Weight-for-height and weight changes over a 2-year period among 335 institutionalized elderly adults at a geriatric care facility are described. Weight-for-height at admission was compared with several current standards for elderly persons. Mean relative weight and proportions of underweight and obese patients varied with the standards used. Although changes in group mean weights were slight, 73% of the patients gained or lost 4.5 kg or more in 2 years. Patients who lost 4.5 kg or more in the interval had a lower 4-year survival rate (p less than .05) than patients who gained weight or remained stable. Fluctuations in weight may be more prevalent among institutionalized elderly persons than previously thought, or than are apparent in analyses of group trends. Monitoring an individual's weight is simple and may be more meaningful than comparison to a standard, especially because weight loss is associated with mortality, until age appropriate standards are developed.