A considerable number of physiological functions are known to show a gradua
l decline with increasing age. However, the effects of ageing differ widely
between organ systems. It is believed that basal metabolic rate (BMR) fall
s dramatically with age. These observations, largely based on cross-section
al surveys, are discussed in light of our present understanding of the biol
ogy of ageing. This paper reviews both the longitudinal and cross-sectional
studies of BMR and presents evidence that the fall in BMR with ageing may
be less dramatic than previously perceived. Indeed, some subjects may show
an increase in BMR with ageing. The mechanism of changes in BMR during agei
ng will be discussed. Organ weight changes appear to have a profound impact
on BMR. The use of BMR to predict total energy expenditure in the 'old eld
erly' ( > 75 y) is unlikely to be of any practical use due to wide intra- a
nd inter-individual variation in BMR. This wide intra- and inter-individual
variation in BMR is due to illness, disease and other metabolic disorders
seen in the elderly. Finally, the importance of measuring BMR in elderly po
pulations for its use in clinical medicine will be discussed.