his power and appeal.Ms. Miller is a staff writer and editor in Opinion.The Times is committed to publishing a diversity of letters to the editor. We’d like to hear what you think about this or any of our articles. Here are some tips. And here’s our email: letters@nytimes.com.Follow The New York Times Opinion section on Facebook, Twitter (@NYTopinion) and Instagram. More