President Joe Biden’s cognitive ability regularly makes headlines as the US eyes up a presidential contest between the two of its oldest-ever candidates. With Donald Trump dominating the Republican primaries and making Biden’s faux pas fodder for his dedicated base, all eyes were on Biden’s annual medical check-up. 

President Joe Biden spent about 2 1/2 hours at Walter Reed National Military Medical Center today for an annual physical that will be closely watched as the 81-year-old president seeks reelection.

The oldest president in US history, Biden would be 86 by the end of a second term, should he win one. After his last exam, performed in February 2023, doctors declared Biden “healthy, vigorous” and “fit” to handle his White House duties. But 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.

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

He also joked about his age, gesturing toward the assembled press corps and telling police leaders at the gathering, “They think I look too young.”

Former President Donald Trump, 77, is the favourite to lock up 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 American president to be inaugurated until Biden broke his record by being inaugurated at 78 in 2021.

A recent special counsel’s report on the investigation into Biden’s handling of classified documents repeatedly derided Biden’s memory, calling it “hazy,” “fuzzy,” “faulty,” “poor” and having “significant limitations”. It also noted that Biden could not recall defining milestones in his own life such as when his son Beau died or when he served as vice president.

Still, addressing reporters the evening of the report’s release, Biden said “my memory is fine” and grew visibly angry as he denied forgetting when his son died of brain cancer in 2015 at the age of 46.

White House press secretary Karine Jean-Pierre takes a question from a reporter during a press briefing at the White House. Photo / AP

White House press secretary Karine Jean-Pierre said today that Biden’s physician, Dr. Kevin O’Connor, was one of a team of 20 different medical specialists who helped complete the physical and told her he “was happy with how everything went”. She said O’Connor would release a “robust, comprehensive” memo on the physical later in the day.

Asked why he wasn’t undergoing a cognitive test as part of the physical, Jean-Pierre said that 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, noting that Biden tackled such diverse issues as today’s crime prevention event before his planned trip to the US-Mexico border on Thursday (US-time) and next week’s State of the Union address.

“This is a very rigorous job,” she added, “and the president has been able to do this job every day for the past three years.”

Biden’s last physical showed that the president had a lesion removed from his chest during the previous year, but the results then otherwise largely matched the findings after Biden’s previous exam in November 2021. That report said his occasional coughing was due to acid reflux, while his stiffened gait was the result of spinal arthritis, a previously broken foot and neuropathy in his feet.

President Joe Biden talks with Seth Meyers during a taping of the "Late Night with Seth Meyers". Photo / AP

The White House also announced last summer that Biden had begun using a continuous positive airway pressure, or CPAP, machine at night to help with sleep apnea — which could be reflected in the final report released later today.

The president had a colonoscopy in 2021, in which a 3-millimetre “benign-appearing polyp” was identified and removed.

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

Biden counters that his age brings wisdom, and he has begun to criticise Trump for the former president’s recent public gaffes. Biden joked that his age was classified information and suggested during a taping in New York on Monday of “Late Night With Seth Meyers″ that Trump mistakenly called his wife Melania, “Mercedes” during a weekend speech at the Conservative Political Action Conference — though the Trump campaign says he was correctly referring to political commentator Mercedes Schlapp.

Trump has indeed had his own share of verbal miscues, mixing up the city and state where he was campaigning, calling Hungarian Prime Minister Viktor Orbán the leader of Turkey and repeatedly mispronouncing the militant group Hamas as “hummus.” More recently, he confused his Republican primary rival Nikki Haley with former Democratic House Speaker Nancy Pelosi.

While he was president, Trump’s annual physical in 2019 revealed that he had gained weight and was up to 110.2kg . With his 1.9m frame, that meant Trump’s Body Mass Index was 30.4. An index rating of 30 is the level at which doctors consider someone obese under this commonly used formula.