I think it's an issue. It's not about age. Not all older people lose their mental acuity. But the numerous gaffes point to some serious medical proble, perhaps early Alzheimers.

I have little doubt he has the onset of Alzheimers. Very disconcerting.

He's fit to hang around on a bus tour with his buddies eating cream puffs and telling old stories. He is fit to fly around in his wife's private plane and fritter away his time and pension money playing craps. He is fit to do all of that, but not much more.

The guy is a walking advertisement for retirement. Problem is, he is the Republican nominee and they are willing to put millions and millions of dollars into propping him up so they can continue the destruction of our environment and economy.

McCain is smart enough and ambitious enough (like GW Bush, he has severe Daddy issues) and ruthless enough to lie and cheat his way to power. Once he gets there, he'll be worse than Bush, because McCain has no governor save his own wants and hates. McCain feels his years as a POW entitles him to do whatever he wants whenever he wants and f-you if you don't like it.

Yes there is something medically wrong with him. I think thats why when he released his medical records, they put such tight conditions on seeing them. They dumped 1200 pages of documents and only permitted a few hours to view them all.

McCain seems incapable of complex, abstract thought. A doctor should weigh in on this, but look at how low his good (HDL) cholesterol is, probably related to medication taken to lower his bad (LDL) cholesterol. We need HDL in the brain to mediate those long neuronal connections involved in complex thought. When cholesterol-lowering meds pull it out of the brain (through the blood-brain barrier), mental acuity suffers greatly. Increased permeability of the blood-brain barrier associated with some of the cholesterol meds also result in leakage of foreign materials into the brain, disrupting neuronal activity.

The cholesterol info in McCain's med report gives a solid basis for concerns about his general mental acuity. Remember that his medical records were scheduled to be released a month or so earlier than they were. I think the delay may have been related to the fact that his doctors switched his cholesterol med around that time from one with links to mental confusion to one with fewer reported memory-related problems. His good cholesterol (HDL) was low initially and decreased further under his medical regimen.It could well be that his handlers wanted a little time to pass after discontinuing the cholesterol-lowering drug that was getting so much attention at the time and instead release his medical records without prior notice later when a lot else was going on so they didn't get the kind of scrutiny and coverage they would have gotten had they been released when originally scheduled. I saw no reporting of the cholesterol-confusion issue at the time.

There's a lot at stake for pharmaceutical companies, which have redirected their efforts from less profitable drugs like antibiotics and vaccines that are used infrequently to drugs like cholesterol-lowering meds that are taken daily by millions of people. Media attention to McCain's situation could cause lots of people to reconsider the trade-offs of drugs they take.

Blood-brain barrier permeability works both ways: good things can move out of the brain, while toxins can move in, obstructing normal functioning of synapses. I think McCain could well be experiencing the effects of both processes, to a degree that it would impair Presidential decision-making. Of course he could be experiencing other mental changes as well, related to Alzheimer's other causes of dementia. But something is definitely going on and it's painful to watch. In news clips from 4 years ago, McCain was much sharper.

I agree with other TPM posters who have predicted that this impairment will be acknowledged before November and McCain will be replaced with another Republican candidate, with much less time for vetting.

Given last night's performance, the opposite seems true.

yes i agree. john mccain looked more mentalyy alert than obama. obama appeared as if he were still in vacation mode.

mccain did what every politician needs to do...run the dabate and get out his message. he did just that. he won.

ohh and what i am really confused about is why obama said the most difficult decision was voting for the iraq war? am i wrong but the guy was not even in the senate when the vote took place. talk a bout a senior moment. maybe obama's fried a few brain cells himself. the recent graying out of his hair may be signs he is not holding up to the stress and pressure very well.

Sorry, but George W. Bush sufficiently lowered the bar for intellectual aptitude necessary to hold the office of president. McCain does not seem mentally impaired compared to Bush.

The mental impairment resides in those who think McCain cannot get elected. He can. He managed to steal the show last night. Not bad for a doddering geezer.

I agree. McCain was much more forthright and concise, and stumbled much less over his words than Obama did. It's interesting - Obama is much better than McCain in scripted speeches, but McCain is much better in debates and unrehearsed situations.