This cross-sectional study examined the relationship between alternative anthropometric indices and the nutritional and metabolic status of the Thai elderly. Four rural communities, each from the 4 main regions of Thailand were surveyed. A total of 2,324 subjects, 60 years old and over were included in the study. Mindex and Demiquet had a very strong relationship to body mass index with the r values of 0.93 and 0.88, respectively. Fat weight had the highest correlation with body mass index in older women, r = 0.94 (P< 0.001) and with Mindex, r = 0.93 (P< 0.001). In regard to anthropometric measurements, the mid-arm circumference had the strongest relationship to all three Quetelet indices, r = 0.76-0.87 (P< 0.001), while subscapular skinfold thickness performed best among skinfold measurements, r = 0.69-0.74 (P< 0.001). BMI achieved a significantly higher degree of correlation with triceps and supra-iliac skinfold thickness, mid-arm circumference and fat weight than Demiquet (P< 0.001 for all variables). The lymphocyte count was the only laboratory test that related rather well to all three Quetelet indices. All three Quetelet indices had nearly the same pattern of relationship to various nutritional parameters. The cut-off points of Mindex denoting under-nutrition, overweight and obesity I in women were 55.95, 69.55 and 75.60 kilogram/metre, respectively. At the same time, the cut-off points of Demiquet denoting under-nutrition, overweight and obesity I in men were 75.60, 93.98 and 102.16 kilogram/metre2, respectively. All this information supports the benefit of using Mindex and Demiquet as alternatives to body mass index for nutritional assessment in older Asian people, especially for the malnourished ones.