Dementia, Depression, and the Nuclear Button: The Shocking Reality of Mental Decline in Command

A startling new study reveals that many world leaders with access to nuclear weapons were suffering from serious health issues—including dementia, depression, strokes, and addiction—while still in power. Some were comatose, others deeply impaired, and in multiple cases, their conditions were deliberately concealed from the public.

The research raises urgent questions about how physical and mental health may have compromised decision-making during global crises, and calls for safeguards such as shared nuclear authority, medical screening, and reduced launch-readiness to prevent catastrophic misjudgments by unfit leaders.

Nuclear Powers, Unfit Leaders

A new study from the University of Otago in New Zealand has found that many former heads of state from the world’s nine nuclear-armed countries were affected by significant health problems during their time in power. These conditions may have impacted their judgment while they had control over nuclear launch codes.

Researchers examined the medical histories of 51 deceased leaders from countries including China, France, India, Israel, North Korea, Pakistan, Russia, the United Kingdom, and the United States. Among them, eight died in office from chronic illnesses, while five others succumbed to heart attacks or strokes. A large number were dealing with multiple serious health conditions, such as dementia, personality disorders, depression, and substance abuse involving drugs or alcohol.

The investigation was led by Professor Nick Wilson of the University of Otago’s Department of Public Health in Wellington, Ōtākou Whakaihu Waka, Pōneke, along with Associate Professor George Thomson and independent researcher Dr. Matt Boyd.

Professor Wilson noted that 15 leaders who left office while still alive had either confirmed or likely health issues that probably played a role in their departure.

Strokes, Depression, and Drinking in Office

“Probably all of this group of 15 leaders had their performance in office impaired by their health conditions. In some cases, the degree of impairment was profound, such as in the case of two former Israeli Prime Ministers: Ariel Sharon, who became comatose after suffering a stroke in office, and Menachem Begin, whose depression was so severe that he spent his last year as leader isolated in his home. Impairment during crises was also seen in the case of Richard Nixon’s bouts of heavy drinking – including during a nuclear crisis involving the Middle East.

“There have also been occasions where health information about leaders has been kept secret at the time.”

U.S. Presidents and Secret Diagnoses

This was the case for multiple US presidents, including Dwight D Eisenhower, whose doctor described his 1955 heart attack as a digestive upset; John F Kennedy, whose aides lied about him having Addison’s disease, a serious, chronic condition; and Ronald Reagan, whose administration hid the extent of his injuries after he was shot in 1981, and the likely signs of his dementia near the end of his term.

Professor Wilson says Kennedy was in poor health during his first two years in office in 1961 and 1962, with his performance likely impaired by Addison’s disease, back pain, and his use of anabolic steroids and amphetamines. It was in 1961 that he authorized the failed CIA-backed Bay of Pigs invasion of Cuba, and that his poor performance at a Cold War summit with Soviet leader Nikita Khrushchev in Vienna was noted. In turn, Khrushchev’s poor mental health probably contributed to his triggering both the Berlin Crisis and the Cuban Missile Crisis.

France and New Zealand’s Hidden Struggles

In France, long-serving President François Mitterrand clung onto power until the end of his term in 1995, despite keeping secret his advanced prostate cancer and after his doctor had concluded in late 1994 that he was no longer capable of carrying out his duties.

This latest study follows previous research involving Professor Wilson on the health of former New Zealand Prime Ministers. It found the performance of at least four of the leaders was impaired, in three cases by poor health, and, in the case of Robert Muldoon, by his heavy drinking.

Professor Wilson says that with the rise in international instability following the Russian invasion of Ukraine in 2022, it has become even more important to ensure there is good leadership and governance in those countries with nuclear weapons.

Unchecked Nuclear Authority: The U.S. Example

“This is particularly the case for the United States, where a leader can in principle authorize the release of nuclear weapons on their own, a situation referred to as a ‘nuclear monarchy’.”

He says there is a range of measures that could reduce global security risks from leaders whose judgment is in question. They include removing nuclear weapons from ‘high alert’ status, adopting ‘no first use’ policies where nations refrain from using nuclear weapons except as a retaliatory second strike, ensuring any weapon launches need authorization by multiple people, and progressing nuclear disarmament treaties.

Leadership Reforms and Mental Health Checks

Professor Wilson says democracies could consider introducing term limits for their leaders, as well as recall systems, so voters could petition for politicians to step down. Requirements for medical and psychological assessments could be introduced for leaders before they take office, and during their terms.

“Maintaining a strong media with investigative journalists can also help expose impairment in leaders.”

Professor Wilson says politicians in general are exposed to high levels of stress, which can affect their mental well-being. A study of UK Members of Parliament has found they were 34 percent more likely to experience mental health problems than other high-income earners.

Reducing Risk Through Better Mental Health Support

“Finding ways to reduce stress on politicians and better address their mental health needs is another way global security risks can be reduced.”

Reference: “The frequently impaired health of leaders of nuclear weapon states: an analysis of 51 deceased leaders” by Nick Wilson, George Thomson and Matt Boyd, 8 July 2025, BMC Research Notes.
DOI: 10.1186/s13104-025-07351-8

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