Joe Biden 'fit for duty', says doctor after physical and neurological exam

Widespread concerns remain over the age of America's oldest president as he runs for a second term. Biden assures, 'everything's great.'

Washington: President Joe Biden on Wednesday was declared "fit for duty" by his longtime doctor, who said that the president had undergone an "extremely detailed" neurological exam that did not turn up evidence of stroke, neurological disorders or Parkinson's disease.

In a summary of Biden's third presidential physical at Walter Reed National Military Medical Center, Dr. Kevin O'Connor did not say whether the examination contained common tests for assessing cognitive decline or detecting signs of dementia that are often recommended for older adults.

O'Connor said that a team of doctors, including a neurologist, two orthopedists and a physical therapist, examined the president, whom O'Connor described as an "active 81-year-old white male." Earlier in the day, Karine Jean-Pierre, the White House press secretary, declined to give specifics about the tests Biden had undergone but said that the president "doesn't need" a cognitive exam.

Biden, the oldest president in the country's history, is facing widespread concerns over his age as he campaigns for a second term. Earlier this month, he was described in a special counsel report as a "well-meaning, elderly man with a poor memory" -- a characterization the president vehemently opposed.

On Wednesday, Biden answered questions about the results of his exam with a joke.

"They think I look too young," he told reporters during a roundtable with law enforcement officials at the White House. "There is nothing different than last year," he said, adding that "everything's great."

The summary released by O'Connor reflected a lengthy and detailed examination. But the president, his advisers and a team of 20 physicians ultimately declined to provide detailed information about Biden's cognitive abilities. Doctors use their discretion in providing assessment tests, and not all doctors perform them. Physicians often use conversations with patients as a screening device.

"For the physician who interacts with a patient on a regular basis, it is perfectly valid for the physician to say, 'I can assess the mental status on a daily basis,'" Dr. Thomas Wisniewski, director of the Center for Cognitive Neurology at NYU Langone Health, said in a telephone interview. "But not if they see each other once a year."

O'Connor is a retired US Army colonel who began serving as a doctor at the White House in 2006, when President George W. Bush was in office. He was Biden's physician when Biden was serving as vice president, and the president brought him back to the White House in 2021.

In his summary, O'Connor said that the examination of Biden had raised "no new concerns," but he offered updates on several medical conditions he had noted in past reports. Last year, Biden had a cancerous lesion removed from his chest during his physical; on Wednesday, O'Connor noted that no further treatment of that lesion was required.

Biden has obstructive sleep apnea, a common sleeping disorder in which a person's airways become blocked. O'Connor noted that the patient had been "remarkably committed to sticking with therapy" and sleeps nearly every night with a machine that helps his airways clear.

Biden has also become noticeably slower in his movements in recent months, walking stiffly as he makes his way to the podium at appearances and taking the short stairs directly into the belly of Air Force One, rather than the taller stairs to the plane's upper door.

O'Connor noted "moderate to severe spondylosis," or degeneration of the spinal disks, which he attributed to age-related "wear and tear" on the president's spine. The doctor also noted that Biden has peripheral neuropathy, a condition defined by nerve damage, pain and stiffening in the feet.

Last year, O'Connor said the stiffness in Biden's gait was the result of "significant spinal arthritis, mild post-fracture foot arthritis and a mild sensory peripheral neuropathy of the feet," for which the president undergoes physical therapy to maintain flexibility.

Biden's gait is somewhat halting, a characteristic that multiple people close to the White House say is partly because of his refusal to wear an orthopedic boot after sustaining a hairline fracture in his foot before taking office.

This year, Connor said, a spinal examination showed a "mildly decreased range of motion." Biden noted discomfort in his left hip, which O'Connor attributed to "mild arthritic changes." The president's hip pain is "most certainly also contributing to his stiffened gait," and O'Connor said that Biden is undergoing physical therapy and that he performs an intensive stretching program four to five times a week.

Biden weighs 178 pounds with a body mass index of 24.1, according to the White House letter -- the same as last year. His blood pressure was listed as 132/78 with a pulse of 64. O'Connor noted several areas of lentigo, or liver spots, and that Biden had "mildly decreased" hot and cold sensations in his feet. Biden takes apixaban, an anticoagulant medication that reduces the risk of blood clotting but can cause people to bleed and bruise easily.

The president had a total cholesterol level of 122. His high-density lipoprotein level was 45, and his low-density lipoprotein level was 68.

Polling shows that a majority of Americans have concerns about Biden's age and ability to run for a second term. And Biden has made unforced errors at events, including recalling interactions with foreign leaders who would have been dead at the time those interactions took place.

As the presidential election heats up, the president has tried in recent days to assuage concerns over his age by reframing the focus on his likely Republican challenger, former President Donald Trump, who is four years younger and who makes a number of exaggerated or outright false claims at his public appearances.

"You got to take a look at the other guy," Biden said during an appearance this week on "Late Night With Seth Meyers."

"He's about as old as I am, but he can't remember his wife's name," he added, referring to a video in which Trump, 77, appeared to forget the name of his wife, Melania.

Biden, O'Connor noted Wednesday, has been "happily married for 46 years" and works out at least five days a week.