In American history, eight sitting presidents have died while still in office. Four passed away from natural causes, and four were assassinated. In every one of those cases, the vice president immediately stepped in and became president. That long-standing rule still applies today.
With Donald Trump beginning his second term in January 2025 at the age of 79, he became the oldest person ever inaugurated as president of the United States. That reality has naturally led many people to wonder what would happen if a president were to die while still serving. Trump broke the previous record held by Joe Biden, who was the oldest president to serve during his term. Trump was even older at the moment of his inauguration than Biden had been at the same point in his presidency.
The US Constitution is very clear on this issue, especially after the addition of the 25th Amendment. If a president dies, resigns, or is removed from office, the vice president automatically becomes president right away. There is no gap in leadership. The vice president would be sworn in as soon as possible and would immediately take on all the powers and responsibilities of the presidency.
If such a situation were to occur during Trump’s term, Vice President JD Vance would take over as president. This exact process has already happened eight times in US history, and it has always followed the same pattern. Once sworn in, the new president has full authority to decide whether to keep existing cabinet members or replace them with new ones.
Because the vice presidency would then be empty, the new president would be required to nominate a new vice president. Under the 25th Amendment, that nominee must be approved by a majority vote in both the House of Representatives and the Senate before they can officially take office.
There is also an interesting age factor involved. If JD Vance were to become president before turning 42, he would be younger than Theodore Roosevelt was when Roosevelt assumed the presidency in 1901 after the assassination of President William McKinley. Roosevelt was 42 at the time and remains the youngest person ever to become president through succession. John F. Kennedy, however, still holds the title of the youngest person ever elected president.
Presidential term limits would also come into play. The 22nd Amendment states that no one can be elected president more than twice. It also explains what happens when someone takes over partway through another president’s term. If a vice president becomes president and serves more than two years of the remaining term, they can only run for president one more time. If they serve two years or less, they are allowed to run and be elected twice.
Trump’s health has been a frequent topic of public discussion, something he has often brushed off. In an interview with The Wall Street Journal, Trump addressed many of the rumors directly. He admitted that he had a CT scan in October, after earlier saying it was an MRI, but insisted there was nothing wrong. He denied claims that he struggles to hear or that he has fallen asleep during White House events, and the newspaper noted that he appeared clearly annoyed by how often his health is debated.
“Let’s talk about health again for the 25th time,” Trump said sarcastically during what the paper described as an impromptu phone call ahead of their story being published.
Trump also revealed that he has taken higher-than-recommended doses of aspirin for about 25 years. He said he believes aspirin helps thin the blood and worries about blood being too thick as it moves through his heart. At the same time, he admitted the aspirin has caused him to bruise more easily.
Trump’s doctor, Navy Captain Sean Barbabella, told the Journal that the CT scan was done to fully rule out any heart-related problems and that no abnormalities were found. Trump has been diagnosed with chronic venous insufficiency, a common condition in older adults that can cause swelling in the legs. Doctors advised him to wear compression socks, but he chose not to.
“I didn’t like them,” Trump said, explaining instead that he now stands up and moves around more often during the day, which he says has helped reduce the swelling. As for visible bruises on his hands seen in photographs, Trump said he now carries makeup with him just in case.
“I have makeup that’s easy to put on, takes about 10 seconds,” he said.
The debate over age and health in the presidency is not new. Trump’s predecessor, Joe Biden, ultimately dropped out of the 2024 election after a shaky debate performance against Trump raised widespread concerns about his age and mental sharpness. The issue of presidential health, especially at advanced ages, continues to be a major point of public attention and political debate.
