Erythrocyte sedimentation rate and disease in the elderly

Area of Science:

• Gerontology
• Clinical Pathology
• Biochemistry

Background:

• The erythrocyte sedimentation rate (ESR) is a common blood test used to detect inflammation.
• Elevated ESR levels are typically associated with disease, but their reliability in the elderly population is questioned.

Purpose of the Study:

• To evaluate the diagnostic utility of the erythrocyte sedimentation rate (ESR) in elderly patients with and without malignant or nonmalignant diseases.
• To determine if ESR is a reliable indicator of disease presence in the aged population.

Main Methods:

• Retrospective analysis of erythrocyte sedimentation rate (ESR) values from 188 elderly autopsy patients.
• Categorization of patients into groups with malignant disease (n=63) and nonmalignant disease (n=125).
• Comparison of ESR levels in diseased patients against established normal ranges for the elderly.

Main Results:

• A significant percentage of elderly patients with malignant disease (26%) and nonmalignant disease (25.6%) exhibited ESR levels below 20 mm/hr, the upper limit of normal.
• Approximately 13% of patients with malignant disease and 9.6% with nonmalignant disease had ESR values below 10 mm/hr.
• Healthy elderly individuals can present with ESR levels as high as 35-40 mm/hr, further complicating interpretation.

Conclusions:

• The erythrocyte sedimentation rate (ESR) is an unreliable biomarker for detecting disease, whether malignant or nonmalignant, in elderly individuals.
• The high prevalence of normal or low ESR values in diseased elderly patients, coupled with elevated rates in healthy individuals, limits its diagnostic value.
• Clinical correlation and further diagnostic testing are essential when interpreting ESR results in the geriatric population.