US President Joe Biden remains "fit for duty" with no new health worries, his doctor said Wednesday after the 81-year-old's last medical ahead of an election in which his age is a key issue.
The keenly awaited annual examination at the Walter Reed military medical center outside Washington came just weeks after a special counsel report that portrayed him as elderly and forgetful.
"He continues to be fit for duty and fully executes all of his responsibilities without any exemptions or accommodations," White House doctor Kevin O'Connor said in a summary.
The only new issue this year was Biden's use of a machine to keep his airways clear at night and reduce sleep disruption, along with an emergency dental procedure, O'Connor said after the examination.
Biden suffers from a range of minor physical issues including a stiff walk due to wear and tear in his spine but there was no significant change in them from last year, the report said.
Biden, who faces a likely rematch with 77-year-old Donald Trump in November, himself joked that the only concern was that doctors "think I look too young."
"Everything's great," he told reporters at the White House.
Biden took a short helicopter ride to the medical center that is often used by US presidents and left after two and a half hours, saluting naval staff and donning sunglasses before leaving in his motorcade.
Press Secretary Karine Jean-Pierre defended Biden not taking a cognitive test, saying it was the assessment of his doctors that the president did not need one.
"The president passes again a cognitive test every day," Jean-Pierre told reporters, citing the domestic and international political issues he dealt with. "This is a very rigorous job."
Biden's routine medical exam comes as voter concerns mount over the age of a leader who would be 86 at the end of a second term in office.
The issue was thrust further into the spotlight by the special counsel report.
It cleared him of illegally retaining classified documents in his home and garage – but said he would come across to a jury as a "well-meaning, elderly man with a poor memory."
Biden launched a fiery counterattack in a press conference at the White House, saying his memory was "fine" and slamming the special counsel for claiming he could not remember when his son Beau died of cancer.
But this week Biden took a more lighthearted tone while trying to deflect the issue back onto his septuagenarian nemesis Trump.
In an interview with late-night TV comic Seth Meyers on Monday, Biden said he was a better bet than "the other guy," who is only four years younger.
In last year's medical exam Biden got a clean bill of health, although he did have a cancerous skin lesion removed from his chest.
Trump routinely depicts Biden as pathetically old, decrepit and unfit for office – despite being nearly the same age and raising eyebrows with a series of verbal gaffes and memory issues of his own.
The real estate tycoon recently confused his rival Republican Nikki Haley with Democratic former House speaker Nancy Pelosi, and said Viktor Orban was president of Turkey, rather than Hungary.
Late last year, Trump released a note from his doctor declaring him to be in "excellent" health, but it was short on details and did not say what tests Trump had undergone when he had a physical in September 2023.
The letter said the results of his cognitive exams were "exceptional" but did not disclose basic information such as Trump's height and weight, cholesterol level or blood pressure.
