US President Joe Biden remains "fit for duty" with no new health worries, his doctor said today 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 centre 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.
Mr 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.
Mr 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.
Mr Biden took a short helicopter ride to the medical centre 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.
Biden 'passes cognitive test every day'
Press Secretary Karine Jean-Pierre defended Mr 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."
Mr 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."
Mr 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 Mr Biden took a more light-hearted tone while trying to deflect the issue back onto his septuagenarian nemesis Mr Trump.
In an interview with late-night TV comic Seth Meyers on Monday, Mr Biden said he was a better bet than "the other guy," who is only four years younger.
In last year's medical exam Mr Biden got a clean bill of health, although he did have a cancerous skin lesion removed from his chest.
Mr Trump routinely depicts Mr 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.
Biden wins Michigan primary amid Gaza protests
Mr Biden won Michigan’s Democratic primary handily, but an "uncommitted" campaign organised by activists disillusioned with the president’s handling of the war in Gaza far surpassing the 10,000-vote margin by which Mr Trump won Michigan in 2016.
That was a goal set by organisers and it was seen as a potential source of embarrassment for the re-election campaign.
Democratic voters had been urged to mark their primary ballots as "uncommitted" in protest at the Gaza policy.
Many in Michigan's Arab-American community who backed President Biden in 2020 are angry, as are some progressive Democrats, over his support for Israel's offensive in Hamas-ruled Gaza where tens of thousands of Palestinians have been killed.
"Our movement emerged victorious tonight and massively surpassed our expectations. Tens of thousands of Michigan Democrats, many of whom who voted for Mr Biden in 2020, are committed to his re-election due to the war in Gaza," the Listen to Michigan campaign, which urged people to vote uncommitted, said in a statement.
Campaign organisers vowed to take what they called their anti-war agenda to the Democratic National Convention in Chicago in August.
In a statement, Mr Biden said: "I want to thank every Michigander who made their voice heard today. Exercising the right to vote and participating in our democracy is what makes America great".
It made no mention of Gaza or the "uncommitted" vote.
"Donald Trump is threatening to drag us even further into the past as he pursues revenge and retribution," Mr Biden said.
Earlier, he said Israel had agreed to halt military activities in Gaza for the Muslim holy month of Ramadan, expected to begin on the evening of 10 March, as Hamas studied a draft for a truce that includes a prisoner-hostage exchange.
Partial returns showed Mr Biden and Mr Trump with solid overall leads in Michigan.
With nearly half the estimated Democratic vote counted, Mr Biden had 80% support, with "uncommitted" getting 13%.
With 58% of the estimated Republican vote counted, Mr Trump had 67% support to Nikki Haley's 27%, Edison Research said.
Michigan routinely offers an "uncommitted" option as a way of questioning whether a named candidate has the support of the party's base. It could not be determined how many of those votes were protesting Mr Biden's Gaza policy.
When former president Barack Obama, a Democrat, ran for re-election in 2012, he faced about 21,000 "uncommitted" voters in Michigan's primary that year. Mr Biden faced substantially more.
Michigan is expected to play a decisive role in the head-to-head 5 November US presidential election.
It is a battleground state that could swing toward either party. Mr Biden beat Mr Trump in Michigan by just 2.8 percentage points in the 2020 election.
"We have to win on 5 November, and we're going to win big, and it's going to be like nothing that anybody has ever seen. It's Going to be fantastic. We win Michigan, we win the whole thing," Mr Trump told supporters in Michigan by phone.
Haley to carry on
Michigan turnout for former UN Ambassador Nikki Haley, who won nearly 40% of republican votes in her home state of South Carolina on Saturday, was also being scrutinised for signs of vulnerability for Mr Trump among moderates, whose support he would need in a general election.
Despite having lost to Mr Trump in every primary race, Ms Haley has performed well with moderate voters, although she has no clear path to the nomination.
Shortly before he was announced as the winner in Michigan, Ms Haley vowed to carry on.
"We've only seen a handful of states vote," Ms Haley told CNN. "We're taking this one state one day at a time."
Additional reporting Reuters
