The demographics and forensic autopsy findings of 125 elderly persons were analyzed to identify the risk factors of fatal accidents among elderly and to develop preventive measures to minimize such events. Cliniconeuropathologic dementing diseases were diagnosed in 13 of the 69 accidental death but only 1 of the 56 nonaccidental death cases, indicating that dementing diseases are associated with accidental deaths of elderly in forensic autopsy populations and suggesting that interventions for preventing fatal accidents should focus on elderly persons with dementia. Blood alcohol was only detected in persons without dementia, indicating that dementing diseases and drunkenness are not coexisting factors for fatal accidents among elderly. Living alone might increase the risk of mortalities associated with accidental injuries because of the absence of a caregiver at the scene and delayed medical help. The majority of fatal accidents occurred outdoors, emphasizing the need for interventions to reduce environmental hazards such as those related to traffic, open water, and cold weather. Increased public awareness of accident risks and preventive interventions will reduce accidental deaths among community-dwelling elderly people.