Fresh questions have been raised about Donald Trump’s health after a new book claimed even some of his own aides privately acknowledged the US President was starting to show signs of ageing. The allegations are contained in Regime Change: Inside the Imperial Presidency of Donald Trump, written by New York Times White House correspondents Maggie Haberman and Jonathan Swan.

The book adds to growing scrutiny of Trump’s health since he returned to the White House. Throughout his second term, the 80-year-old President has been seen with swollen ankles and bruising on his hands, while reports have also highlighted occasions when he appeared to fall asleep during White House meetings and major international summits. Trump has also been photographed with a rash on his neck, repeatedly boasted about “acing” a dementia screening test which he says measures intelligence, and has faced scrutiny over lengthy speeches and interview answers that frequently veer off topic. However, Haberman and Swan claim there were further signs of ageing behind the scenes.

“He was also having trouble hearing, asking people to repeat questions they had just asked,” the authors wrote.

They added: “Joint press conferences with world leaders were more often held in the Oval Office than in the East Room, in part because the acoustics were better, and he didn’t have to stand for an hour.”

The authors wrote that although Trump has long been known for speaking candidly, “whatever thin verbal filter he had in the past was gone”.

They added that some aides privately remarked that, for the first time, he was beginning to appear old to them.

“Those who spent time with him could see the signs -the moments of fatigue, the cupped hand behind the ear,” Haberman and Swan wrote.

The book also revisits the issue of Trump’s swollen ankles, which doctors have previously linked to chronic venous insufficiency.

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