Erythrocyte sedimentation rate and disease in the elderly.

The erythrocyte sedimentation rate (ESR) is not always elevated in relation to disease. Of 188 elderly autopsy patients studied, 125 had nonmalignant disease and 63 had malignant disease. Of the patients with malignant disease, 13 percent had a clinical ESR of less than 10 mm/hr and 26 percent a rate of less than 20 mm/hr, the upper level of normal for the elderly. Of the patients with nonmalignant disease, 9.6 percent had an ESR of less than 10 mm/hr and 25.6 percent a rate of less than 20 mm/hr. Thus, in about a quarter of the patients, the ESR was below the top normal level for the elderly. Moreover, the ESR may be as high as 35--40 mm/hr in healthy aged persons. Therefore, the ESR is unreliable as a test for the presence of disease (malignant or nonmalignant) in the elderly.