By Nicolas Hulscher, MPH

A new peer-reviewed study titled, The frequently impaired health of leaders of nuclear weapon states: an analysis of 51 deceased leaders, has revealed a chilling truth: 45% of past leaders of nuclear?armed nations since the dawn of the atomic age had health conditions that could impair judgment - some while holding sole authority to launch nuclear weapons.

The study analyzed the biographies of 51 deceased leaders from the U.S., Russia/Soviet Union, China, UK, France, India, Pakistan, Israel, and North Korea:

Key Findings

• Prevalence of impairment: Almost half (45%) had serious health conditions while in power.

• Death in office: 17% died from chronic illness while still leading, often after years of declining capacity.

⇒ On average, these leaders had 3.9 health conditions each — with Mao Zedong having 10.

⇒ 62% had cardiovascular disease (heart attack or stroke).

⇒ Many had multi?infarct dementia, severe depression, personality disorders, substance abuse problems, or cognitive decline.

• Health?related departures: Of the leaders who left office alive, 38% had health problems likely influencing their exit.

⇒ This group averaged 2.9 conditions each, from severe mood disorders and partial deafness to early Alzheimer's and Parkinson's disease.

• Direct impairment during crises: Examples include Khrushchev's volatile mental state during the Cuban Missile Crisis and Nixon being too intoxicated to participate in a nuclear alert decision during a Middle East crisis.

• Sole authority risk: In countries like the U.S., Russia, and North Korea, a single leader can order a nuclear strike — with no parliamentary approval required.