Abstract

Intellectually challenged heads of state have had a remarkable impact on the course of history and the problem of age-associated impairment in politicians appears to increase with growing life expectancy. Lenin, Paul Deschanel, Woodrow Wilson, Franklin D. Roosevelt, Heinrich Lübke, Urho Kekkonen, Mao tse tung, Ronald Reagan, Pope John Paul II., and Robert Mugabe were still in power while showing signs of cognitive impairment. Margaret Thatcher, Walter Scheel, Helmut Kohl and many others developed dementia after their resignation. Mild cognitive impairment in Paul von Hindenburg and in communist sclerocrats (Andropow, Breshnew, Ceausescu, Honecker, Mielke and others) may have contributed to the rise of Adolf Hitler and the downfall of communist regimes, respectively. Two prototypes of presidential dementia have to be distinguished: the tragic senile King-Lear-form with cognitive deficits and the buffalo- and buffoon-like King-Ubu-type with predominant behavioral disturbances.