MAGA says that he had a cane in one hand and a bible in the other, so couldn't shake hands. That suggests he's unable to work out how to manage the cane and bible and remain polite and civilised.

He could have dementia or just be ill-mannered. Either way, he comes across as wooden and arrogant. No smile or personality. I gather that's his son at the edge of the photo. A pretty moronic way to behave and no role model.