Biden's bill of health: Annual check-up reveals more details about President's sleep apnea disorder which is linked to dementia - as well as heart and cholesterol conditions which put him at risk of strokes

President Joe Biden's annual physical revealed 'no new concerns' - but it shed more light on several health conditions suffered by the 81-year-old.

Dr Kevin O'Connor said the 'most notable' change in the past year concerned Biden's sleep apnea - a disorder the President has had for 16 years and which is associated with an increased risk of dementia.

The White House doctor said that last spring Biden began using of a mask that delivers pressurized air into the nose and mouth to make sure he breathes properly when he sleeps.

'We revisited the issue this past spring, and conducted a formal sleep study,' Dr O'Connor wrote in his summary. 'This study confirmed my suspicion that the President would benefit from optimizing his sleep efficiency with PAP [breathing device].'

It has been well documented since 2008 that the president suffers from the condition, but the notes indicate there were signs it may get worse.

Last year, Biden was pictured with marks on his face, which the White House later said were from a CPAP machine being used to manage his condition. 

More than 30million Americans are diagnosed with sleep apnea, which sees sufferers snore, choke, and gasp 20 to 30 times every hour in the night.

And the older a person is, the more severe the effects of the disorder may be.

A 2022 study found patients with sleep apnea had a 43 percent increased risk of developing any type of neurocognitive disorder, a 28 percent increased risk of Alzheimer's disease and a 54 percent increased risk of Parkinson's disease. 

Doctors say the link with dementia was likely to be caused by the brain being starved of oxygen during sleep, which can damage blood vessels and disrupt the balance of an enzyme which helps regulate the protein which causes plaque.

Dr O'Connor said the White House medical team experimented with several different types of masks before finding one comfortable enough for Biden to wear throughout the night.

Biden, 81, is 'active and robust' and 'fit to serve,' his doctors say in physical results

President Joe Biden's 2024 physical remained largely unchanged from last year, with his White House doctor saying there are 'no new concerns' and labeling the 81-year-old 'fit to serve.'

'Most people do experience some difficulties getting used to falling asleep while wearing a mask on their face, as well as with keeping it on throughout the night,' the notes say.

'This is reasonably anticipated and, in fact, should be expected. The president had a very similar experience. But with trials of several different masks, we have been able to identify a couple of products which fit him very comfortably and effectively.'

Dr O'Connor wrote in his medical summary that the president's sleep apnea condition is 'stable' and he 'has demonstrated excellent response to PAP and is diligently compliant with therapy.'

The physician added: 'He continues to be fit for duty and fully executes all of his responsibilities without any exemptions or accommodations.'

Another significant health development over the last year, Dr O'Connor wrote, was a dental emergency the President suffered that caused him to undergo an urgent root canal in June. 

The doctor said there were no complications and Biden - who is known for his love of ice cream - recovered well.

Biden's routine physical included consultations with doctors specializing in optometry, dentistry, orthopedics, neurology, physical therapy, cardiology and dermatology.

The White House confirmed the president did not undergo any cognitive tests.

However, he did undergo 'an extremely detailed neurological exam' that ruled out 'stroke, multiple sclerosis, Parkinson's or ascending lateral sclerosis.' 

Neurological exams include CT scans and MRIs of brain, conduction studies to test nerves, and electroencephalography (EEG) or electromyography (EMG) to measure brain activity and nerve function. 

Cognitive tests measure cognition and brain function and processing. They include: number and word recall tests, drawing tests, tests that measure attention, language and reasoning and questionnaires.

Biden was photographed last year with a mark on his face that was later revealed to have been caused by wearing a mask to treat his sleep apnea 

Marine One is seen landing at Walter Reed National Military Medical Center in Bethesda, Maryland, as President Joe Biden arrived for his physical Wednesday

DailyMail.com revealed earlier this month the cognitive test Biden could have to take if his doctor deemed it necessary. 

In addition to sleep apnea, the physical revealed Biden has an irregular heartbeat, or atrial fibrillation, which causes an irregular and often unusually fast heartbeat and drastically raises the risk of a stroke.

The President has suffered from the condition since 2003. He takes the blood thinner apixaban, brand name Eliquis, to treat the heart condition. 

Heart arrhythmia can cause a variety of serious heart health complications including blood clots.

If a blood clot breaks loose, it can travel directly from the heart to the brain, which can cause a stroke - which is why people with irregular heartbeats are at up to a five times greater risk of one.

Biden also has high cholesterol, which is being managed with statin medication that should prevent the problem developing into hardened arteries or something more serious.

The other conditions noted in his physical have all previously been documented. They include acid reflux, season allergies, a stiffened gait and nerve damage in his feet. 

Dr O'Connor noted all of these were 'stable' with no change from last examination. 

For his various conditions, the president takes the blood thinner Apixaban, Rosuvastatin to lower cholesterol, nasal sprays for allergies, famotidine for his acid reflux and esomeprazole for heartburn. 

These drugs can lead to adverse side effects, including confusion, dizziness, headaches, anxiety, agitation and drowsiness.