Age is the most important risk factor for the development of infectious diseases, cancer and chronic inflammatory
diseases including rheumatoid arthritis (RA). The very act of living causes damage to cells. A network of molecular,
cellular and physiological maintenance and repair systems creates a buffering capacity against these damages. Aging leads
to progressive shrinkage of the buffering capacity and increases vulnerability. In order to better understand the complex
mammalian aging processes, nine hallmarks of aging and their interrelatedness were recently put forward.
RA is a chronic autoimmune disease affecting the joints. Although RA may develop at a young age, the incidence of RA
increases with age. It has been suggested that RA may develop as a consequence of premature aging (immunosenescence)
of the immune system. Alternatively, premature aging may be the consequence of the inflammatory state in RA. In an effort
to answer this chicken and egg conundrum, we here outline and discuss the nine hallmarks of aging, their contribution
to the pre-aged phenotype and the effects of treatment on the reversibility of immunosenescence in RA.