President Joe Biden is going to receive his annual routine physical at Walter Reed National Military Medical Center on Wednesday, which will likely be the last presidential health update before the 2024 election as Biden faces persistent questions about his age.

The president is expected to be seen by his physician, Dr. Kevin O’Connor, who has previously issued a report on the president’s health following physicals. Biden will appear before reporters at 1:30 p.m. ET. when he delivers remarks on community safety and actions to fight crime.

The White House said it will publicly release a written summary of the president’s physical later on Wednesday. The daily press briefing is scheduled for 2:30 p.m. on Wednesday as well.

At 81, Biden is the oldest president to have held the office. He would be 86 years old at the end of a potential second term.

Biden has been persistently dogged by criticism and concerns over his age and stamina. In a CNN poll conducted by SSRS released earlier this month, 46% of Democrats were concerned about his age. A recent national Quinnipiac University poll found only about one-third of registered voters (35%) say Biden has the requisite physical fitness, while 34% say he has the mental fitness to serve a second term.

Biden sought to tackle the issue head-on during a recent news conference, slamming a report from special counsel Robert Hur that cast him as a “well-meaning, elderly man with a poor memory.”

“I am well-meaning. And I’m an elderly man. And I know what the hell I’m doing. I’ve been president – I put this country back on its feet. I don’t need his recommendation,” a visibly seething Biden said at the time.

At an off-camera fundraiser a few weeks later, Biden made a frank acknowledgement about his age, saying “I may not run as fast as I used to.”

“I tell you what: I’ve been around long enough to know what’s going on,” he told a group of donors in Beverly Hills, California. “I’ve been around long enough to hopefully, with age, have a little bit of wisdom about how we can get things done.

Biden has framed his age as a source of wisdom of experience, and earlier this week, he tested a new line of attack against former President Donald Trump during an appearance on NBC’s “Late Night with Seth Meyers,” suggesting that voters should not just consider how old a candidate is, but “how old (their) ideas are.”

Wednesday’s Walter Reed visit will mark Biden’s third physical since taking office. Last year, O’Connor wrote that Biden was “healthy,” “vigorous” and “fit to successfully execute the duties of the presidency.”

O’Connor noted last year that Biden experiences a “stiff gait,” and was prescribed custom orthotics. He is also being treated for non-valvular atrial fibrillation, or AFib – an irregular heartbeat. O’Connor said Biden experiences no symptoms from the condition. He does experience “occasional symptoms of gastroesophageal reflux,” namely having to clear his throat often, O’Connor said.

A cognitive test has not been part of a standard presidential physical. If Biden or his doctor have a specific concern his doctor could perform a brief assessment that might determine whether further evaluation is recommended.

The US Preventive Services Taskforce – a group of independent experts whose recommendations guide doctors’ decisions and influence insurance coverage – says there’s insufficient evidence to assess benefits and harms of screening for cognitive impairments in asymptomatic adults 65 and older. It notes that evaluation for cognitive impairment most commonly occurs “as a result of patient- or caregiver-reported concerns or symptoms, or clinician’s suspicion.”

White House press secretary Karine Jean-Pierre told reporters earlier this month that Biden’s physician did not think a cognitive test was warranted during his last physical.

“I remember talking to the president’s doctor last year, when I was asked about a cognitive test,” she said, recounting a conversation with O’Connor. “Because of the president’s actions every day, what he deals with world leaders, the domestic issues that he has to deal with, he believes … that shows that the president is very much active and understands what’s going on … and didn’t believe that a test like that was warranted because of just who he is as president of the United States and everything that he has to deal with.”

Last summer, the White House said Biden had recently begun using a CPAP – continuous positive airway pressure – machine to treat sleep apnea after the president was seen with indentations from straps on both sides of his face. An official familiar with the matter said Biden began using the device to improve sleep quality. While it was not noted in his publicly released physical, medical records released in 2008 indicated Biden had a recurring issue with sleep apnea.

A health record released by Biden’s doctor in 2019 said sleep apnea “has been considered, but his symptoms have improved significantly after his sinus and nasal passage surgeries.”

Sleep apnea is a sleep disorder in which breathing repeatedly stops and starts. About 30 million people in the United States have sleep apnea, but only 6 million are diagnosed with the condition, according to the American Medical Association. A CPAP machine “uses mild air pressure to keep breathing airways open while you sleep,” according to the National Institutes of Health.

Biden was also forced to cancel events on his schedule for one day last June due to an unplanned root canal following pain in a lower premolar. The procedure was “successfully completed” at the White House by a team from Walter Reed, O’Connor said.