You have given two extreme alternatives. Let's be reasonable. Of course the rich and powerful have access to the finest, must cutting edge, and most expensive life-extension technologies known, including all manner of nutrients and supplements, holistic treatments, and all kinds of physio- psychoactive drugs. Biden, for example, is probably kept stable by physicians and observers round the clock, and they surely adjust his various dosages to accommodate stressful events and workloads followed by recovery periods.