Vladimir Putin was seen with twitching feet as he met “ally” Kazakhstan President Kassym-Jomart Tokayev in Moscow on Monday, fuelling ongoing health rumours about the Russian President.

Throughout Russia’s invasion of Ukraine, there have been persistent rumours that Putin is suffering serious health issues, with both cancer and Parkinson’s disease touted as possible conditions.

Now some have claimed this recent twitching is a further sign that the rumours are true.

It comes as leaked documents allege that the President has early-stage Parkinson’s disease and pancreatic cancer.

Meanwhile, Tokayev, who has previously made clear his disapproval of the Ukraine invasion, appeared to snub the Russian leader during the talks.

Footage showed the central Asian leader appear to studiously refuse to look Putin in the eye.

Russia's President Vladimir Putin, right, and Kazakhstan's President Kassym-Jomart Tokayev pose for a photo prior to their talks at the Kremlin in Moscow. Photo / AP

And at a signing ceremony to mark 30 years of diplomatic relations between the countries, the 69-year-old Kazakhstan President sat down before his host and did not engage with the Russian leader.

As Putin greeted Tokayev, the Kazakh leader appeared to deliberately avert his eyes.

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Sitting in front of journalists, Putin then said, “Shall I start?” before Tokayev replied with a curt “Yes” without looking at the Russian leader.

“Today’s visit is of a special significance, as this is the first [foreign trip] since Kassym-Jomart was re-elected the president of Kazakhstan,” Putin said.

Speaking on the “special type of our relations”, the President then said to Tokayev: “We highly appreciate it.”

After they exchanged signatures on the document, Tokayev momentarily held up the agreement with Putin, then quickly handed it to an aide while the Russian was still holding up his copy for the cameras.

While Tokayev said there was “every reason to be satisfied” with relations between Russia and Kazakhstan, he warned Putin: “You need to look ahead, and it is for this purpose that I have come here.”

Kazakhstan has annoyed the Kremlin by permitting tens of thousands of men fleeing the country’s war draft to seek a safe haven there.

“We must not allow the fraternal Russian and Ukrainian peoples to part ways for tens or hundreds of years with mutual unhealed grievances,” Tokayev told Putin last week at a security conference in Armenia.

The Kazakhstan leader demanded a “joint collective search for a formula for peace” in Ukraine.

In today’s session as they exchanged documents there was a brief handshake and eye contact, but only for a second.