Hypothermia occurs more commonly in those individuals who have underlying disease or are incapacitated, such as under the influence of alcohol. People can die from improperly heated homes or apartments or if they are caught outside in the cold. Alcoholics can become hypothermic if they fall asleep in the cold while inebriated. Nursing-home patients can succumb to the cold after becoming confused and walk outdoors during winter months.

There are usually no external signs of trauma unless the individual was rendered incapacitated by an injury before dying from the cold.

"Paradoxical undressing" may occur because the individual may begin to undress while dying from the cold. This may appear suspicious if the decedent is a naked woman found outside with her clothes strewn about. An initial impression may suggest sexual assault, however, further investigation should uncover the correct manner and cause of death.

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