President Donald Trump’s aides have reportedly been forced to make a key change to how they deal with their leader as questions about the exact state of his health grow louder.

Almost since he took office there have been questions over whether Trump, 79, is fit enough not just to last his entire term, but an entire year in the job.

Despite his doctor, Sean Barbabella, signing off Trump to keep working, there has been wild speculation that he wears a catheter and has dementia, claims that have been dismissed by the White House.

These speculations have been amplified by bruising on Trump’s hands (caused by a lot of handshaking White House Press Secretary Karoline Leavitt claimed), and his apparent sleepiness during some White House meetings, as well as his occasional struggle to hear things.

On the latter, his “aides, donors and friends” have now had to talk louder in meetings so that Trump can hear them, reports the Wall Street Journal.

Trump responded to claims about problems with his hearing and in one press conference said sarcastically: “I can’t hear you. I can’t hear you. I can’t hear a word you’re saying.”

He later added that he only struggles to hear people “when there’s a lot of people talking”. Be this as it may, other experts have weighed in with much more serious theories about what is going on the physiognomy of Trump.

Speaking on the ‘Inside Trump’s head podcast’, biographer Michael Wolff addressed White House chief of staff Susie Wiles’ comment to Vanity Fair that Trump had an “alcoholic’s personality”. Mr Wolff instead suggested Trump had a different personality altogether.

He alleged: “Susie Wiles might just as well have said that it’s like dealing with a dementia patient. The uninhibited aspects of his personality – anger, self-pity…become increasingly more uninhibited. He opens his mouth, and you go ‘, this is a problem.’”

Mr Wolff continued and said Trump’s potential age related issues echo the issues and criticism levelled against Joe Biden during his sole term as President.

He said: “There is no way to diagnose the President. Clearly, Joe Biden had enormous cognitive difficulties. Everyone around him closed ranks to protect him.

“There is no mechanism for an objective diagnosis. This is not different now for Donald Trump. There is no way for us to say ‘he is experiencing cognitive issues of an alarming variety. Although Susie Wiles’ ‘alcoholic personality’ comment was curious.”