Medical screening of elderly heads of state

As the world population grows older, and as work retirement ages are being increasingly abolished in many countries, it is more likely that there will be elderly Heads of State who hold powerful positions which can result in great good or great harm. On the basis of this narrative review, we propose that elderly Heads of State over the age of 70 years have annual medical screening that includes comprehensive neuropsychological testing, psychiatric screening and brain imaging, so that we can be reassured of the mental integrity of such leaders and so as to prevent harmful decisions being taken by mentally-compromised Heads of State.