What was said about Joe Biden's health and 'cognitive decline' in damning report?

A new report examining former US president Joe Biden’s health has raised fresh questions about his fitness for office, alleging that senior aides "exercised the authority of the former president" while masking evidence of his declining mental sharpness.

Published on Tuesday (28 October), the 100-page document, The Biden Autopen Presidency: Decline, Delusion, and Deception in the White House, was produced by the Republican-led House Oversight Committee.

According to the report, committee members interviewed former White House officials about Biden’s condition and the alleged use of an autopen to sign documents in his name. The group also sent a letter to Attorney General Pam Bondi, calling for an official inquiry.

“The cost of the scheme to hide the fallout of President Biden’s diminished physical and mental acuity was great but will likely never be fully calculated,” the document reads. “The cover-up put American national security at risk and the nation’s trust in its leaders in jeopardy.”

The report accuses figures within Biden’s inner circle of orchestrating a “cover-up of the president’s cognitive decline”, focusing particular scrutiny on his physician, Dr Kevin O’Connor. The former president’s doctor invoked his constitutional right against self-incrimination when questioned by investigators.

Two of Biden’s senior aides, Anthony Bernal and Annie Tomasini, reportedly did the same. The committee said that all three “should face further scrutiny” from the Justice Department.

Republican members claimed that O’Connor failed to administer a cognitive assessment to Biden.

"It is shocking that the physician to the president would invoke the Fifth Amendment when asked whether he ever thought the president he served was unfit to execute his duties," the GOP report states.

Former deputy chief of staff Bruce Reed told the panel that colleagues had approached Dr O’Connor to discuss concerns about the president’s wellbeing. He claimed that he "heard Doc O’Connor say [cognitive exams] are meaningless."

The committee’s findings went further, suggesting that “Dr O’Connor’s financial and personal ties to the Biden family demonstrate the incentives he had to conceal President Biden’s deterioration from the American people.”

When questioned about perceptions of Biden’s mental state following the 2024 debate, former aide Steve Ricchetti rejected the idea, telling investigators: “It isn’t how the country perceived it. That just isn’t true.”

The report concludes by asserting that some executive decisions taken during Biden’s presidency – including pardons involving members of his family – should be considered “void”, arguing there is no definitive proof that he personally authorised them.

However, the document does not present concrete evidence to support that claim, relying instead on descriptions of aides’ behaviour to suggest a coordinated “cover-up” of Biden’s age and health concerns.

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