Aim To analyze older adults’ health‐related decision‐making profile. Methods Secondary analysis of a population‐based study with 6945 older‐adults (aged ≥60 years) in Southern Brazil. Multiple logistic regressions were calculated to describe the odds of deciding alone or asking for advice, compared with the chance of letting someone else decide about health‐related issues. Associated variables were age, sex, marital status, education level, number of chronic morbidities, having children and quality of life. Results The odds of asking for advice instead of letting others decide were significantly higher in the younger group and those with better levels of quality of life, independent of other variables. The chance of asking for advice was lower for unmarried (62%), widowed (76%) and those with children (50%). The chance of men deciding for themselves about their health instead of letting others decide was 47% higher compared with women (P = 0.0002), but 45% lower in the older group (P < 0.0001). Participants who where unmarried and childless, and individuals with better levels of quality of life were more likely to decide alone instead of letting others decide (P < 0.05). Conclusions Decision‐making is fundamental for older adults’ good quality of life. Aging makes older adults more vulnerable to dependence; however, it does not necessarily mean that they lose or decrease their ability to make decisions regarding their own health and desires. Geriatr Gerontol Int 2017; 17: 798‐803.