If President Joe Biden is to be reelected, then an issues-oriented campaign must be subordinate to one that combats the antipathy directed toward him. A recent New York Times and Siena College poll showed Donald Trump leading Biden in five of the six key swing states, due in part to a negative portrayal of Biden by Republicans as being in cognitive decline.

Cognitive function is a legitimate concern for voters, especially when both presumed presidential candidates are of advanced age, but accusations of impairment are serious and must be supported by medical science not “dirty tricks” politics.

Studies show that Intermittent Explosive Disorder (IED), a mental health condition marked by frequent impulsive anger outbursts, is associated with cognition decline and dementia risk. Donald Trump could be the IED poster person. His uncontrollable angry outbursts, followed by incoherent utterances, not only meet the definition of this anger disorder, they should sound the alarm bell that Trump’s mental health, not Biden’s, is problematic for the electorate (”Political violence threatens to intensify as the 2024 presidential race heats up,” Nov. 18).

— Jim Paladino, Tampa, Florida

Add your voice: Respond to this piece or other Sun content by submitting your own letter.