We studied 39 nursing home patients and proxies to assess their decision-making capability and preferences regarding advance directives (ADs) or "living wills." Most patients willingly stated preferences; over half opted to forego burdensome measures when death appeared imminent. Patients perceived as decisionally capable were more likely to forego life-sustaining measures than those of questionable capability. The vast majority of proxies disapproved of using life-sustaining measures, even in some cases with limited knowledge of patients' preferences.

In a retirement community group of 73 relatively fit elderly white persons, a cross-sectional study of 53 different blood tests was conducted. The five test categories for blood values were hematology, chemistry, thyroid function, protein electrophoresis, and immunology. Fifteen percent of the blood findings were outside the range accepted as normal by the examining laboratories. Most of the subjects showed between 5 and 10 "abnormal" values within the five test categories. Since the findings were fairly predictable in view of the patho-anatomic changes that accompany aging, and since the manifestations of disease were at most subclinical, only minor alterations in individual management were needed. Subsequent appropriate clinical re-evaluation of these subjects during a six-month follow-up revealed no striking changes. It would appear that the ranges of "normal" reference values may need to be expanded. Although cross-sectional laboratory studies are useful, longitudinal studies seem essential if clinicians are to attain a more valid perspective.

The zinc status of 135 elderly blacks, aged 60 to 87 years, from urban low-income households was evaluated based on the zinc content of hair and/or serum. The mean (+/- SD) hair zinc concentration was 142 +/- 77 microgram/g and the mean (+/- SD) serum zinc concentration was 93 +/- 15 microgram/dl. Of the study population 39% had a hair zinc concentration less than or equal to 100 microgram/g and/or a serum zinc concentration less than or equal to 80 microgram/dl. Eleven percent had a hair zinc concentration less than or equal to 70 microgram/g and/or a serum zinc concentration less than or equal to 70 microgram/dl. These findings suggest that the zinc status of this elderly population may be less than ideal.

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