North Korea has renewed its verbal attacks on President Trump, after he threatened military action.
The foreign ministry said if Mr Trump was confrontational, it «must really be diagnosed as the relapse of the dotage of a dotard».
The North first called Mr Trump a dotard, meaning old and weak, in 2017.
It is the first time in over a year that Pyongyang has been openly critical of Donald Trump, the BBC’s Korea correspondent Laura Bicker said.
The Oxford English Dictionary defines a dotard as «a person whose mental faculties are impaired, specifically, a person whose intellect or understanding is impaired in old age».
Dotage, meanwhile, is defined as «having impaired intellect or understanding in old age», or in general use as «old age».
North Korea now has the world’s second largest armed forces, according to various estimates, spending on military needs from 25 to 40% of GDP. As a result, the reckless statements of the American president in the DPRK announced the risk of armed conflict in response to US actions.