More than 230 doctors, nurses and health care professionals are calling on former President Donald Trump to release his medical records, arguing that he should be transparent about his health “given his advancing age.”

“Trump is falling concerningly short of any standard of fitness for office and displaying alarming characteristics of declining acuity,” the 238 signatories wrote in a letter dated Oct. 13 and first obtained by CBS News. “In the limited opportunities we can examine his behavior, he’s providing a deeply concerning snapshot.”

The letter was organized by the group “Doctors for Harris,” which is unaffiliated with Vice President Kamala Harris’ campaign. The doctors and nurses note that presidential candidates have traditionally disclosed their medical records, including Arizona Sen. John McCain, who did so during his 2008 presidential campaign. In his 2020 race against President Biden, Trump released results of his physical in the June before Election Day.

The letter noted that absent detailed health records, “we are left to extrapolate from public appearances.”

“As we all age, we lose sharpness and revert to base instincts. We are seeing that from Trump, as he uses his rallies and appearances to ramble, meander, and crudely lash out at his many perceived grievances,” the doctors wrote.

The letter comes as Harris has been putting pressure on Trump to release his medical records, with her campaign viewing their contrast in age as a salient argument. Trump is 78, and Harris turns 60 on Sunday.

Last Friday, Harris released a letter from the physician to the vice president that said she “possesses the physical and mental resiliency” to serve as president. It also detailed specifics about her medical history and vitals, and said her most recent physical was “unremarkable.” 

Harris again called on Trump to release details about his health in an interview released on Monday.

“I put out my medical records. He won’t put out his medical records. And you have to ask, why is this staff doing that? And it may be because they think he’s just not ready, and [is] unfit and unstable and should not have that level of transparency for the American people,” Harris told journalist Roland Martin in an interview for his Black Star Network.

Trump’s campaign responded to Harris’ release last Friday with letters from his personal physician Dr. Ronny Jackson, including one after the assassination attempt at a rally in Butler, Pennsylvania, that said he is in “perfect and excellent health to be Commander in Chief.” The letters do not contain specifics about his health.

If elected, Trump would be the oldest president in history by the end of his term. 

Mark Lopatin, a retired rheumatologist in Pennsylvania who signed the letter, said that he sees Trump as a man “who rambles” and “gets off track.”

“You’re talking about the most powerful man, or female, in the world. You’re talking about a job which is probably more stressful than any other job that I can imagine. The question is, does the person who takes that job have the resources — healthwise, physically, mentally, emotionally — to deal with that?” said Lopatin. “It boils down to transparency and intent and these kinds of things that I see from one candidate and not from another.”

On Monday, Trump called Harris’ mental acuity into question and said she should submit to a cognitive test. “Her actions have led many to believe there could be something very wrong with her,” he wrote in a post on Truth Social. The letter from the vice president’s physician released last Friday said Harris “remains in excellent health.”

Trump had told CBS News in an August interview that he would “gladly” release his medical records to the public and that he “aced” two cognitive tests. Asked Monday if details on those cognitive tests and more recent medical results would be released, Trump’s campaign pointed to their statement last Friday.

Before Mr. Biden dropped out of the race, polls showed doubts from voters about Mr. Biden’s mental and cognitive health. That has flipped since Harris became the nominee. 

A CBS News poll of the “blue wall” states of Michigan, Pennsylvania and Wisconsin in September found that between 64% to 68% of registered voters in those states believed Harris has the mental and cognitive health to serve as president, compared to between 47% and 49% of voters who said the same about Trump.