German authorities suspect that some of the remains found in a World War II-era mass grave are from child victims of Adolf Hitler's euthanasia program, which killed people the Nazis considered worthless, officials said Friday.

Prosecutors acting on a tip from an aging witness have opened a murder investigation, despite the difficulty of finding conclusive evidence more than 60 years after the end of the war and the likelihood that most or all of those responsible are dead.

"As long as we have even the slightest indication that the children were victims of the Nazi euthanasia program, we will keep on investigating," prosecutor Ulrich Maass said.

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Forensic experts have spent the past several days exhuming the remains from a Roman Catholic cemetery in Menden's Arnsberg district. The remains of 51 people have been discovered so far.

Twenty-two of the skeletons appeared to be of children ranging from newborns to 7-year-olds. Some showed signs of physical or mental handicap, such as those associated with Down's syndrome, he said.

Those signs and the young age of the deceased triggered the euthanasia suspicions.

Maass, a prosecutor at the Dortmund-based Central Office for Investigation of Nazi-era Crimes, said he had begun a criminal investigation for at least 22 counts of murder.

"Of course, there is the question of how we are to prove these crimes after all this time. If the children were poisoned, that will be practically impossible," Maass said.

"Many patients were probably simply left to starve. In this case, it is impossible to prove who is guilty," he said.

Others, including the 29 adults found in the grave, could have been killed in Allied bombing raids or in flooding after the British bombers known as the "dambusters" destroyed the dam in the Moehne valley in 1943, he said.

The prosecutors hope that several witness, including an elderly woman who worked during the war in the nearby Wickede-Wimbern Hospital, where he suspects the children were killed, would be able to help his case.

"A hospital administrator and a doctor are also still alive," Maass said. It was not clear if the doctor had anything to do with the children, he said.

He declined to say who tipped off authorities about the grave.

According to the initial results of the investigation, the bodies were buried in two cemeteries in Menden between January 1944 and April 1945. In the chaos of the final months of the war, Maass said the hospital workers appeared to have giving up regular burial in favor of hurriedly casting them into a mass grave.

About 200,000 people, many of them children, who were deemed unfit were killed by doctors under the Nazis as part of a vast Europe-wide euthanasia program, according to the U.S. Holocaust Museum.

Karl Brandt, Adolf Hitler's personal physician led the program, which was designed to purify the German race. Brandt was convicted along with other Nazi doctors at the Nuremberg trials after the war and executed.

According to Harald Jenner, a prominent German historian, up to 8,000 minors died in facilities for the disabled between 1939 and 1945 under mostly unclear circumstances.

Another estimated 70,000 disabled or mentally ill adults were deliberately killed under a secret Nazi program code-named T4 in specially established death camps in 1940-1941.

The victims were told they were to take a shower and then killed with poisonous gas, pioneering techniques used in the Final Solution against Europe's Jews, according to the Holocaust Museum. Victims' families were sent urns of ashes and a fictive death certificate.

Jenner said many more disabled people died of hunger and neglect toward the end of the war as they were evacuated to remote facilities to free up hospital beds.

"There wasn't always an order to kill them," Jenner told reporters in an interview.

"The manager of a home might have simply received another 300 people to look after and the authorities said they couldn't provide any more food."