BETHESDA, Md.- President Biden “continues to be fit for duty,” his doctor wrote Wednesday after conducting an annual physical that was closely watched as the president seeks re-election.

“President Biden is a healthy, active, robust, 81-year-old male who remains fit to successfully execute the duties of the presidency,” Dr. Kevin O’Connor wrote in a six-page memo on the president’s health, following a physical that took President Biden to Walter Reed National Military Medical Center for more than 2½ hours.

The memo added that President Biden, “feels well and this year’s physical identifies no new concerns.”

The oldest president in U.S. history, President Biden would be 86 by the end of a second term, should he win one. After his last exam, performed in February 2023, doctors declared President Biden “healthy, vigorous” and “fit” to handle his White House duties. But voters are approaching this year’s election with misgivings about President Biden’s age, having scrutinized his gaffes, his coughing, his slow walking and even a tumble off his bicycle.

After he returned to the White House, President Biden attended an event on combating crime and suggested that when it came to his health, “there is nothing different than last year.”

He also joked about his age, gesturing toward the assembled press corps and telling police leaders at the gathering, “They think I look too young.”

Former President Donald Trump, 77, is the favorite to lock up the Republican nomination later this month, which would bring him closer to a November rematch against President Biden. Mr. Trump was 70 when he took office in 2017, which made him the oldest American president to be inaugurated, until President Biden broke his record by being inaugurated at 78 in 2021.

A recent special counsel’s report on the investigation into President Biden’s handling of classified documents repeatedly derided Biden’s memory, calling it “hazy,” “fuzzy,” “faulty,” “poor” and having “significant limitations.” It also noted that President Biden could not recall defining milestones in his own life such as when his son Beau died or when he served as vice president.

Still, addressing reporters the evening of the report’s release, President Biden said “my memory is fine” and grew visibly angry as he denied forgetting when his son died of brain cancer in 2015 at the age of 46.

White House press secretary Karine Jean-Pierre said Wednesday that Dr. O’Connor was one of a team of 20 different medical specialists who helped complete the physical and told her he “was happy with how everything went.”

Asked why he wasn’t undergoing a cognitive test as part of the physical, Ms. Jean-Pierre said that Dr. O’Connor and President Biden’s neurologist “don’t believe he needs one.”

“He passes a cognitive test every day, every day as he moves from one topic to another topic, understanding the granular level of these topics,” Ms. Jean-Pierre said, noting that President Biden tackled such diverse issues as Wednesday’s crime prevention event before his planned trip to the U.S.-Mexico border on Thursday and next week’s State of the Union address.

“This is a very rigorous job,” she added, “and the president has been able to do this job every day for the past three years.”

President Biden’s last physical showed that the president had a lesion removed from his chest over the previous year, but the results then otherwise largely matched the findings after President Biden’s previous exam in November 2021. That report said his

occasional coughing was due to acid reflux, while his stiffened gait was the result of spinal arthritis, a previously broken foot and neuropathy in his feet.