Background: Seniors aged 75 and above have the highest suicide rates of all age groups in most industrialized countries. However, research concerning risk factors for suicide in the old elderly is sparse.

Objective: The purpose was to determine predictors for suicide among the old elderly (75+). Data concerning the young elderly (65-74 years) are shown for comparison.

Methods: 85 consecutive cases of suicide that occurred in western Sweden and 153 control persons with the same sex, birth year, and zip code as the suicide cases were randomly selected from the tax register. The old elderly group included 38 cases and 71 controls; the young elderly group included 47 cases and 82 controls. Data concerning the suicide cases were collected through interviews with close informants; controls were interviewed in person. The interview included questions on past-year life events and mental and physical health. Medical records were reviewed for cases and controls. The Cumulative Illness Rating Scale - Geriatrics was used to rate illness burden.

Results: Family conflict, serious physical illness, loneliness, and both major and minor depressions were associated with suicide in the 75+ group. Economic problems predicted suicide in the younger but not in the older elderly. Old elderly suicide victims with depression (major or minor) were less likely to have received depression treatment than their younger counterparts.

Conclusions: Better recognition and treatment of both major and minor depression should constitute an important target for the prevention of suicide in the old elderly. Intervention studies with large numbers of senior participants are sorely needed.