AbstractObjectiveSuicide rates in persons over 65 have been reported to be higher than those of younger age groups. Since the absolute number of suicides in the elderly is expected to rise, more precise ways to identify potential risk factors for elderly suicides are needed.MethodsOn the basis of forensic examinations suicide rates and methods in elderly Finns of northern Finland were compared with those of adults aged 18–64 years. Data from earlier illnesses of the suicide victims were scrutinized for records of multiple physical disorders.ResultsOver the 15‐year period the mean annual suicide rate per population of 100 000 was significantly lower in the elderly (22.5) than adults aged 18–64 years (38.4). A decrease in suicide rates over time occurred in both groups. Suicide methods among elderly were more often violent, and they were seldom under the influence of alcohol. They also had a high prevalence of previous hospital‐treated depressive episodes and hospital‐treated physical illnesses. A lifetime history of hospital‐treated depression was more common among elderly victims who had received hospital treatment for genitourinary diseases, injuries or poisonings after their 50th birthday.ConclusionsOur results from elderly suicide victims suggest an association between multiple physical illnesses and a history of depression. Especially, genitourinary diseases as well as hospital treatment due to injuries or poisonings were shown to associate with depression. Elderly Northern Finns showed lower suicide rates, and they decreased during the study period suggesting that active preventive measures against suicide are also feasible in the elderly. Copyright © 2006 John Wiley & Sons, Ltd.