BACKGROUND: Suicide rates traditionally increased with ageing. There is a paucity of studies examining factors associated with age-associated trends in suicide rates. METHODS: The relationship between suicide rates and ageing was examined by ascertaining suicide rates in the seven age-bands 16-24 years to 75+ years from the World Health Organization for 97 countries. The relationship between socio-economic status, income inequality, healthcare expenditure, child mortality rates and life expectancy and countries with an increase, a decline and no change in suicide rates with ageing was examined using data from the United Nations. RESULTS: In males and females there was a decline in 5 and 10 countries, an increase in 33 and 37 countries and no change in 59 and 50 countries respectively in suicide rates with ageing. Age-associated trends in suicide rates were significantly associated with socio-economic status (males) or income inequality (females), per capita expenditure in healthcare, the proportion of gross-national domestic product spent on healthcare, child mortality rates and life expectancy. CONCLUSIONS: The current study, of factors associated with age-associated trends in suicide rates, confirmed a previously developed five sequential stage model to explain the relationship between elderly suicide rates and socio-economic status and income inequality, quality and quantity of healthcare services, child mortality rates and life expectancy.