In a post on Telegram, Medvedev said Biden, who is 80, has been confusing names and dates, gets lost in his office, and keeps secret documents in the garage of his personal home.
The US president "spent more than a hundred billion dollars on a collapsing country unknown to ordinary Americans," he said, referring to Washington's support for Kyiv.
But still, he added, the US blames all its economic problems "on the machinations of Russia."
Medvedev, a former Russian president and prime minister, said Biden "may absentmindedly start a Third World War."
"However, progressive dementia is not an obstacle to being elected president of the United States again," he concluded.
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