The hair is no whiter, the girth, perhaps, no wider. But the Boris Yeltsin who is trying to lead Russia out of its latest crisis is not the same man who led his country triumphantly out of the communist past.
By nearly all accounts, Russia's president moves more slowly and appears to think less clearly than he did just a few years ago - changes that might not be unusual in a 67-year-old man but that could have profound implications for his country.To be sure, Yeltsin is still very much in charge of a government that concentrates enormous power in the hands of the president. Under a constitution he rammed into law in 1993, parliament is more of an advisory body than a true partner in government.
He has even seemed energized at times in recent weeks as he battled with parliament over his choice for prime minister. The president settled on a compromise candidate, Yevgeny Primakov, who is a year older than Yeltsin and also has suffered serious health problems in recent years.
With two years left in his term, Yeltsin remains a masterful political tactician. But he is a man whose health and mental acuity are almost certainly diminished.
The change seems so marked that Russians and Westerners alike are starting to make a comparison that would have been unthinkable not long ago. They say Yeltsin reminds them of the late Soviet leader Leonid Brezhnev, whose last years in office were a painful parody of leadership.
Alexander Bovin, former Russian ambassador to Israel, was recently quoted by a newspaper as saying Yeltsin is a lot like Brezhnev in his "middle period," when the Soviet leader was marked by a "slow gait, stateliness, somewhat royal appearance, sometimes not fully articulated speech."
One difference, Bovin said, is that Yeltsin seems to be "more cloistered and cut off from objective information and the people than Brezhnev was."
Those are harsh words, given Brezhnev's reputation, which can be summed up in the name given his tenure, from 1964-82: the Era of Stagnation.
"The late Brezhnev, the late Yeltsin - they're much the same," said Marshall Goldman, a Russian scholar at Harvard. "Look at a video of (Yeltsin) in August 1991 and look at the difference in behavior today."
That August, Yeltsin, then the president of the Russian republic of the Soviet Union, became an international hero when he clambered atop a T-72 tank and defied a coup attempt against Soviet leader Mikhail Gorbachev.
He was a strapping, vigorous man, quick on his feet both physically and mentally, whose seemingly spontaneous action and words stirred a nation to resist a return to totalitarianism.
Today, Yeltsin often seems sluggish. His face frequently appears puffy. Even after a month of vacation this summer, he had bags under his eyes and appeared tired.
His physical health has been a concern for some time. Yeltsin was suffering from heart disease during the 1996 presidential election and had a heart attack, followed by multiple bypass surgery, in the months after his victory.
Of equal concern these days is his mental agility.
For all the concern, Yeltsin remains a formidable politician with remarkable survival skills.
Grigory Yavlinsky, a former Yeltsin aide who now leads the social democratic party Yabloko, says he has a stock answer for anyone who doubts Yeltsin's staying power: "He will catch a cold at your funeral."