US PRESIDENT JOE Biden “continues to be fit for duty”, his doctor wrote after conducting an annual medical examination that is being closely watched as the 81-year-old remains committed to seeking re-election in November.

Doubts over Biden’s fitness to continue as president for another four years have grown as November’s election draws closer. The oldest president in US history, Biden would be 86 by the end of a second term, should he win one.

“President Biden is a healthy, active, robust, 81-year-old male who remains fit to successfully execute the duties of the presidency,” his doctor Kevin O’Connor said in a six-page memo on the president’s health, following a physical that lasted more than two and a half hours.

His memo added that Biden “feels well and this year’s physical identifies no new concerns”.

Dr O’Connor wrote that the president is adjusting well to a new device that helps control his sleep apnoea and has experienced some hip discomfort but also works out five times per week.

Biden’s latest physical mirrored one he had in February last year when Dr O’Connor described Biden as “healthy, vigorous” and “fit” to handle his White House duties.

Still, voters are approaching this year’s election with misgivings about Biden’s age, having scrutinised his gaffes, his coughing, his slow walking and even a tumble off his bicycle.

His mental fitness was called into question recently after a special counsel report advised that he not be prosecuted for mishandling classified documents while he was vice-president because a jury would see him as “a sympathetic, well-meaning, elderly man with a poor memory”. 

That report also noted that Mr Biden could not recall defining milestones in his own life such as when his son Beau died or when he served as vice president.

White House press secretary Karine Jean-Pierre said that Dr O’Connor was one of a team of 20 different medical specialists who helped complete the physical.

Asked why Biden was not undergoing a cognitive test as part of the physical, Jean-Pierre said that Dr O’Connor and Biden’s neurologist “don’t believe he needs one”.

“He passes a cognitive test every day, every day as he moves from one topic to another topic, understanding the granular level of these topics,” Jean-Pierre said.

“This is a very rigorous job,” she added.

After the medical examination yesterday, Biden returned to the White House and attended an event on combating crime and suggested that when it came to his health “everything is squared away” and “there is nothing different than last year”.

He also joked about his age and people thinking “I look too young”.

Former president Donald Trump, 77, is the favourite to win the Republican nomination later this month, which would bring him closer to a November rematch against Biden.

Trump was 70 when he took office in 2017, which made him the oldest US president to be inaugurated, until Biden broke his record when he was inaugurated at the age of 78 in 2021.

Dr O’Connor’s report said that Biden’s stiff walking was no worse than last year and was the result of arthritic changes in his spine. He said the president also noted “some increased left hip discomfort”.

There were no signs of stroke, multiple sclerosis, Parkinson’s or other similar conditions in what the report called an “extremely detailed neurologic exam.”

Last summer, Biden began using a continuous positive airway pressure, or CPAP, machine at night to help with sleep apnoea, and Dr O’Connor wrote that the president had responded well to that treatment and is “diligently compliant” about using it.

Many Americans, including Democrats, have expressed reservations about Biden seeking a second term during this autumn’s election. Only 37% of Democrats say Biden should pursue re-election, down from 52% before the 2022 midterm elections, according to a poll from The Associated Press-NORC Centre for Public Affairs Research.

Biden counters that his age brings wisdom, and he has begun to criticise Trump for the former president’s own recent public gaffes.

With reporting from Press Association.