Health-Impaired Leaders Spark Nuclear War Fears, Study Warns

Numerous past heads of state from the globe's nine countries possessing nuclear weapons experienced health issues during their tenure, prompting worries about their judgment capabilities as they held authority over nuclear missile activation codes, a study from the University of Otago in New Zealand, has discovered.

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A research project examined the medical records of 51 former heads of state from nations possessing nuclear weapons: China, France, India, Israel, North Korea, Pakistan, Russia, the United Kingdom, and the United States. Eight of these individuals passed away due to long-term illnesses during their time in power, whereas five succumbed to heart attacks or strokes. Several leaders faced various significant health challenges throughout their tenure, such as memory loss, mental conditions, depressive symptoms, and substance misuse.

The study was headed by Professor Nick Wilson, affiliated with the School of Population Health at the University of Otago, Wellington— Ōtākou Whakaihu Waka, Pōneke—and included contributions from Associate Professor George Thomson and independent researcher Dr. Matt Boyd.

According to Professor Wilson, among the leaders who exited power while still living, 15 were known or suspected to have health problems that probably contributed to their leaving office. "It’s likely that each of these 15 leaders experienced some impact on their work due to their medical conditions. In certain instances, the effect was significant—for example, with two ex-Israeli prime ministers: Ariel Sharon, who fell into a coma following a stroke during his time in office, and Menachem Begin, whose deep depression led him to isolate himself at home for most of his final year as head of state."

"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."

Several U.S. presidents faced similar situations, such as Dwight D. Eisenhower, whose physician referred to his 1955 heart episode as merely an issue with digestion; John F. Kennedy, where his staff concealed his diagnosis of Addison’s disease, a severe long-term illness; and Ronald Reagan, whose team downplayed the severity of his wounds following the 1981 assassination attempt, along with potential indicators of dementia toward the conclusion of his presidency.

According to Professor Wilson, President Kennedy experienced significant health issues during his initial two years in power—specifically 1961 and 1962—which may have affected his ability to perform effectively. These challenges included Addison’s disease, chronic back discomfort, as well as the consumption of anabolic steroids and stimulants. The year 1961 marked when he approved the unsuccessful CIA-supported invasion of Cuba at the Bay of Pigs, along with a poorly conducted meeting with Soviet Premier Nikita Khrushchev in Vienna. As a result, Khrushchev's own psychological state might have played a role in instigating both the Berlin Crisis and the Cuban Missile Crisis.

In France, longtime president François Mitterrand remained in office until the conclusion of his tenure in 1995, even though he concealed his severe prostate cancer and following his physician's determination in late 1994 that he could no longer perform his responsibilities.

A recent investigation builds upon earlier studies led by Professor Wilson regarding the well-being of ex-prime ministers from New Zealand. The findings indicate that the effectiveness of at least four leaders was affected, with three instances linked to declining health, and specifically for Robert Muldoon, due to excessive alcohol consumption.

Professor Wilson states that due to increased global uncertainty after Russia's attack on Ukraine in 2022, it is now crucial to maintain strong leadership and management in nations possessing nuclear arms. "Especially true for the United States, where a single individual may theoretically approve the deployment of atomic weapons—a scenario known as a 'nuclear monarchy.'"

He mentions various steps that might lower global security threats posed by leaders with questionable decision-making. These involve taking nuclear arms out of "high alert" mode, implementing "no first use" policies wherein countries promise not to initiate nuclear attacks unless responding to an initial one, making sure all missile launches require approval from several individuals, and advancing agreements aimed at reducing nuclear arsenals.

Professor Wilson suggests that democratic nations might explore implementing time restrictions for political figures, along with mechanisms allowing citizens to demand removal through petitions. Medical and mental health evaluations could be mandated prior to taking office and throughout their tenure. "A robust press featuring investigative reporters can also aid in revealing deficiencies among leaders."

Professor Wilson states that politicians typically face significant amounts of pressure, which may impact their psychological health. Research involving members of the UK Parliament revealed that they had a 34% higher chance of facing mental health issues compared to others with similar income levels.

Identifying methods to lessen pressure on political figures and improve support for their psychological well-being represents another approach to diminishing worldwide security threats." "Another strategy for minimizing global security dangers involves discovering approaches to ease the burden on elected officials and enhance care for their emotional wellness." "Reducing the strain experienced by leaders and providing improved attention to their psychological health serves as an additional means of lowering international security concerns." "One more method to decrease global safety hazards is through efforts aimed at alleviating the stress faced by those in politics and offering enhanced assistance for their mental wellbeing." "Addressing the psychological demands placed upon public servants and finding solutions to lower their tension levels can also contribute to reducing major world-threatening situations.

More information: Nick Wilson and others, The often compromised health of leaders from nations possessing nuclear weapons: an examination of 51 deceased leaders, BMC Research Notes (2025). DOI: 10.1186/s13104-025-07351-8

Supplied by the University of Otago

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