Was he drunk? On meds or suffering from a brain seizure? That’s what observers are asking as Joe Biden, who is 76, slurs his way through yet another campaign rally. Only days ago he kicked off his bid to be the oldest president in history.

In 2016 Biden spoke about the two brain surgeries he needed to deal with cranial aneurysms. His candid comments came at the White House National Conference on Mental Health in 2016.

Biden told the White House audience “they take a saw and they cut your head off” and “they literally had to take the top of my head off.” He also recounted that as he was being wheeled into surgery he asked the neurosurgeon, “What are my chances of getting off this table completely normal?” The surgeon told Biden he had a better chance of living—and that that chance was in the 35 to 50 percent range.

Those brain malfunctions may be affecting the Biden who is now 76. His less than impressive speech failed to engross attendees of his rally during his first speech as a presidential candidate. News outlets are saying his age, and possibly brain malfunctions, showed in a very public way and it wasn’t pretty.

The former Vice President, who has joked that he’s a lady’s man, has also undergone extensive cosmetic surgery including Botox injections, repeatedly stumbled and slurred his way through his 27-minute remarks at a campaign stop in Pittsburgh. His almost every sentence was peppered with verbal stumbles.

He opened: “I want to thank Rich Fritzgerald, the county executive for — the baladanny — the Alleghengy County executive for being here.”

“The country wasn’t built by Wall St. bankers, CEOs, and hudge — heh — and hedge fund managers,” Biden stammered during what was supposed to be a headline moment.

At various points he stumbled over words like “dignity,” “successful,” and “hospitals.” Occasionally words were entirely indecipherable.

“Union workers, the UAW took extredable — cuts in their pensions and their future and the less to get GM working,” Biden said.

Observers compare the disturbing episode to recent speeches by Nancy Pelosi, who some say is suffering onset dementia. In addition, Hillary Clinton was seen on video dozens of times stumbling through speeches verbally and stumbling physically giving some cause about her health conditions.