The Dramatic Way American Presidents Age During Their Presidency

We've all heard the talk and seen the photographic evidence: being President of the United States is a tough job. The stress is almost mind-boggling, and it's tough to imagine if you're not in politics, so let's put it this way. Imagine knowing you have one kid that you'd got to pick up from school, but you've also got to work late, cook something for tomorrow's potluck lunch, mediate a dispute between your neighbors, figure out which bills you're going to pay, talk to the town about fixing the potholes in the roads that gave you yet another flat tire, get in an exercise session, and then visit your cousin in the hospital.

Now, imagine doing that for 330 million people, and that's kind of what it's like to be president.

It's no secret that presidents tend to change a lot in the years between their election and their exit of the White House. Most have more than a few gray hairs, faces are lined, and the stress is clear. Even Stephen King made mention of the phenomenon in The Stand, writing: "We used to watch presidents decay before our very eyes from month to month and even week to week on national TV..." What's going on here? Is it such a dangerous job that it takes a massive physical toll? Let's look at the surprisingly complicated answer, and see just how different some presidents look before and after they held the office.

In 2009, Dr. Michael Roizen of the Cleveland Clinic talked to CNN about the health — and potential aging — that then-President Barack Obama was likely to confront. President Obama was 47-years-old at the time, and while Roizen noted he was "...a fairly young guy and doesn't have great of a risk," he went on to say that "If he's president for eight years, he ends up having the risk of disability or dying, like someone who is 16 years older."

What does that mean? According to Roizen, "The typical person who lives one year ages one year. The typical president ages two years for every year they are in office." Roizen says that he came to that conclusion by collecting and analyzing the public medical records of presidents going back to Theodore Roosevelt. He looked at things like blood pressure and factors like lifestyle choices and levels of exercise, and found plenty of evidence in the physical changes of recent presidents like Ronald Reagan (pictured). Reagan, he says, went from "joking and incredibly quick-witted about current events" to making "jokes... of olden days." Even Bill Clinton — who made it a point to emphasize his youth — left office with white hair and a heavily wrinkled face, after being worn down by the stress and scandals.

That seems logical, based on the way we see presidents change. But other studies suggest there's much more going on here.

Premature aging and a longer-than-normal lifespan seem to be at complete odds with each other, so what's going on here? Olshansky has a few things that might explain it, and it starts with the average age most presidents have been when they enter office. "If you take any 50-year-old man or 40-year-old man and you follow them for four years or eight years, chances are they're going to be losing the hair that they have and in many instances, a significant portion of it will turn gray," he says (via History). "So what we're seeing [...] is really not inconsistent with what we see in any other man [that] age in the US or elsewhere."

And that kind of makes sense. Eight years is a long time, and Olshansky adds that they're also in the public eye day in and day out. They're high-profile, so when they complain about things like back pain it's front-page news even though it happens to literally everyone in the world. He reminds us: "[...] the rest of us experience [these issues] when we grow older as well."

He also says (via the Journal of the American Medical Association) that not only did early presidents have a good chance at living a long life because they'd already survived their most dangerous years, but that presidents also have something important in common: wealth, status, and access to the very best medical care available, no matter what the era.

Some have suggested that along with signs of premature aging come a hidden danger: heart disease. 

In 2019, Bernie Sanders made headlines when — after suffering from what the American Heart Association described as "chest discomfort" — he was taken to the hospital, found to have a blocked artery, and underwent surgery to have several stents implanted. That prompted New York Magazine to take a look at presidents and their history of heart disease. In short? They found a lot. Dwight D. Eisenhower (pictured) had a major heart attack while in office, along with a stroke. LBJ had a heart attack at 47 and several more after he left the presidency — the final one was fatal. Warren G. Harding had his fatal heart attack while in office, and others — like George W. Bush and Bill Clinton — had heart surgeries not long after leaving office. The American College of Cardiology lists even more: Grover Cleveland suffered a fatal heart attack, Calvin Coolidge died of a blood clot in his heart, while William Taft, FDR, Harry Truman, and Gerald Ford were also diagnosed with various types of heart disease.

While not a president, it's worth noting that Dick Cheney had his first heart attack when he was just 37-years-old, and in 2012, he had a heart transplant — all of which suggests there's a greater danger than a few gray hairs lurking in the White House.

In 2015, then-Vice President Joe Biden announced the tragic passing of his son, Beau. Diagnosed with brain cancer two years before, he passed after first being given a clean bill of health, then suffering a relapse. Then-President Obama issued this statement (in part, via The Guardian): "Michelle and I are grieving. Beau Biden was a friend of ours. His beloved family... are friends of ours. And Joe and Jill Biden are as good as friends get."

It's easy to forget that personal lives don't stop when someone steps into the office of president, and in some cases, personal tragedy has compounded the stress of the office. Take Franklin Pierce. According to the BBC, Pierce's 11-year-old son — his only surviving child — was killed in a train derailment just before his inauguration. The loss was devastating: Pierce ultimately spiraled into grief, sought solace in alcohol, and died of liver failure.

Calvin Coolidge (pictured) was in the White House when his 16-year-old son died after a foot infection — caused when he played tennis on the White House courts, without socks — turned into deadly blood poisoning. Coolidge once remarked that, "Whenever I look out of the window, I always see my boy playing tennis on that court there." His behavior grew more and more erratic, and he all but retreated from public life. He later wrote: "I do not know why such a price was exacted for occupying the White House."

When the University of Illinois's Jay Olshansky found that presidents only appeared to age... well, what does that mean, exactly? Basically, as he told CNN: "No one dies from gray hair and wrinkles."

After all, some people start seeing gray hair when they're still in their 20s, and according to what Dr. Jennifer Chwalek told Business Insider, the main thing that determines when and how fast a person's going to go gray is genetics. Now, what does that mean for presidents? Basically, that not only is a short life span not in their future, but that some of the lifestyle choices they make can keep them feeling healthy, even when they're still in a high-stress job. 

Ronan Factora, a Cleveland Clinic specialist in geriatric medicine, told The Denver Post that many recent presidents have opted to take the best medicine there is for combating the effects of stress: exercise. Barack Obama (pictured) was well-known for workouts that included everything from runs on the treadmill to basketball, while some — like Clinton and Carter — stuck to the jogging, and George W. Bush switched to cycling when his knees didn't allow him to run any more. It was 4-mile runs and exercising with the Marines for George HW Bush, and horseback riding for Reagan. It's about more than getting in shape, experts say: it's about increasing blood flow and getting all the benefits — including increased brain activity — that come from that.