BETHESDA, Md. — President Joe Biden “continues to be fit for duty,” his doctor wrote Wednesday after conducting an annual physical that was closely watched as the 81-year-old seeks reelection.

“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 Biden to Walter Reed National Military Medical Center for more than 2 1/2 hours.

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

The oldest president in U.S. history, 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 Biden “healthy, vigorous” and “fit” to handle his White House duties.

But voters are approaching this year’s election with misgivings about 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, 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, setting a November rematch against Biden. Trump was 70 when he took office in 2017, which made him the oldest American president to be inaugurated, until Biden broke his record by being inaugurated at 78 in 2021.

White House press secretary Karine Jean-Pierre said Wednesday that 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, Jean-Pierre said that O’Connor and 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,” Jean-Pierre said.

“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.”