‘There’s some serious stuff going on right now.’
Earlier this month, Jackson again questioned Biden’s fitness after the president awkwardly fumbled with notes in his suit jacket pocket to answer a reporter's question on something he was briefed on just moments before during an appearance at a Michigan fruit shop.
'With the most recent hack by the Russians, would you say that this means –' a reporter began asking Biden as he checked out from King Orchards farm store in Central Lake, Michigan on July 3.
The 78-year-old president, however, cut off the reporter, saying US intelligence is not sure if the hack came from the Kremlin.
'We're not sure it's the Russians,' he said.
'I got a brief when I was on the plane. That's why I was late getting off the plane.'
'I'll be in better shape to talk to you about it –' Biden started, then cut himself off.
He then proceeded to awkwardly fumble with the notes in his pocket as he attempted to answer the reporter's question while checking out with the cashier, who asked him to no answer, 'Would you like a receipt?'
'I'll tell you what they sent me,' Biden said, while looking at the paper he pulled from his pocket, not answering the cashier's question.
'The idea – first of all we're not sure who it is for certain, number one. And what I did, I directed the full resources of the government to assist in a response if we determine – what else you need?' Biden said, redirecting his attention to the cashier.
'Oh nothing, you're all set,' she responded.
'I directed the intelligence community to give me a deep dive on what's happened. I'll know better tomorrow,' he said in continuing his response before putting the paper back in his pocket.
The ordeal was clipped by the Republican National Committee Twitter account and reposted by Trump's former White House press secretary Kayleigh McEnany.
Jackson, the Republican from Texas who was elected to Congress after serving as Trump's top White House doctor, said he thinks that Biden should be administered the Montreal Cognitive Assessment (MoCA) to test for memory impairment, dementia, and other possible maladies.
'I think he's demonstrating every single day that there is something going on,' Jackson told Fox News on Saturday.
'You don't need to be a physician to look at this behavior and see there's something concerning happening.
'He's just not aging gracefully at this point.'
Biden, who is known for misspeaking and making verbal gaffes, has had his cognitive fitness questioned after mixing up the names of aides and colleagues while seeming to forget job titles and other details.
During a news conference at last month's G7 summit meeting in the United Kingdom, Biden appeared to mix up Syria and Libya three times.
Jackson said Trump set a precedent when he agreed to undergo the testing. The 45th president was known to give rambling, run-on statements in press interviews that prompted observers to question his cognitive fitness.
'The far left and the mainstream media were demanding that be the new standard for anybody who's going to lead our country and be our Commander-in-Chief and our head of state,' Jackson told Fox News earlier this month.
'I'm just saying I agree with them at this point - we need to get it done.'
He has also mistakenly referred to his vice president, Kamala Harris, as 'President Harris.'
Jackson added: 'You can go back – there's forty years of tape of this man – he's always made gaffes and stuff but these are different, he's confused, he's disoriented,' the congressman said.
'We all know people who are 100-years old, who basically are as sharp as a tack, and we know people who are in their mid-60s that having some cognitive difficulties…and I think he's on that end of the spectrum.'
Last month, the White House said Biden plans to take his annual physical 'later this year.'
The White House has committed to releasing the results of a medical check-up before the end of the year, but officials are generally reluctant to discuss the president's health.
'I'm just asking them, when you do the physical exam include the cognitive assessment,' Jackson said.
'As far as I'm concerned the standard precedent has been set and they need to follow and do the same.'
Jackson was promoted to a White House physician while still deployed in Iraq in 2006.
He's served in three administrations - those of Presidents George W. Bush, Barack Obama and Donald Trump - and held a variety of positions, including the physician supervisor for Camp David, before being promoted to physician to the president under Obama in 2013.
Jackson himself was subject to an Inspector General's report in March that found he engaged in 'inappropriate conduct' involving alcohol use, 'disparaged' and 'belittled' subordinates.
He was Trump's unsuccessful nominee in 2018 to become the Secretary of Veterans Affairs.
The congressman announced last month that he sent Biden a letter urging him to take a cognitive test.
Jackson has been circulating the letter with House colleagues and has been able to get the signatures of 13 GOP lawmakers.
The letter cites the president's 'mental decline and forgetfulness', notes several of his 'gaffes', and urges the White House to publish the test results immediately.
It was addressed to the president, his physician Dr. Kevin O'Connor and Chief Medical Advisor Dr. Anthony Fauci, and called on the Biden to share the results with the country.
'The American people deserve to have absolute confidence in their president,' it read.
'They deserve to know that he or she can perform the duties demanded of the office, and they deserve to have full transparency on the mental state of their highest elected leader.
'I would argue that the American people don't have that confidence in President Biden.'
It goes on to list examples of moments of the president's apparent confusion - forgetting the name of the Defense Secretary, muddling Air Force One with Air Force Two, and apparently forgetting the words to the first line of the Declaration of Independence.
'Just everything that has been going on for the last year and a half … [Biden] doesn't know what's going on, where he's at. He's very confused all the time,' he said in an interview with The Hill.
Jackson was the physician in the Obama and Trump administrations, but has never evaluated Biden.
He was famous for his partisan diagnoses, on one occasion saying that Trump had 'incredibly good genes' and that 'if he had a healthier diet over the last 20 years, he might live to be 200 years old.'
Former President Donald Trump received a perfect score on a standard cognitive assessment test, his doctor revealed in a White House briefing in January 2018.
The 10-minute test, known as the Montreal Cognitive Assessment (MoCA), was created in 1996 for medical professionals to identify mild cognitive dysfunction.
It assesses concentration, attention, memory, language, calculations, orientation, executive functions and visual skills.
Trump scored 30 out of 30. A score above 26 is deemed 'normal,' while anything lower than that is cause for concern.
Those who do well on the test do not need further cognitive examination.
The average score is 27.4. People with mild cognitive impairment score an average of 22.1, while Alzheimer's patients tend to score around 16.
First used in Montreal, Canada, the test is now one of the most respected methods of assessing cognitive health worldwide, available in 55 languages and dialects, and formats for testing illiterate patients and in other cultural settings (by changing certain references).
Trump was the first U.S. president to undergo the test as part of his presidential physical.