The House Oversight Committee released a sweeping report on Tuesday finding that senior aides to former President Joe Biden exercised presidential powers without his knowledge or consent, aiding in his signing of executive actions, directing policy, and managing his public appearances as his cognitive decline worsened.

The 90-page report, “The Biden Autopen Presidency: Decline, Delusion, and Deception in the White House,” accuses Biden’s inner circle of running the government in his stead and concealing his medical deterioration through stage-managed appearances and manipulated decision processes. Committee Chairman James Comer (R-KY) said the findings raise “constitutional and criminal concerns” about the validity of executive actions taken between 2021 and the end of his term in office.