Opinion | I’m a doctor. Biden’s debate performance led me to a very different takeaway.

Following President Joe Biden’s troubling performance at the presidential debate with Donald Trump, Democrats have been consumed by a frenzied dispute around which candidate should replace Biden on the November 2024 ballot. But I came away from the debate with a different takeaway: How does the United States treat its aging population? Despite advancements in diversity, equity, and inclusion initiatives, ageism remains one of the last socially acceptable prejudices, not so subtly ingrained in our culture, media and institutions.

Age is inescapable. It comes for all of us, if we’re lucky. For those who are not experiencing symptoms of advanced aging themselves, they’re almost surely impacted by an acquaintance or family member who is. Yet as a society we portray aging as something to be feared and avoided, reinforcing negative perceptions that contribute to the marginalization of older adults — including our elected leaders. At the same time, society is pushing to increase longevity and life expectancy, evidenced by an entire industry based on the fallacy that we can stave off age with the right product, practice or diet.

Our treatment of older Americans reflects a dismal reality: We are not prepared for our aging population; the number of people 85 and older is expected to nearly quadruple between 2000 and 2040. By 2034, older adults will outnumber children under the age of 18 in the United States for the first time in history. With this aging come some important societal dilemmas. Older adults have more chronic health needs, are more isolated and are also more likely to work and experience workplace discrimination due to their age. And as we age, we are also leaning on family members for assistance: 1 in 4 family members serve as a caregiver, often unpaid. One in 6 older Americans face hiring discrimination when looking for a job and 2 in 3 face discrimination once hired.

Biden’s symptoms on display during the debate were a medical textbook of common findings for a geriatric population — delayed response time, difficulty finding words and so on. Combine that with little sleep and a viral illness or a cold, anyone over the age of 40 would likely suffer similar symptoms like hoarse voice, slowed reaction time and confusion.

This is not a defense for the debate performance, but simply a reminder that both presidential candidates are, simply put, old. With such age there is an expected degree of possible setbacks; a bad cold, a hip fracture that could turn fatal, a cardiac event that lands you in the hospital. It is completely misguided to also deny our society’s appetite for engaging in both ageism and our own amnesia regarding the effects of age.

Historically, the age of U.S. presidents has been a subject of debate and scrutiny, with concerns often raised about their physical and mental capacity to handle the rigorous demands of the presidency. When Ronald Reagan took office in 1981 at the age of 69, he became the oldest president to be inaugurated at that time. During his second term, which began when he was 73, questions about his age and cognitive abilities intensified. Despite these concerns, Reagan completed his term and left office at 77, setting a record as the oldest president at the end of his tenure.

Since Reagan’s time, the life expectancy for all adults, including white males, has increased several years due to advancements in medical technology, such as innovations in cancer treatment and cardiac drugs, even with Covid-19 causing a setback in life expectancy. In short, we are living longer and longer thanks to science. Having two of the oldest people to date running for presidential office is a sign of success and progress, even with the setbacks it presents.

Which brings us back to the age paradox: Our desire to live longer is difficult to reconcile with society’s treatment of people who manage to do it. Polling data indicates that a majority of voters have reservations about the ability of older candidates to effectively manage the responsibilities of the presidency. For instance, a Pew Research Center survey found that only 3% of Americans believe the best age for a president is in their 70s or older, with the majority preferring candidates in their 50s. The concerns are not unfounded, as cognitive decline can affect decision-making, memory and the ability to handle stress — all critical aspects of presidential responsibility. But it is also true that age brings experience and wisdom, undoubtedly valuable assets in a president.

While debates will always have some element of disagreement, and the recent one is no exception, a conversation about aging need not be yet another thing that divides us. Instead, it is a chance to reflect deeply and show great compassion for our elderly, while also acknowledging that we are intelligent enough to discern between showmanship and substance. Therein lies true common ground.

This article was originally published on MSNBC.com