Biden’s doctor says there are no new concerns with the president’s health and he remains fit to serve

Washington (CNN) — President Joe Biden is fit for duty, his doctor reported Wednesday following the president’s annual physical, in what is expected to be the last update on Biden’s health before November’s election.

Dr. Kevin O’Connor said in a memo there are “no new concerns” with the president’s health revealed by this year’s physical. The White House said earlier Wednesday that no cognitive test was administered as O’Connor did not find it necessary.

“The President feels well and this year’s physical identified no new concerns. He continues to be fit for duty and fully executes all of his responsibilities without any exemptions or accommodations,” O’Connor wrote.

He added, “President Biden is a healthy, active, robust 81-year-old male, who remains fit to successfully execute the duties of the Presidency, to include those as Chief Executive, Head of State and Commander in Chief.”

Now 81, Biden is the oldest president to have held the office. He would be 86 years old at the end of a potential second term.

Biden has been persistently dogged by criticism and concerns over his age and stamina. In a CNN poll conducted by SSRS released earlier this month, 46% of Democrats were concerned about his age. A recent national Quinnipiac University poll found only about one-third of registered voters (35%) say Biden has the requisite physical fitness, while 34% say he has the mental fitness to serve a second term.

During the daily press briefing on Wednesday, White House press secretary Karine Jean-Pierre said Biden’s physician assessed that the president “doesn’t need a cognitive test.” A cognitive test has not been part of a standard presidential physical, but Biden’s predecessor and likely future political opponent, Donald Trump, did take one during at least one of his presidential physicals. If Biden or his doctor had a specific concern, his doctor could perform a brief assessment that might determine whether further evaluation is recommended.

The US Preventive Services Task Force – a group of independent experts whose recommendations guide doctors’ decisions and influence insurance coverage – says there’s insufficient evidence to assess benefits and harms of screening for cognitive impairments in asymptomatic adults 65 and older. It notes that evaluation for cognitive impairment most commonly occurs “as a result of patient- or caregiver-reported concerns or symptoms, or clinician’s suspicion.”

CNN medical analyst Dr. Jonathan Reiner, who was not a part of the team that examined Biden, said it was likely a medically correct decision not to do a cognitive exam but he may have recommended Biden take one anyway.

“If I were the president’s physician, I probably would have pushed to do it because it’s going to stick out like a sore thumb when people like me read this report, with all of the concern about the patient’s age and some of the other issues related to his cognitive capacity going forward,” Reiner said. “From a political standpoint, I probably would have urged them to report that, but that’s certainly a determination made by the patient and political advisors.”

O’Connor’s letter details the specialties of the additional doctors brought in: optometry, dentistry, orthopedics (foot and ankle), orthopedics (spine), physical therapy, neurology, sleep medicine, cardiology, radiology and dermatology. O’Connor also noted in the letter that other physicians in the White House Medical Unit reviewed his report.

“Each of these specialists have independently reviewed the chart, examined the President, and concur with my findings and recommendations,” O’Connor wrote.

The president’s doctor also included details from the president’s physical exam, noting that the president weighs 178 pounds and is 6 feet tall, which is exactly the height and weight recorded in his last physical in February 2023. O’Connor also said the president “continues to work out for at least five days per week.”

Previous exams noted Biden had a stiffened gait caused by “wear and tear” on his spine. The exam on Wednesday noted Biden’s “arthritic changes remain moderate to severe, but still do not result in nerve root compression significant enough that they would warrant any specific treatment.”

Biden recently complained of some left hip soreness, the memo said, “which is most certainly also contributing to his stiffened gait.” While Biden’s gait remains stiff, it has not worsened from last year, the memo said.

An “extremely detailed” neurologic exam found no findings that would be consistent with neurological disorders such as stroke, multiple sclerosis or Parkinson’s disease.

The neurologic exam is an “important piece of information,” Reiner said.

“Potential things that could cause the stiffness of the gait are neurologic conditions that include entities like Parkinson’s disease, or multiple sclerosis, or Lou Gehrig’s disease,” Reiner said. “The neurologic consultants who saw the president do not think any of those are in play. Instead, this is more of a mechanical problem from having degenerative disease of the spine and subsequent stiffness. It speaks to the thoroughness of the exam that they had neurology see him as well.”

While Biden’s age has been among his top political concerns heading into his reelection run, the president treated it with humor on Wednesday, saying his doctors “think I look too young.”

Biden has sought to tackle the age issue head-on recently, such as during a recent news conference, slamming a report from special counsel Robert Hur that said a jury may see him as a “well-meaning, elderly man with a poor memory.”

“I am well-meaning. And I’m an elderly man. And I know what the hell I’m doing. I’ve been president – I put this country back on its feet. I don’t need his recommendation,” a visibly seething Biden said at the time.

At an off-camera fundraiser a few weeks later, however, Biden made a frank acknowledgement about his age, saying “I may not run as fast as I used to.”

“I tell you what: I’ve been around long enough to know what’s going on,” he told a group of donors in Beverly Hills, California. “I’ve been around long enough to hopefully, with age, have a little bit of wisdom about how we can get things done.

Biden has framed his age as a source of wisdom of experience, and earlier this week, he tested a new line of attack against former President Donald Trump during an appearance on NBC’s “Late Night with Seth Meyers,” suggesting that voters should not just consider how old a candidate is, but “how old (their) ideas are.”

Wednesday’s Walter Reed visit marks Biden’s third physical since taking office. O’Connor wrote that many of the health concerns noted last year were stable in this year’s exam.

Biden is being treated for non-valvular atrial fibrillation, or AFib – an irregular heartbeat. O’Connor said Biden still experiences no symptoms from the condition. He also continues to experience “occasional symptoms of gastroesophageal reflux,” namely having to clear his throat often, O’Connor said.

Last summer, the White House said Biden had recently begun using a CPAP – continuous positive airway pressure – machine to treat sleep apnea after the president was seen with indentations from straps on both sides of his face. An official familiar with the matter said Biden began using the device to improve sleep quality. While it was not noted in his publicly released physical, medical records released in 2008 indicated Biden had a recurring issue with sleep apnea.

Sleep apnea is a sleep disorder in which breathing repeatedly stops and starts. About 30 million people in the United States have sleep apnea, but only 6 million are diagnosed with the condition, according to the American Medical Association. A CPAP machine “uses mild air pressure to keep breathing airways open while you sleep,” according to the National Institutes of Health.

In Wednesday’s letter, O’Connor wrote the president “has demonstrated excellent response to PAP and is diligently compliant with therapy.”

Biden was also forced to cancel events on his schedule for one day last June due to an unplanned root canal following pain in a lower premolar. The procedure was “successfully completed” at the White House by a team from Walter Reed, O’Connor said. 

Presidents are under no legal requirement to release information about their health and can choose which details are made public. Reports from the White House physician over the last several decades have consistently described the office-holder as fit to serve.

CNN’s Kevin Liptak and Mira Cheng contributed to this report. 

This story has been updated with additional reporting.

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