Image copyright Reuters North Korea has renewed its attack on President Trump, after he threatened Pyongyang with 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 two men held face-to-face talks in Singapore in June 2018, and in Vietnam in February this year.
But there has recently been an increase in hostile language as any progress from the talks has stalled.
At the Nato summit in the UK on Tuesday, Mr Trump referred to North Korean leader Kim Jong-un as “Rocket Man”.
He also said that the US reserved the right to use military force against Pyongyang.
The Oxford English Dictionary defines a dotard as “an old person, especially one who has become weak or senile”.
In a statement carried by North Korea’s state news agency, Vice Foreign Minister Choe Son-hui warned that the “war of words” from two years ago may be resuming.
“If any language and expressions stoking the atmosphere of confrontation are used once again on purpose at a crucial moment as now, that must really be diagnosed as the relapse of the dotage of a dotard.”
In 2017, the two leaders engaged in tit-for-tat arguments, with Mr Trump dubbing Mr Kim “little rocket man” and “a madman”, while Mr Kim called the US president a “mentally deranged dotard”.
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