WASHINGTON — For much of his life, President Trump has promoted himself as a virtual superman who has endless energy, needs little sleep, rarely gets sick and excelled at sports in his youth. As he once dictated in a statement put out in the name of an agreeable doctor, he is “the healthiest individual ever elected to the presidency.”
So as Mr. Trump seeks to become the oldest individual ever elected to the office for a second term, recent questions about his mental and physical condition have sent him into paroxysms of pique. They have complicated his own efforts to question the health of his challenger and fellow septuagenarian, former Vice President Joseph R. Biden Jr.
The president elevated the issue this week by taking the bait of a critic’s tweet and denying that he had “mini-strokes” last year around the time of a mysterious trip to the hospital. But Mr. Trump only raised more questions when he could not keep his explanations for that hospital visit straight. He wrote that it “was to complete my yearly physical” — contrary to how he explained it at the time, when he said it was “phase one of my yearly physical” to be completed later.
The matter comes up a couple of months after Mr. Trump’s appearance at a commencement ceremony at the United States Military Academy at West Point provoked speculation because he had trouble lifting a water glass to his lips, requiring him to use two hands, and he seemed especially tentative walking down a ramp as if afraid he might fall. He bristled at the talk and ridiculed the idea that he had any trouble that day. He has since boasted that he has aced a dementia test showing that “I’m cognitively there.”
Just last week, in an interview with The New York Times, Mr. Trump volunteered without being asked that he was in strong shape. “I feel good,” he said. “I think I feel better than I did four years ago.”
The question of presidential health has sometimes played an important role in election contests, but rarely has it seemed more acute than this year as Mr. Trump, 74, squares off against Mr. Biden, 77, who would be the oldest person ever elected president and has sometimes verbally stumbled.
The president has repeatedly suggested that Mr. Biden suffers from some form of decline like dementia without using the word and twice in the past week falsely asserted without any evidence whatsoever that the former vice president was on drugs. It was a repeat of a similar tactic Mr. Trump used against Hillary Clinton in their campaign four years ago.
“He’s on some kind of an enhancement, in my opinion,” Mr. Trump said in an interview with Fox News that aired on Tuesday night, contending that he and Mr. Biden should both take drug tests before their debates this fall, just as he challenged Mrs. Clinton to do in 2016. Like Mrs. Clinton, Mr. Biden has ignored the proposal.
The president’s trip to Walter Reed National Military Medical Center in Maryland last November remains the subject of questions. In a new book, “Donald Trump v. the United States,” Michael S. Schmidt, a Times reporter, writes that word went out that day for Vice President Mike Pence to be on standby in case the president underwent a procedure requiring anesthesia.
Reports on the book prompted Joe Lockhart, a White House press secretary under President Bill Clinton, to pose a question this week on Twitter: “Did @realDonaldTrump have a stroke which he is hiding from the American public?”
Mr. Trump first saw the reports about Mr. Pence on “standby” leading newscasts in the morning, and at some point someone gave him an article or a series of tweets that included Mr. Lockhart’s. Angered, the president complained to aides that he really had been going for a physical and that the story about Mr. Pence was not true. He blasted out a tweet denying that he had “a series of mini-strokes” — oddly disputing something a little different from the stroke Mr. Lockhart asked about — and instructed the White House physician to follow with a statement confirming it.
Mr. Trump’s campaign then followed with a statement calling on CNN to fire Mr. Lockhart as a contributor for “knowingly pushing a conspiracy theory about President Trump’s health.” In the same statement, the campaign pushed its own conspiracy theory about Mr. Biden’s health, describing him as “somebody who truly has lost a step.” Late Tuesday night, Mr. Trump returned to Twitter to declare that “Mike Pence was never put on standby.”
Asked on Fox News on Tuesday whether he had been standing by in case Mr. Trump was anesthetized, Mr. Pence initially ducked the question, saying that Mr. Trump “is in excellent health” and as vice president “I’m always informed of the president’s movements.”
Pressed by the anchor Bret Baier, Mr. Pence did not deny the report but pleaded no memory of it. “I don’t recall being told to be on standby,” he said. “I was informed that the president had a doctor’s appointment.” He added, “Part of this job is you’re always on standby.”
Mr. Trump, weighing in last spring at 244 pounds, is overweight and by his own account prefers cheeseburgers to healthier food. Other than golf, he scorns exercise on the theory that it depletes a person’s finite energy. A coronary calcium CT scan in 2018 recorded a score of 133, meaning that he has a form of heart disease common to men in their 70s that is normally treatable with cholesterol-reducing medication and better diet.
By various accounts, he does not need as much sleep as most people, and often remains awake past midnight and then is up again by dawn. But aides say he generally works from the White House residence in the morning and occasionally sleeps in after a nighttime rally. His brother Robert Trump, three years younger, died last month and the White House has not disclosed the cause, although a family friend said he had experienced brain bleeds, which began after a recent fall.
The president’s Saturday afternoon trip to Walter Reed on Nov. 16 was not on his public schedule and seemed out of the normal schedule for an annual checkup. At the time, White House officials said that it was “to begin portions of his routine annual physical exam” and that he had “a quick exam and labs,” without disclosing any specifics.
Aides pointed out that it was hardly a secret, though, since he brought his usual pool of journalists, who reported the fact of it if not any details, and they noted that he was seen getting into his motorcade at the time without assistance. They also noted that he later did return for a comprehensive physical exam in April and a summary reporting that “the president remains healthy” was released in June.
“For almost four years, the media, online conspiracy theorists and even some left-wing politicians have irresponsibly speculated that the president is not well — a disgusting assumption that has no basis in fact or reality — and it needs to stop,” Judd Deere, a White House spokesman, said in a statement on Wednesday. “President Trump has more energy, stamina and vigor than any person of his age I’ve ever met, and the American people can rest assured that he’s more than up to the task of serving as president.”
Mr. Deere’s statement did not explain why the president said on Twitter on Tuesday that the November trip “was to complete my yearly physical” when at the time both he and his staff called it the beginning of his annual checkup.
Mr. Lockhart, for one, was not convinced. “I think they still have not answered the question of why he took an unannounced visit to the hospital and seem incredibly afraid of a simple question,” he said Wednesday.
Maggie Haberman contributed reporting from New York.