Look at the video comparing Mr. Bush from 1994 to 2004. Ignore the commentary for now, but notice the obvious deterioration in his speaking skills.
According to Mr. Bush's official medical record that is made public, he takes no medication except vitamins and has no major illnesses or diagnoses. Absent, however, is any mention of a cognitive or psychiatric evaluation.
Cognitive dysfunction can occur gradually over many years and can be due to any of several factors including but not limited to infections, atherosclerosis, tumors, neuronal degeneration, substance abuse and trauma. Previous presidents, most notably Ronald Reagan and Woodrow Wilson, suffered catastrophic brain syndromes that very likely started while serving as president, and in both cases the country was put in unknown jeopardy due to a lack of judgment by its chief executive. Nixon reportedly used psychotropic drugs while in the latter days of his aborted term.
President Bush has admitted to heavy alcohol abuse as a younger man, as well as a de facto admisssion of cocaine use, both of which can cause cerebral damage. Also, Bush has been diagnosed with Lyme disease which can also have neurologic sequelae. Even without these risk factors, a high ranking official such as the US president surely warrants some evaluation from time to time.
One difference today is that scientific advances have benefited the diagnosis of mental and cognitive impairment, and also the stigma attached to such maladies has been decreasing. Neuropsychiatric evaluations are commonplace and specialists are available with objective tests that can provide insight into the extent and cause of cognitive impairment.
Why is this important? For obvious reasons the nation's well-being is contingent on having capable people at the helm. The US Constitution provides for a succession plan when the president is not able to perform his duties, and these judgments should not be left to spouses and White House staffers. Some conjecture recently surrounds Bush's conspicuous absence from the Republican Convention as possibly due to his failing mental status, which thus fueled conjecture that the speech was pre-recorded.
A reasonable approach would be to have every president and vice-president undergo a formal neuropsychiatric evaluation upon taking office and then have it repeated every 24 months or upon request of both houses of Congress. Those results should be made available to the ranking members of the Congress for action as necessary.
The planet is becoming a more complex theater of activity and the US presidency is arguably the single most powerful office in the world. We cannot afford to allow mental impairment jeopardize our well-being or the safety of the world.
I don't know if Bush is demented, but I do know that it should be considered. And we have a right and duty to know... especially if we are planning to elect septuagenarians on a regular basis.
My hunch is that Bush just isn't right. I'd also wager that, as in the case of Ronald Reagan, an announcement is made in the coming years regarding the impaired mental status of George W. Bush.