Washington CNN —
President Joe Biden is fit to carry out his duties, his physician said Wednesday after the president’s annual physical, what is expected to be the last update on his health before the November election.
In a memo, Dr. Kevin O’Connor said “there were no new concerns” about the president’s health that emerged from this year’s physical, but the White House said later in the day that a cognitive test had not been performed because Dr. O’Connor did not feel it was necessary.
“The President remains in good health, and his medical examination this year revealed no new issues. The President remains fit to carry out his duties and is performing his full duties without any exemptions or exemptions,” O’Connor wrote.
He added that “President Biden is a healthy, active and robust 81-year-old man who remains physically capable of successfully executing the duties of the Office of the President, including his duties as Executive, Head of State and Commander in Chief.”
At 81, Biden is the oldest person to hold the presidency and will be 86 at the end of his second term.
Biden has been dogged by constant criticism and concerns about his age and physical strength. An SSRS CNN poll released earlier this month found that 46% of Democrats were concerned about Biden’s age. A recent Quinnipiac University national poll found that just a third of registered voters (35%) said Biden has the requisite physical strength, while 34% said he has the requisite mental strength to serve a second term.
White House press secretary Karine Jean-Pierre said at a regular press conference on Wednesday that Biden’s physicians had determined the president “does not need cognitive testing.” Cognitive testing is not part of standard presidential medical exams, but Biden’s predecessor and likely future political opponent, Donald Trump, underwent cognitive testing during at least one medical exam as president. If Biden or his physician have specific concerns, his physician could conduct a brief evaluation to determine whether further testing is needed.
The U.S. Preventive Services Task Force, a group of independent experts who make recommendations that guide doctors’ decisions and influence insurance coverage, says there is insufficient evidence to evaluate the benefits and harms of testing for cognitive impairment in asymptomatic adults over 65. It notes that evaluation for cognitive impairment is most often done “as a result of concerns or symptoms reported by a patient or caregiver, or as a result of a clinician’s suspicion.”
CNN medical analyst Dr. Jonathan Reiner, who was not part of the team that examined Biden, said it was likely the right medical decision not to administer the cognitive testing but that he may have still recommended that Biden get tested.
“If I were the president’s physician, I probably would have pushed for it to be done, because the report would stand out to someone like me when I read it, given the patient’s age and other issues about his future cognitive abilities,” Reiner said. “From a political standpoint, I probably would have urged them to report it, but it’s certainly a decision made by the patient and his political advisers.”
O’Connor’s letter detailed the specialties of the new doctors: optometry, dentistry, orthopedics (foot and ankle), orthopedics (spine), physical therapy, neurology, sleep medicine, cardiology, radiology and dermatology. O’Connor wrote in the letter that other doctors in the White House Medical Unit also reviewed the report.
“Each of these experts independently reviewed the chart, examined the President, and concurred with my findings and recommendations,” O’Connor wrote.
The president’s physician also detailed the president’s physical exam, noting that the president weighs 178 pounds and is six feet tall, the exact same height and weight recorded at his last physical in February 2023. O’Connor also noted that the president “continues to exercise at least five days a week.”
An earlier exam had noted Biden’s gait was stiff due to “wear and tear” in his spine. Wednesday’s exam noted Biden’s “arthritic changes remain moderate to severe, but have not resulted in nerve root compression requiring specialized treatment.”
The memo said Biden has recently complained of pain in his left hip, “which has undoubtedly contributed to the stiffness in his gait.” Biden’s gait remains stiff, but is no worse than it was last year, the memo said.
A “very thorough” neurological examination found no findings consistent with neurological disorders such as stroke, multiple sclerosis or Parkinson’s disease.
A neurological exam is “important information,” Reiner said.
“Possible causes of the stiffness in his gait include neurological disorders such as Parkinson’s disease, multiple sclerosis, and Lou Gehrig’s disease,” Reiner said. “The neurologist who examined the president does not believe any of these are involved. Rather, this is a mechanical issue with degenerative disease of the spine and the resulting stiffness. The fact that a neurologist was also involved indicates that the evaluation was thorough.”
Biden’s age has become one of the biggest political concerns in his reelection bid, but the president addressed it with humor on Wednesday, saying doctors “think I’m too young.”
Biden has attempted to address the issue of his age head on in recent days, blasting special counsel Robert Hur’s report that said jurors may view Biden as “an elderly man with good intentions but limited memory” during a recent press conference.
“I mean well, and I’m an old man, and I know what I’m doing. I served as president, I turned this country around, and I don’t need his endorsement,” a visibly exasperated Biden said at the time.
But at a camera-free fundraiser a few weeks later, Biden candidly acknowledged his age, saying, “I might not be able to run as fast as I used to.”
“Let me be clear, I’ve lived long enough to know what’s going on,” he told a group of donors in Beverly Hills, Calif. “I’ve lived a long time, and with age I suppose there’s a little bit of wisdom to how to get things done.”
Biden has positioned his age as a source of wisdom from experience, and earlier this week he tried out a new attack on former President Donald Trump during an appearance on NBC’s “Late Night with Seth Meyers,” suggesting voters should consider not just a candidate’s age but “how old-fashioned their ideas are.”
Wednesday’s check-up at Walter Reed Hospital will mark Biden’s third physical since taking office, and O’Connor wrote that many of the health concerns flagged up last year have remained stable in tests this year.
Biden is being treated for atrial fibrillation (AFib), an irregular heartbeat. O’Connor said Biden has not yet experienced any symptoms from the disease. He also continues to experience “gastroesophageal reflux symptoms” that require him to frequently clear his throat, she said.
Last summer, the White House announced that Biden had begun using a CPAP machine to treat his sleep apnea after he noticed strap marks on both sides of his face. Officials familiar with the matter said Biden began using the machine to improve the quality of his sleep. Though not listed in his publicly released medical records, medical records released in 2008 show Biden had recurring episodes of sleep apnea.
Sleep apnea is a sleep disorder in which breathing stops and starts repeatedly. According to the American Medical Association, approximately 30 million people in the United States have sleep apnea, but only 6 million are diagnosed with the condition. According to the National Institutes of Health, CPAP devices “use gentle air pressure to keep your breathing airways open while you sleep.”
O’Connor wrote in Wednesday’s letter that the president has “excellently responded to the PAP and is diligently complying with treatment.”
Biden was also forced to cancel a day of planned events last June for an unscheduled root canal procedure for a painful lower bicuspid tooth, which O’Connor said was “successfully completed” at the White House by a team from Walter Reed Hospital.
The president is under no legal obligation to release information about his health and can choose which details to make public, and White House physician reports over the past few decades have consistently said the president is fit to perform his duties.
CNN’s Kevin Liptak and Mila Chen contributed to this report.
This story has been updated with additional reports.