Trump used note cards. So did W. Bush and the presidents before him. Should we worry that Biden uses them, too?

• Donors have expressed concerns with President Joe Biden's reliance on note cards, per Axios.
• They viewed the cheat sheets as another sign of Biden's old age, per the report.
• Presidents have long relied on prepared notes to address their constituents, historian says.

At a recent closed-door fundraiser, President Joe Biden had to rely on note cards prepped by his staff to provide donors with detailed answers on his policy.

This, according to Axios, had some donors concerned: Is Biden's age showing again?

Media gaffes and, more recently, a damning report from special counsel Robert Hur that questioned the president's memory have fueled speculation about Biden's ability to lead at the age of 81 — and for another four years if he is elected in November. Considering that context, sure, the cheat sheets likely don't help.

But since the advent of mass communication technology and, as a result, an increasing expectation of US leaders to make public addresses, presidents have long relied on note cards and teleprompters to face their constituents.

Peter Kastor, a history professor at the Washington University in St. Louis whose research focuses on the American presidency, told Business Insider that he argues this practice began at least a century ago when President Calvin Coolidge made the first presidential broadcast over the radio in 1923, marking the first time an entire nation heard the sound of its president.

"There's a long tradition of presidents doing this, and I would actually argue that it is, in the grand history of the presidency, a relatively recent tradition of presidents finding themselves in front of large audiences — certainly in front of the press — in which they deliver comments," Kastor said.

Even US presidents who had the public reputation of being robust and nimble needed note cards, Kastor said.

John F. Kennedy, who was able to keep his medical problems, including persistent back pain, hidden from the public, used note cards.

And before the teleprompter, presidents such as Woodrow Wilson, John Adams, and Theodore Roosevelt, who was the youngest person to take office at the age of 42, worked off written words on a page, Kastor said.

But Ronald Reagan may serve as the closest parallel in US history to the public scrutiny Biden gets for his cognition, Kastor argued.

"Especially in the final two years of his presidency, there were critics who had regularly observed that it was only because Reagan was a skilled actor and because he had a teleprompter that he was able to communicate effectively," Kastor said. "And there were people saying … get him off the teleprompter, and we know he's not all there."

Reagan, of course, famously announced his diagnosis of Alzheimer's disease several years after he left office.

Presidents from recent US history, including Barack Obama and Donald Trump, are no exception.

David Frum, former President George W. Bush's former speechwriter, recently wrote for The Atlantic about how he often prepared "cheat sheets" for the president, who was 54 when he took office and often flexed his athleticism.

"President Bush had — and has — phenomenal recall of names and faces. Contrary to some negative reports, he had a deep mastery of policy detail. But like everybody in a highly demanding job, sometimes stress and exhaustion overpowered his active mind," Frum wrote, recalling an instance when Bush "blanked" when the president was trying to explain the benefits of cutting top tax rates.

Former President Donald Trump, who is now 77, has received flack for relying on note cards albeit for different reasons.

Shortly after the deadly high school shooting in Parkland, Florida, in 2018, Trump met with survivors of gun violence at the White House during which photographers captured an image of the president's notes.

The note card showed five bullet points instructing Trump on how he could express sympathy and attentiveness to the survivors, including one note that said, "I hear you."

"With Trump, that snapshot was something that, in the moment, was used as evidence that he was callous and uncaring," Kastor said, noting that the image's controversy was less so about the fact that Trump was caught with a physical note card.

Kastor told BI that he wouldn't make any claims on Biden's cognition. However, the conversation around his health and age, he argues, appears to stem from a more recent shift in the public's idea of a US president that has largely been shaped by the three administrations that preceded Trump: the Clinton, W. Bush, and Obama presidencies.

"The three of them together established a certain notion of presidential health that presidents are supposed to be young, fit, outdoorsy, athletic, and physically healthy. They're supposed to speak in a way that suggests this kind of energy of body and mind," Kastor said, noting that all three of them were in the same age bracket when they took office. "When I first started teaching the presidency, my students had spent their entire lives in a world where presidents were young, athletic, and fit."