Summary

Erythocyte sedimentation rate (ESR) is one of the oldest measures of inflammation. It is used extensively in clinical medicine and has shown some utility in biomedical research. It is a nonspecific inflammation assay, and although it is less sensitive than more modern measures such as C-reactive protein, it is a useful measure in chronic illnesses.

In general, ESR increases with age and appears to be a biomarker of aging in general. It predicts both cardiovascular disease (CVD) and cancer and is elevated in autoimmune disorders such as rheumatoid arthritis. Further, it predicts mortality both in the general population and in those with chronic illnesses such as CVD and cancer, independent of other indicators of illness severity.

Interestingly, ESR is not associated with anxiety or general measures of distress but is consistently associated with measures of depression and suicidal ideation. Further, the effect of depressive symptoms on mortality appears to be mediated through increases in ESR.

Studies of the relationship between stress and ESR have been less consistent, primarily because early studies were largely cross-sectional and in small samples. Studies using more modern, longitudinal analyses in larger samples may show more consistent results, especially if multilevel modeling was used that examined within-person changes in ESR in response to stress. Given that other large, longitudinal studies, such as the Baltimore Longitudinal Study on Aging, the Rotterdam Study, The Reykjavik Cohort Study, and Women’s Healthy Ageing Study have included ESR in their biomedical assays, it should be possible to analyze existing data to examine how psychosocial factors influence inflamm-aging in humans.