BACKGROUND: Older adults have the highest suicide rates globally, yet contemporary national evidence on suicide in later-life remains limited in Ireland.

OBJECTIVE: To examine the rates, sociodemographic and clinical factors of older adults who die by suicide in Ireland.

METHODS: Retrospective analysis of coronial files of older adults aged ≥60 years who died by suicide in Ireland during 2015-2020, with adults aged 18-59 years as a comparison group. Crude suicide rates per 100 000 were calculated. Differences in sociodemographic and clinical variables were tested using χ or Fisher's exact tests. ORs with 95% CIs compared suicide methods between age groups. Poisson regression models estimated changes in suicide rates. A Lived Experience group contributed to interpretation.

FINDINGS: Between 2015 and 2020, 654 older adults died by suicide. The average suicide rate for older adults was 12.0 per 100 000 compared with 17.5 per 100 000 among adults aged 18-59. However, marked within-group variation existed, with older single males having the highest suicide rate overall (38.1 per 100 000). Among older adults, males aged 60-69 years had the highest rate (21.8 per 100 000). Suicide risk increased during summer, especially among older adults. Rates declined in 2020 in older males. Among individuals who died by suicide, older adults were more likely to be married, live alone and in agricultural and managerial socioeconomic groups compared with adults aged 18-59. Among suicide deaths, older adults were more likely to have physical health conditions, recent acute pain, loneliness and seen their general practitioner (GP). Within the suicide cohort, financial concerns and interpersonal difficulties were more commonly experienced by younger adults. Method profiles differed by age, with drowning and firearm-related suicides higher among older adults.

CONCLUSIONS: Older adults who died by suicide in Ireland had distinct sociodemographic and clinical profiles compared with younger adults. While mental health symptoms were common across age groups, later-life suicide was more frequently characterised by physical health conditions, loneliness and recent healthcare contact.

CLINICAL IMPLICATIONS: Findings highlight the need for sex-specific and age-specific suicide prevention strategies that address systemic factors, including improved GP training and strengthened community-based services. Increased contact with healthcare services highlights opportunities for intervention.