Public perception of dementia has emerged as a key factor in the 2024 United States presidential election. The first televised presidential debate (27 June 2024) evoked a groundswell of concern about the neuropsychological health and political viability of President Joseph R. Biden, Jr. A rapid erosion of public support ensued, culminating in the collapse of the reelection campaign the following month. Political attacks on the cognitive fitness of world leaders create dissonance for clinical neuroscientists. We are ethically prohibited from remotely diagnosing public figures. Yet, we are also citizens with the right to feel and express personal concerns. In this commentary, I will address an often-uneasy relationship between politics and neuropsychology with a focus on the history and rationale for ethical guidelines such as the Goldwater Rule. I will also discuss lessons learned from recent events in the 2024 US election cycle about neurological health literacy (e.g. How is dementia diagnosed?) and broader impacts of age-based political attacks on global public health initiatives that target stigma reduction and improved early detection of dementia.