WASHINGTON \u2014 When Barack Obama underwent a routine physical exam as president, his doctor noted that he had moved on from cigarettes to nicotine gum. Bill Clinton\u2019s doctor included details about his fluctuating weight. Richard Nixon\u2019s doctor complained that he didn\u2019t exercise enough.<\/p>\n
There is no legal requirement to follow when it comes to the president\u2019s checkups, and the amount of information released has always been up to the man himself. But President Biden\u2019s exam on Thursday will get extra scrutiny because, at 80, he is America\u2019s oldest president.<\/p>\n
\u201cThere probably is more pressure in this situation,\u201d said Dr. Dan Blazer, professor emeritus at the Duke University School of Medicine. \u201cThat\u2019s just our society.\u201d<\/p>\n
Mr. Biden\u2019s exam has been\u00a0delayed for weeks because of what officials said were scheduling issues. Karine Jean-Pierre, the White House press secretary, said the administration would follow the same routine as with Mr. Biden\u2019s previous physical.<\/p>\n
\u201cWe want to be transparent,\u201d Ms. Jean-Pierre said on Tuesday. \u201cWe want to make sure you have the information, and it will be coming from the physician.<\/p>\n
In 2021, after a checkup and a colonoscopy at Walter Reed National Military Medical Center, the White House released a six-page letter from the president\u2019s physician, Kevin O\u2019Connor, declaring Mr. Biden \u201chealthy, vigorous\u201d and fit to carry out his duties.<\/p>\n
He noted at the time that the president had developed a \u201cmore pronounced\u201d tendency to cough during speaking engagements and a stiffer gait caused by age-related changes in his spine. He also ruled out the possibility that the stiffness could be caused by a stroke, multiple sclerosis, Parkinson\u2019s or other neurological disorders.<\/p>\n
Dr. O\u2019Connor did not say in his report whether Mr. Biden underwent cognitive testing. While many doctors recommend the testing for older adults, presidents have not regularly made public such examinations, said Matthew Dallek, a political historian.<\/p>\n
But because of Mr. Biden\u2019s age, \u201cthe more positive information, the more Biden can give the public a clean bill of health, the probably more reassuring it is for people,\u201d Mr. Dallek said.<\/p>\n
Mr. Biden has said he intends to run for a second term, but his age has become an uncomfortable issue for him and his party. It also has left him vulnerable to attacks by Republicans.<\/p>\n
How Times reporters cover politics.<\/strong><\/span>\u00a0We rely on our journalists to be independent observers. So while Times staff members may vote, they are not allowed to endorse or campaign for candidates or political causes. This includes participating in marches or rallies in support of a movement or giving money to, or raising money for, any political candidate or election cause.<\/span><\/span><\/p>\n Nikki Haley, who announced her presidential bid on Tuesday, called for \u201cmandatory mental competency tests for politicians over 75 years old,\u201d a threshold that would include both Mr. Biden and Donald J. Trump. And in her rebuttal against Mr. Biden\u2019s State of the Union address last week, Gov. Sarah Huckabee Sanders of Arkansas called Mr. Biden\u00a0\u201cunfit.\u201d<\/p>\n Mr. Biden has dismissed those concerns, telling voters simply: \u201cWatch me.\u201d<\/p>\n Although the tradition of publicizing the results of the president\u2019s physical dates back to Mr. Nixon, the expectations about how much information to release have varied. <\/p>\n \u201cEven though there are norms in place, each White House can do it differently,\u201d Mr.\u00a0Dallek\u00a0said. \u201cBut of course you cannot divorce the politics from the physicals.\u201d<\/p>\n Mr. Dallek said Mr. Biden\u2019s level of transparency was \u201cpretty consistent\u201d with that of President George W. Bush and Mr. Obama, who both provided information on height, weight and cholesterol. Mr. Bush\u2019s doctor said his patient smoked the occasional cigar, while Mr. Obama\u2019s physician went as far as saying the president took Nexium for \u201coccasional acid reflux symptoms,\u201d as well as daily vitamin D tablets.<\/p>\n In 2018, the Trump administration sent Dr. Ronny Jackson, the former White House physician, to declare to reporters that Mr. Trump enjoyed \u201cexcellent health\u201d without initially releasing any basic information, such as weight, blood pressure or cholesterol levels. A memorandum on his health released in 2019 did not detail the physical examinations that Mr. Trump underwent, or their results, as the White House physician did for Mr. Obama.<\/p>\n Some presidential candidates have gone to great lengths to answer questions about their age or health. In 2008, after Senator John McCain secured the Republican presidential nomination, his doctors invited about 20 reporters to a room in Arizona to examine Mr. McCain\u2019s medical records.<\/p>\n The reporters were given two stacks of medical reports totaling more than 1,000 pages, including lab results, clinical notes, pathology reports, doctor\u2019s orders and anesthesia reports, handwritten notes, and insurance information, much of it from the Mayo Clinic in Scottsdale, Ariz., where he was treated for cancer.<\/p>\n Still, Dr. Blazer cautioned that the standard physical reports were limited in how much they could tell you about a president. \u201cThe main thing is finding out what he is capable of doing the next year,\u201d he said. \u201cThat\u2019s all you could expect of the annual physical.\u201d<\/p>\n Michael D. Shear\u00a0contributed reporting.<\/p>\n