LAUSR

Background and aim of the study In Germany, a constant demographic change is taking place, which leads to an increasing aging of the society. The present study aimed to analyze natural deaths occurring at an age of ≥ 65 years, since health vulnerability in this age group is gaining importance. Material and methods Autopsy reports of the Institute of Forensic Medicine, University Hospital of the Goethe University Frankfurt/Main, Germany, were retrospectively evaluated regarding natural death cases of ≥ 65-year-olds in a time comparison (period I: 2000-2002; period II: 2013-2015). Results During both periods, a total of 1206 autopsies concerning this age group were performed. Among these, 404 cases (33.5%) of unnatural death and 39 cases (3.2%) of a combination of natural and unnatural death were recorded; in 94 cases (7.8%), the manner of death could not be elucidated. The majority (n = 669; 55.5%) included cases of natural death. In the largest group of these (n = 350; 52.3%), cardiac causes of death were predominant, followed by 132 (19.7%) respiratory and 47 (7.0%) abdominal causes of death. In addition, 37 (5.5%) cases of malignant neoplasms, 33 (4.9%) of ruptures of large vessels, 33 (4.9%) of cerebral, and 37 (5.5%) other cases of natural death were noted. A significant decrease of cardiac causes of death was observed in the comparison of periods I and II. In particular, there was a significant decrease in high-grade occlusive coronary sclerosis. Moreover, there were significant differences between both sexes. Men had significantly more bypasses, stents and heart scars and suffered a myocardial infarction about 10 years earlier than women. Conclusion The results of the present study are largely consistent with the literature. The decrease in numbers of cardiac deaths may be attributed to increasingly better medical care and to a significantly higher rate of stent implantation. Especially in times of pandemics, the role of forensic gerontology will become more important.