“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 took a short helicopter ride to the medical centre that is often used by US presidents and left after just over two and a half hours, saluting naval staff and donning sunglasses before leaving in his motorcade.

The White House said Biden’s long-time doctor Kevin O’Connor was “happy with how everything went”, adding that the assessment had involved a team of 20 doctors.

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 this month when a brutal special counsel report portrayed Biden as elderly and forgetful, giving ammunition to his Republican rivals.

The investigation 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 counter-attack 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 lighter-hearted tone while trying to deflect the issue back onto his septuagenarian nemesis Trump.

In an interview with late-night television comic Seth Meyers on Monday, Biden said he was a better bet than “the other guy”, who is only four years younger.

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.