UNIVERSITY OF MARYLAND
Claude D. Pepper Older Americans Independence Center

Jay Magaziner, Ph.D., M.S.Hyg
MPI 		  410-706-3553   jmagazin@som.umaryland.edu
Alice Ryan, Ph.D.
MPI		   410-605-7851   aryan@som.umaryland.edu
Les Katzel, M.D., Ph.D.
MPI		   410-605-7248   lkatzel@som.umaryland.edu
Anne Sullens, M.A
Program Director		   410-706-1695   asullens@som.umaryland.edu
     
CENTER DESCRIPTION

The mission of the UM-OAIC is to address the process by which function is lost, and the multiple factors that affect the onset and progression of disability. Building on these important perspectives, the UMOAIC focuses on the restoration of function (i.e., enablement) in order to improve function in those with impairments, and prevent or delay further progression in those who are already disabled. This is accomplished by 1) conducting research that examines the mechanisms underlying the functional impairments associated with chronic diseases in older people, such as stroke, hip fracture, obesity, Type-2 diabetes, osteoarthritis, Parkinson's disease, and vascular disease; 2) designing novel, efficacious rehabilitation interventions that produce clinically relevant outcomes and study the mechanisms underlying these interventions; 3) translating interventions found to be efficacious in UM-OAIC clinical laboratories and other clinical centers for implementation and rigorous evaluation outside the clinic (e.g., home, senior center, gym); 4) supporting pilot and exploratory studies (PESs), UM-OAIC REC Scholar research, development projects (DPs), and externally funded projects (EP) that are consistent with the UM-OAIC theme; and 5) supporting the development of junior faculty and REC Scholars from multiple disciplines as they pursue careers as independent, academic scientists with expertise in the study of older persons with disabling diseases through mentor-based, didactic and experiential training in bench-to-bedside-to-community translational research.

The UM-OAIC has three resource cores (RC): Biostatistics and Informatics (RC1); Applied Physiology and  Mechanisms (RC-2); and Rehabilitation Science and Technologies (RC-3), that serve as resources for the conduct of innovative exercise and activity-based rehabilitation research. An enhanced Research Education Core (REC) will provide didactic and experiential, and leadership training under the guidance of an interdisciplinary mentoring teams to prepare the next generation of scientists committed to careers in aging research. A Pilot and Exploratory Studies Core (PESC) supports the development and execution of pilot and REC Scholar projects.  Center aims will be accomplished by: 1) advancing our understanding of the mechanisms by which exercise and activity-based and multi-modal rehabilitation interventions directed a specific impairments affect multiple body systems; 2) developing and testing interventions to restore function and minimize disability following acute disabling events and to prevent declines related to serious chronic diseases; and 3) training the next generation of investigators who will further the understanding of the aging process and develop interventions that help promote health and independence in older adults with disabling medical conditions.  

CORES
Leadership and Administrative Core (LAC)
Leader 1:    Jay Magaziner, PhD, MS Hyg.   jmagazin@som.umaryland.edu
Leader 2:    Leslie I. Katzel, MD   lkatzel@som.umaryland.edu
Leader 3:    Alice Ryan, PhD   aryan@som.umaryland.edu
The Leadership and Administrative Core (LAC) ensures that the UM-OAIC provides support for conducting novel research and training the next generation of scientists pursuing research careers in aging and oversight to the five UM-OAIC cores. Core leaders also foster maximal outreach and interaction with the rest of the University of Maryland, Baltimore (UMB) inter-professional campus, other OAICs, and research programs elsewhere pursuing work on areas relevant to the UM-OAIC’s enablement theme. The LAC will receive input and guidance, and discuss program operations in the Core Leadership Executive Committee (CLEC) meeting of core leaders; the UM-OAIC Research and Education Advisory Panel (REAP) charged with reviewing proposed Development and Pilot Exploratory Studies and progress of Scholars; a Community Advisory Board (CAB) that will provide input on issues that are most relevant for enabling function in older persons with disabling conditions in different communities and on the merit of research that is being proposed and conducted in the UM-OAIC; an Internal Advisory Committee (IAC) that evaluates UM-OAIC progress and accomplishments, and provides advice on ways to extend research on aging to other university centers and departments; and an External Advisory Board (EAB) that will provide guidance to the program and report progress annually to the NIA. In addition, the LAC receives advice from an Internal Data and Safety Monitoring Board (I-DSMB) that will review the conduct of clinical protocols to ensure patient safety and progress of projects, and an External Data and Safety Monitoring Board (E-DSMB) that will provide another layer of review by experienced, impartial scientists that will monitor study progress and data quality and safety, and report to the NIA annually.

Research Education Component (REC)
Leader 1:    Mary-Claire Roghmann, MD, MS   mroghman@som.umaryland.edu
Leader 2:    Odessa Addison, DPT, PhD   oaddison@som.umaryland.edu
The purpose of the Research Education Core (REC) is to support the development of junior faculty from multiple disciplines as they pursue careers as scientists with a focus on the restoration of function among older adults with impairments and on the prevention or delay of progression in those who are already disabled. The REC supports Scholars and affiliated faculty (who are former Scholars or junior faculty with career development awards related to our mission) in mentor-based research training and other career development activities in a supportive research environment. The REC will achieve the above with the following aims: 1) Recruit and retain REC Scholars and affiliated faculty committed to research careers congruent with the UM-OAIC mission; 2) train REC Scholars and affiliated faculty through mentored research projects and individualized training plans which use the resources of the UM-OAIC, the national OAIC network and other NIA supported programs; 3) Develop a Leadership Academy which will teach leadership skills and provide leadership experience for promising junior and mid-level scientists with demonstrated commitment and expertise to become the next leaders, in the UM-OAIC and nationally, in research aimed at improving function in older adults and 4) evaluate the UM-OAIC Research Education Core with the help of experts in the University of Maryland Baltimore (UMB) Faculty Center for Teaching and Learning and in the Research Education Advisory Panel (REAP).

Pilot and Exploratory Studies Core (PESC)
Leader 1:    Stephen Seliger, MD, MS   sseliger@som.umaryland.edu
Leader 2:    Jennifer Albrecht   jalbrecht@som.umaryland.edu
Leader 3:    Avelino Verceles   averceles@som.umaryland.edu
The purpose of the UM-OAIC Pilot and Exploratory Studies Core (PESC) is to provide critical initial funding for pilot and exploratory studies that are consistent with the UM-OAICs overall goal of advancing the study of enablement in older adults by: 1) identifying the deficits associated with specific disabling conditions; 2) investigating the mechanisms and pathophysiology responsible for these deficits; and 3) developing exercise, other activity-based interventions, and multi-modal rehabilitation strategies that target these mechanisms and deficits; 4) testing them in clinical laboratories/centers under carefully controlled conditions; and 5) adapting them for implementation and further testing in home and other settings outside the medical center. To meet this objective, the PESC will attract junior investigators (and established investigators new to aging research) across a broad range of disciplines to study rehabilitation and recovery in older adults and in relevant pre-clinical models, stimulate new studies in aging-related rehabilitation research through targeted funding, encourage new interdisciplinary collaborations, and translate efficacious therapies across the spectrum from bench to clinical laboratory to community practice. This will advance the UM-OAIC research goal of expanding therapies in the broadest context of rehabilitation that emphasizes restorative and preventive medicine to promote the recovery and enablement of older adults with disabling conditions.

Applied Physiology and Tissue Mechanisms
Leader 1:    Alice Ryan, PhD   aryan@som.umaryland.edu
Leader 2:    Leslie I. Katzel, MD   lkatzel@som.umaryland.edu
Leader 3:    Chris Ward, PhD   ward@som.umaryland.edu
RC-2 provides UM-OAIC investigators comprehensive support for quantified physical activity, functional and metabolic phenotyping, and blood and tissue bioassays to advance clinical research. Research performed by UM-OAIC investigators demonstrates that various modes of exercise, and/or rehabilitation training, improve cardiovascular fitness, muscle endurance, strength, neuromotor control, and body composition in older people with chronic disease and disability such as those with stroke, peripheral arterial disease (PAD), congestive heart failure, obesity, diabetes, hip fracture, an intensive care unit stay, HIV and cancer. Collectively, these works inform our overarching hypothesis that exercise, activity-based, and multi-modal rehabilitation can improve multiple physiological systems in older mobility-limited individuals which in turn can improve functional performance, reduce cardiometabolic disease risk, and prevent further functional decline. To achieve this goal, RC2 implements specific aims that: 1) advance research focused on the mechanisms of functional decline in older persons with disability and the mitigation of decline with exercise or activity-based or multi-modal rehabilitation and 2) provide mentoring and training to REC Scholars, affiliated faculty, and UM-OAIC researchers in the performance of aging research relevant to exercise and rehabilitation-based restoration of function and the prevention of functional declines in older people with chronic disabling diseases.

Biostatistics and Informatics
Leader 1:    John D. Sorkin, MD, PhD   jsorkin@som.umaryland.edu
Leader 2:    Michelle Shardell, PhD   mshardell@som.umaryland.edu
Leader 3:    Michael Terrin, MD, MPH   mterrin@som.umaryland.edu
Leader 4:    Laurence Magder, PhD   lmagder@som.umaryland.edu
The goal of the Biostatistics and Informatics Core (RC-1) plays a central role in UM-OAIC research helping investigators design, conduct, and report results of research studies. RC-1 plays a key role in the coordination and integration of UM-OAIC. Our informatics infrastructure facilitates UM-OAIC operation and oversight by tracking study progress, recording and reporting adverse events, monitoring core requests and use, and providing reports to PIs and Core leaders. RC-1 participates in REC organized education efforts and participates in other research training initiatives at the university. This core has 2 two major goals: 1) to support the conduct of studies that promote the independence of older adults with disabling conditions; 2) train the next generation of investigators who will conduct studies that promote health and independence in older adults. One-on-one training will take place as we help Scholars and other investigators design, execute, analyze and publish their results and as we participate in Research Design Studios, Project Initiation Support Groups and Research Working Groups. In addition, the RC-1 will help investigators find and enroll participants for their research projects, we are expanding our recruitment efforts by adding an investigator experienced in recruiting older persons. Finally, the core will also develop biostatistical methods and informatics resources that facilitate funded and supported projects of the UM-OAIC.

Rehabilitation Science and Technologies Core
Leader 1:    Li-Qun (Larry) Zhang, PhD   l-zhang@som.umaryland.edu
Leader 2:    Kelly Westlake, PhD, MSc, PT   kwestlake@som.umaryland.edu
Rehabilitation Science and Technologies Resource Core 3 (RC-3), aims to improve our ability to prevent and reverse these declines. We build on this core’s strengths in rehabilitation medicine and physical therapy with a focus on gait, balance and mobility research, by expanding to mechanistic studies of motor learning and activity-dependent plasticity. Incorporation of new bioengineering capacity has expanded the resources and mentoring needed by UM-OAIC investigators to design, test, and translate novel rehabilitative technologies and engineering-informed approaches into new services and products. Technology transfer processes and academic-private partnerships are introduced to accelerate translation into community practice and into products with public health impact. The central hypothesis of RC-3 is that rehabilitation science-based therapeutics that leverage activity-dependent plasticity and neuromotor learning (including balance, mobility training, and bioengineering-modelled rehabilitation robotics and other technologies) will improve recovery and enhance function in older adults with functional limitations and disability and will be accomplished through the following aims: Specific Aim 1. To support investigations of sensory, motor, and cognitive mechanisms that underlie loss of functional independence and improvements produced by preventative or rehabilitative interventions. This will be accomplished by providing a repertoire of rehabilitation assessment and training of sensory, motor and cognitive function, development of assistive technologies, assessments of neuroplasticity, and tests of neurocognitive function. Specific Aim 2. To mentor and support REC Scholars and UM-OAIC researchers in the design, development and implementation of sensory, motor, and cognitive rehabilitation studies. These studies may involve implementation of technologies and examining underlying sensory, motor, and cognitive mechanisms to reduce and prevent functional declines in older persons with or at risk for functional limitations . Specific Aim 3. To facilitate translation of UM-OAIC discoveries across the mechanistic, rehabilitation engineering, applied clinical testing, and technology transfer phases into evidence-based clinical assessments and interventions using novel products and tools for precision rehabilitation.

CAREER DEVELOPMENT
REC Scholar, Research & Grants Funded During Pepper Supported Time Years /
Publications
 
Brittany Burch
Assistant Professor / Department of Organizational Systems and Adult Health, University of Maryland School of Nursing
Preserving Ability through Virtual Exercise (PAVE)
The overall objective of this proposed project is to explore the feasibility and preliminary effectiveness of a virtual reality physical activity intervention to engage older adults in physical activity and maintain physical function during their hospital stay. The proposed study, Preserving Ability through Virtual Exercise (PAVE), will be a cluster randomized controlled trial with 40 older patients from one hospital randomized to the PAVE intervention and 40 older patients from another comparable hospital randomized to the education only control. Building off a community-based pilot study, this proposed study will examine the following specific aims: (Primary) Aim 1: Using the NIH Behavior Change consortium guidelines the Acceptability/Appropriateness of Intervention Measure, and the Simulator Sickness Questionnaire, determine the feasibility of the PAVE intervention among hospitalized older adults, compared to the education control group. Aim 2: Test the preliminary effectiveness of the PAVE intervention on 1) time spent in physical activity during the hospital stay and 2) maintenance of physical function, compared to the education control group.
 2024-2026 /
25 (total)
12 (1st/Sr)
 
Stephanie Jo, MD, PhD
Assistant Professor / Department of Diagnostic Radiology and Nuclear Medicine, UMSOM
Identification of high-risk prognostic factors of osteoarthritis based on single nucleotide polymorphism and MRI morphometry utilizing the Osteoarthritis Initiative database
Hypothesis: OA susceptibility SNPs along with semiquantitative and quantitative knee MRI features of OA can predict future knee arthroplasty and severity of pain. Specific aims: Specific aim 1: Identify SNPs associated with semiquantitative and quantitative OA features on knee MRI: Current studies have identified OA susceptibility SNPs based on clinical diagnosis and radiographs. This study will utilize MRI features, which are more specific and sensitive for early OA and OA severity, for SNP association. Specific aim 2: Develop models to predict future knee arthroplasty and pain score based on SNPs and semiquantitative and quantitative OA features on MRI: OA susceptibility SNPs are not part of OA assessment in the current clinical setting, and evaluating 100+ SNPs may not be practical. Also, no studies have yet evaluated the additional predictive value of SNPs and MRI features of OA over the clinical symptoms and signs. This aim will develop OA prediction models with SNP genotype and MRI phenotype for clinical use.
 2023-2025 /
18 (total)
7 (1st/Sr)
 
Sui-Seng Tee, PhD
Assistant Professor / Department of Diagnostic Radiology and Nuclear Medicine, UMSOM
Metabolic Imaging as a Biomarker of Muscle Aging
Metabolic imaging using hyperpolarized magnetic resonance imaging (HP-MRI) is based on injecting non-radioactive, carbon-13 (13C) labeled metabolites as contrast agents, allowing quantification of metabolic flux7. Uniquely, this technique uses non-ionizing radiation, allowing longitudinal imaging. Therefore, this grant breaks new ground in proposing to track metabolic flux in muscles over time, while the organism ages. Indeed, altered metabolism is a hallmark of aging8 and altered muscle metabolism is closely linked with age-related functional decline9. Our overarching hypothesis is HP-MRI detects alterations in glycolytic and mitochondrial metabolism that can be used as predictive and prognostic biomarkers. To this end, we propose 2 aims: Specific Aim 1: Longitudinal Muscle Imaging of Aging in Mice 1.1: Metabolic Imaging of Sarcopenia in a mouse model of physiological aging 1.2: Compare imaging with gold-standard body composition measures, frailty index and histology Specific Aim 2: Metabolic Imaging of Exercise Regimens in Mice 2.1: Compare high-intensity intermittent training (HIIT) with moderate intensity continuous training (MICT) using metabolic imaging 2.2: Validation of metabolic Imaging
  • OAIC Coordinating Center: Early Career Faculty Flexible, High Value Award. Tee (PI). 07/2022-06/2023. $5,000

 2023-2025 /
11 (total)
5 (1st/Sr)
 
Jeanine Ursitti, PhD
Assistant Professor / Department of Orthopaedics
Cell Mechanics as a Biomarker of Osteosarcopenia”
Abstract: Previous work has identified increased cytoskeletal stiffness, driven by increased levels of microtubules post-translationally modified by detyrosination, as a common predictor of biological dysfunction across bone, skeletal muscle, and cardiac tissue. Our new preliminary evidence in aging mice (17-78 weeks) finds increasing microtubule detyrosination in muscle and bone and increased stiffness/mechanics in the muscle fiber. The goal of this pilot project is to determine whether microtubule dependent cytoskeletal stiffness is a novel biomarker of biological aging. Here we will extend our measures of cell mechanics (in isolated intact skeletal muscle fibers) and tubulin biochemistry (in skeletal muscle and bone), to circulating peripheral blood mononuclear cells (PBMCs), to test our hypothesis that the level of microtubule detyrosination, and microtubule dependent cytoskeletal stiffness, are biomarkers of biological age. Hypothesis/Aims: We hypothesize that age-related changes in microtubule (MT) structure and post-translational modifications in Peripheral Blood Mononuclear Cells (PBMCs) will track with changes in skeletal muscle fibers, bone osteocytes, and perhaps other tissues, making it a predictive, easily assessable biomarker. We further hypothesize that the cellular stiffness of PBMCs will track with deTyrosinated MTs (deTyr-MTs) in aging skeletal muscle. We have two specific aims: Aim 1: Define age dependent changes in cytoskeletal structure and properties across disparate tissues and blood monocytes. Aim 2. Determine age-related changes in PBMC mechanics as a biomarker of aging and treatment efficacy.
  • OAIC Coordinating Center: Early Career Faculty Flexible, High Value Award. Ursitti (PI). 07/2021-06/2022. $5,000

 2021-2024 /
9 (total)
2 (1st/Sr)
 
Andrea Levine, MD
Assistant Professor / Department of Medicine
The Longevity of ARDS Inflammatory Subphenotypes and Their Role in Predicting Functional Recovery in Older Adults
Abstract: Acute Respiratory Distress Syndrome (ARDS) is a life-threatening illness of severe hypoxemia. A hyper- and hypo-inflammatory subphenotype exist with a differential treatment effect. We aim to describe the longevity of the subphenotypes determine whether these subphenotypes can predict functional recovery in older adult patients. Hypothesis/Aims: Subphenotype longevity: To determine whether the ARDS subphenotype established on hospital admission is sustained during the inpatient hospitalization and post-acute recovery phase. Approach: We will utilize a parsimonious combination of validated plasma biomarkers (IL-8, HCO-3, and Protein C) to determine whether ARDS subphenotypes established at admission are maintained through the duration of the inpatient hospitalization and at post-acute follow-up three months after discharge in older adult patients. Aim 2: Correlation with longitudinal functional recovery: To determine whether ARDS subphenotype predicts the trajectory of functional recovery in older survivors of ARDS. Approach: In a pilot study, survivors of ARDS will be followed at three months after hospital discharge and assessed for pulmonary recovery via spirometry, neurocognitive function using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), psychiatric status using the Hospital Anxiety and Depression Survey (HADS) and PCL-5 and neuromuscular function using a six-minute walk test and short physical performance battery (SPPB). We will determine whether the inflammatory subphenotype assigned at hospital discharge predicts functional recovery at three-months after hospital discharge.
  • UM-OAIC Pilot Award: The Longevity of ARDS Inflammatory Subphenotypes and Their Role in Predicting Functional Recovery in Older Adults. Levine (PI). 07/2021-06/2024. $46,350
  • NIH Loan Repayment Program: The Longevity of ARDS Inflammatory Subphenotypes and Their Role in Predicting Functional Recovery in Older Adults. Levine (PI). 07/2022-06/2024. $100,000

 2022-2024 /
28 (total)
9 (1st/Sr)
 
Past Scholars
F. Rainer von Coelln, Dr. med, Department of Neurology, University of Maryland School of Medicine (2017-2020)
Tasneem Khambaty, PhD, Department of Psychology, University of Maryland Baltimore County (2018-2021)
Sarasijhaa Desikan, MD, Department of Surgery, University of Maryland School of Medicine (2020-2022)
Jason Falvey, PT, DPT, PhD, Department of Physical Therapy and Rehabilitation Science (2021-2021)

PILOT/EXPLORATORY PROJECTS (11 Pilot Projects Listed)
1. Project Title: Mobile Sensor Investigation of Gait Variability and Hip abductors
  Leader: Odessa Addison, DPT, PhD
  Abstract: Our work suggests that dysfunction of the hip abductors may contribute to balance and mobility limitations resulting in increased fall risk. We have previously shown that gait variability, defined as fluctuations between gait cycles, are an important assessment of mobility and balance function and related to muscle composition of the hip abductor muscles. Gait variability is traditionally assessed via a short 25-foot walk way. However, this distance is too short to account for the impact of fatigue. We propose examining changes in gait variability over a six-minute walk distance may allow for an earlier detection of fall risk by exposing impairments that occur under conditions of fatigue that would otherwise go undetected. The overall aim of our work is to study the use of technology-based assessments and interventions which impact enablement of older adults. Hypothesis/Aims: Aim 1: Examine changes in gait variability between the early and late phase of the six-minute walk. Aim 2: Compare how gait variability in the early and late phases of the six-minute walk relates to muscle size and composition of the hip abductors. Aim 3: Examine how changes in the hip abductors after a 12-week intervention relates to changes in gait variability during the early and late phases of the six-minute walk.
 
2. Project Title: Cell Mechanics as a Biomarker of Osteosarcopenia
  Leader: Jeanine Ursitti, PhD
  Abstract: Previous work has identified increased cytoskeletal stiffness, driven by increased levels of microtubules post-translationally modified by detyrosination, as a common predictor of biological dysfunction across bone, skeletal muscle, and cardiac tissue. Our new preliminary evidence in aging mice (17-78 weeks) finds increasing microtubule detyrosination in muscle and bone and increased stiffness/mechanics in the muscle fiber. The goal of this pilot project is to determine whether microtubule dependent cytoskeletal stiffness is a novel biomarker of biological aging. Here we will extend our measures of cell mechanics (in isolated intact skeletal muscle fibers) and tubulin biochemistry (in skeletal muscle and bone), to circulating peripheral blood mononuclear cells (PBMCs), to test our hypothesis that the level of microtubule detyrosination, and microtubule dependent cytoskeletal stiffness, are biomarkers of biological age. Hypothesis/Aims: We hypothesize that age-related changes in microtubule (MT) structure and post-translational modifications in Peripheral Blood Mononuclear Cells (PBMCs) will track with changes in skeletal muscle fibers, bone osteocytes, and perhaps other tissues, making it a predictive, easily assessable biomarker. We further hypothesize that the cellular stiffness of PBMCs will track with deTyrosinated MTs (deTyr-MTs) in aging skeletal muscle. We have two specific aims: Aim 1: Define age dependent changes in cytoskeletal structure and properties across disparate tissues and blood monocytes. Aim 2. Determine age-related changes in PBMC mechanics as a biomarker of aging and treatment efficacy.
 
3. Project Title: The Longevity of ARDS Inflammatory Subphenotypes and Their Role in Predicting Functional Recovery in Older Adults
  Leader: Andrea Levine, MD
  Hypothesis/Aims: Subphenotype longevity: To determine whether the ARDS subphenotype established on hospital admission is sustained during the inpatient hospitalization and post-acute recovery phase. Approach: We will utilize a parsimonious combination of validated plasma biomarkers (IL-8, HCO-3, and Protein C) to determine whether ARDS subphenotypes established at admission are maintained through the duration of the inpatient hospitalization and at post-acute follow-up three months after discharge in older adult patients. Aim 2: Correlation with longitudinal functional recovery: To determine whether ARDS subphenotype predicts the trajectory of functional recovery in older survivors of ARDS. Approach: In a pilot study, survivors of ARDS will be followed at three months after hospital discharge and assessed for pulmonary recovery via spirometry, neurocognitive function using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), psychiatric status using the Hospital Anxiety and Depression Survey (HADS) and PCL-5 and neuromuscular function using a six-minute walk test and short physical performance battery (SPPB). We will determine whether the inflammatory subphenotype assigned at hospital discharge predicts functional recovery at three-months after hospital discharge.
 
4. Project Title: The Effects of Neuromuscular Activity and Muscle Structure on Stepping Performance in older Adults
  Leader: Marcel Lanza, PhD
  Abstract: This pilot project seeks to understand the effects that age has on the time to transfer weight, torque production, and neuromuscular control during the weight transfer for different step directions and whether a step direction is more impaired. The results of this project may provide insight into the direction most likely to result in a fall among older adults. Hypothesis/Aims: The aims of this project are: 1) to determine the age associated changes in the control of the weight transfer of the lateral, forward, and backward steps by comparing older to younger adults; 2) to determine the age associated changes in the hip abductors and adductors rate of torque development and rate of activation of the lateral, forward, and backward steps between young and older adults; 3) to determine the age associated changes in the hip abductors and adductors muscle structure and association with the weight transfer.
 
5. Project Title: Retinal Blood Flow and its Evolution with Aging
  Leader: Osamah Saeedi, MD, MS
  Abstract: We are investigating objective and quantitative retinal vascular biomarkers of functional performance, specifically cognition, and mobility in older adults. We anticipate that participants with lower cognitive and balance scores will have significantly lower vessel density, retinal blood flow velocity, and vasomotion. Hypothesis/Aims: Specific Aim 1: Quantitively investigate the relationship between cognitive and mobility performance with retinal microvascular metrics: Aim 1A: Correlate cognitive and mobility performance with retinal vessel density and flow rate using in vivo measures of ocular blood flow: optical coherence tomography angiography (OCTA) and laser speckle contrast imaging (LSCI). We hypothesize that participants with lower cognitive and balance scores will have significantly lower vessel density and retinal blood flow velocity as measured by OCTA and LSCI respectively. Aim 1B: Correlate cognitive and mobility performance with vasomotion using in vivo erythrocyte mediated angiography (EMA). We hypothesize that vasomotion, as quantified by vascular erythrocyte pausing in the optic disc and the macula, will be significantly impaired in participants with lower cognitive and balance scores. Specific Aim 2: Confirm the validity of these vascular biomarkers in comparison with the systemic microvasculature using in vivo nailfold video capillaroscopy (NVC). We hypothesize that the retinal vascular parameters will demonstrate greater diagnostic accuracy in differentiating participants according to their cognitive and balance performance levels.
 
6. Project Title: Exercise Capacity Improvement in Heart Failure with Preserved Ejection Fraction and Pulmonary Hypertension (PH-HFpEF) after SGLT2 Inhibitor (Empagliflozin) Initiation
  Leader: Steven Cassady, MD
  We propose a pilot study to evaluate use of SGLT2 inhibitors on functional outcomes in a cohort of patients with HFpEF and pulmonary hypertension determined by echocardiography. Our primary outcome will be the change in peak VO2 achieved by patients during maximal cardiopulmonary exercise testing (CPET) from within 20 days of drug initiation to 90 days after drug initiation. Secondary outcomes will include CPET-derived measures of ventilatory efficiency as well as changes in performance on the Short Physical Performance Battery and six-minute walk testing. Through the establishment of improved functional outcomes in this specific patient population, we hope to demonstrate sufficient benefit to encourage wider prescribing of SGLT2 inhibitors in PH-HFpEF and to generate promising data for larger scale studies in this population. Additionally, this study would also function to provide blood samples to be used for future investigation of the metabolic effects of SGLT2 inhibitor use in this group.
 
7. Project Title: Time-restricted eating to entrain circadian rhythm, increase physiological responsiveness, and prevent stressor-induced frailty
  Leader: Amber Kleckner, PhD
  Frailty affects more than 5.4 million people over the age of 65 in the United States alone (>10%) and is one of the main reasons older adults lose independence. Frailty, or the reduction of physiological reserve, does not progress linearly; its pathogenesis often accelerates in response to a “stressor event,” for example cancer and its treatment. Specifically, a diagnosis with prostate cancer and androgen deprivation therapy (ADT) treatment are associated with accelerated frailty. While the body is resilient to everyday stressors, large-scale, enduring stressors can accumulate and cause the body to have difficulty predicting energy supply and demand. The result is that stress-induced energy costs compete with cellular growth, maintenance, and repair, i.e., frailty. Treatments for frailty are intensive (e.g., resistance exercise) and often unsuccessful, and there are critical needs to 1) develop effective interventions to prevent and treat frailty, and 2) identify physiological precursors to frailty so that we can provide timely intervention(s) to prevent progression to the frail state. We theorize that entrainment of circadian rhythm, or the body’s internal body clock, will improve the body’s ability to predict energy supply and demand, and therefore enable the body to allocate more resources to anabolic processes and promote resilience to toxicities caused by ADT. Time-restricted eating (TRE) entails consuming food within a defined, consistent window every day. It has emerged as a powerful intervention to entrain circadian rhythm and regulate metabolic homeostasis. We hypothesize that, by entraining circadian rhythm, TRE can enhance physiological regulation and prevent stressor-induced frailty. To test this hypothesis, we will recruit 30 patients over 55 years old undergoing ADT therapy for prostate cancer. Participants will be randomized 1:1 to a 12-week TRE intervention or a time- and attention-matched nutrition control intervention; both groups will be under the supervision of a licensed clinical nutritionist with expertise in the cancer population to ensure adequate nutrient intake. At baseline and post-intervention, we will assess frailty using Fried’s Frailty Index and a novel set of five physiological responsiveness measures: a) lying-to-standing blood pressure, b) heart rate variability, c) oral glucose tolerance test, d) 24-hour circadian cortisol rhythm, and e) usual vs. fast gait speed. These data will allow us to test the feasibility of TRE among patients with prostate cancer during ADT treatment and optimize measures of reduced physiological reserve with the ultimate goal of optimizing an intervention to prevent the progression of frailty.
 
8. Project Title: Metabolic Imaging as a Biomarker of Muscle Aging
  Leader: Sui Seng Tee, PhD
  Sarcopenia is an age-related decline of muscle function and mass that increases the risk of death1 and exerts a significant cost on healthcare systems2. Diagnostic guidelines continue to evolve, from an initial focus on muscle mass to increased attention on muscle function. Current guidelines include both muscle mass and function, in the form of handgrip strength for diagnosis. However, lower extremity strength is a more important contributor to frailty. There is an unmet need for quantification of lower extremity muscle function. The long-term objective is to enable translation of metabolic imaging as a non-invasive tool to quantify muscle metabolism in sarcopenia to deliver objective measures of muscle quality in the management of sarcopenia. Metabolic imaging using hyperpolarized magnetic resonance imaging (HP-MRI) is based on injecting non-radioactive, carbon-13 (C) labeled metabolites as contrast agents, allowing quantification of metabolic flux. Uniquely, this technique uses non-ionizing radiation, allowing longitudinal imaging. Therefore, this grant breaks new ground in proposing to track metabolic flux in muscles over time, while the organism ages. Indeed, altered metabolism is a hallmark of aging8 and altered muscle metabolism is closely linked with age-related functional decline. Our overarching hypothesis is HP-MRI detects alterations in glycolytic and mitochondrial metabolism that can be used as predictive and prognostic biomarkers. To this end, we propose 2 aims: Specific Aim 1: Longitudinal Muscle Imaging of Aging in Mice 1.1: Metabolic Imaging of Sarcopenia in a mouse model of physiological aging 1.2: Compare imaging with gold-standard body composition measures, frailty index and histology Specific Aim 2: Metabolic Imaging of Exercise Regimens in Mice 2.1: Compare high-intensity intermittent training (HIIT) with moderate intensity continuous training (MICT) using metabolic imaging 2.2: Validation of metabolic Imaging This study delivers methods to track sarcopenia based on non-invasive quantification of metabolism. This work builds on my training in metabolic imaging but extends its application to aging. This is motivated by the lack of tools to study muscle physiology non-invasively. Completion of the aims is significant, providing the first evidence for quantifying metabolic flux to track sarcopenia. A multi-disciplinary team of experts in imaging, biochemistry and exercise physiology has been assembled to ensure success. There is also a clear path to translation, as HP-MRI is already being used in patients at the University of Maryland.
 
9. Project Title: Develop machine learning algorithm for a novel MRI biomarker that is highly associated with knee arthroplasty utilizing the Osteoarthritis Initiative database
  Leader: Stephanie Jo, MD, PhD
  This pilot project proposal will supplement the current Pepper Center REC scholar award project, which is focused on developing a risk assessment model for osteoarthritis outcome. Osteoarthritis (OA) is highly prevalent in the aging population, affecting over 30 million people in the United States alone and one of the leading causes of disability 1. Despite the high disease burden and slow progression of disease over years, there is currently no treatment to halt, reverse, or prevent OA, and there is limited standard risk assessment of OA that predicts OA outcome for target therapy of high-risk patients. Knee joint is a common site for OA, and because of the relatively large size of the joint and the ease of imaging, knee joint was frequently evaluated in OA imaging research. Recently, MRIs are frequently employed in clinical assessment of knee OA. There are expert consensus semiquantitative OA scoring on knee MRI, and multiple machine learning algorithms that characterize various features of knee OA on MRI. However, while accurate and reliable, semiquantitative knee OA scoring schemes on MRI are complex and difficult to apply in clinical setting. For example, MOAKS divides knee into 19 subregions on axial, sagittal, and coronal sequences 2. Similarly, machine learning algorithms invariably included Double Echo Steady State (DESS) MRI sequence for analysis 3,4, which has useful research features but is not routinely acquired in clinical MRI exams because of long scan time and motion sensitivity 5,6. This limits the application of existing studies in real-life patients. Cartilage loss fraction is a quantitative measure on the sagittal Intermediate Weight (IW) MRI sequence, which is nearly universally acquired in routine clinical knee MRI and immediately applicable to nearly all patients in the United States. My preliminary study as a Pepper REC scholar has identified cartilage loss fraction to be highly associated with knee arthroplasty, the end stage treatment for knee OA. As the next step, the preliminary result needs to be validated in a larger sample size. Osteoarthritis Initiative (OAI) is a publicly available database with OA clinical and imaging data, which will be used for this project. This project aims to generate machine learning algorithm to derive cartilage loss fraction from the knee MRI sagittal IW sequence to facilitate evaluation. The resulting algorithm will be used for further validation of cartilage loss fraction’s association with knee arthroplasty in a larger sample size. Specific aim 1: Develop a machine learning based algorithm to automatically derive cartilage loss fraction from knee MRI. Specific aim 2: Use algorithm developed from aim 1 to automatically obtain cartilage loss fraction from knee MRI in a larger sample size using OAI database, and evaluate cartilage loss fraction’s utility in predicting knee arthroplasty. Hypothesis: Cartilage loss fraction is highly associated with knee arthroplasty. With the algorithm resulting from this project, I plan to further validate the cartilage loss fraction’s value in predicting knee arthroplasty as well as other important OA outcomes of pain and function in a larger number of existing OA databases and real-life patients. Once there is validation of cartilage loss fraction in OA outcome, the imaging biomarker can be used in clinical therapy selection and patient counseling as well as OA therapeutics/ disease-modifying drug clinical trial for participant risk assessment and a surrogate endpoint.
 
10. Project Title: A Novel Approach to Causal Trajectory Analysis: Identifying Sub-cohorts of ADRD Older Adults Associated with Poor Post-Fracture Recovery
  Leader: Chixiang Chen, PhD
  Older adults living with Alzheimer's disease and related dementias (ADRD) are up to three times more likely than cognitively intact older adults to sustain a hip fracture1. Moreover, among older adults who experience a hip fracture, those with ADRD experience more than 50 fewer days at home (DAH) in the year after the fracture than those without ADRD2, 3. The growing ADRD hip-fracture population incurs greater post-fracture healthcare costs for treatment and recovery than patients without ADRD, placing a disproportionate economic burden on the healthcare system. Given the significant costs and consequences of hip fractures among older adults4, improving post-fracture recovery for those living with ADRD is a crucial national priority. A barrier to improving post-fracture recovery is that patients with ADRD are highly heterogeneous. This heterogeneity hinders our ability to risk stratify patients and focus interventions on those at highest risk and with greatest likelihood of benefit. Thus, it remains unclear which ADRD patient subgroups experience unfavorable recovery trajectories after post-fracture hospital discharge. As a pivotal step toward personalized healthcare, identifying high-risk subpopulations will enhance our ability to individualize intervention targets to improve postfracture recovery, optimize resource allocation, and maintain older adults’ independence in the community setting. As the University of Maryland Claude D. Pepper Older Americans Independence Center (UM-OAIC) focuses on enablement, our goal of supporting post-fracture recovery for older adults with ADRD is directly aligned with the scope and strengths of our Pepper Center. To uncover and characterize post-fracture recovery trajectories after hospital discharge, we leverage monthlevel DAH, a claim-based, patient-centered outcome highly valued by older adults and pertinent to the concept of aging in place5, 6: i.e., n,growing older at home. Our prior work has detected significant patient-level heterogeneity in 12-month DAH trajectories after post-fracture hospital discharge among older adults with ADRD7 and has detected that greater comorbidity burden is significantly associated with fewer DAH3. However, we hypothesize that not all comorbidities impact all patients in the same way. In this project, we aim to understand (1) what comorbidity clusters8 (e.g., diabetes, heart/kidney disease, or certain combinations) are most influential on post-fracture outcomes and (2) whether and how comorbidity clusters differentially influence DAH in different types of patients (i.e., effect modification), in terms of their age, sex, race, area deprivation, etc. While important clinically, identifying comorbidity clusters is particularly challenging due to high patient-level heterogeneity, complex confounding issues, and high mortality rates in using Medicare claims and Medicare-linked data. Existing methods in clustering9, 10 may not adequately address all these issues simultaneously, potentially resulting in biased detection. To overcome these barriers, we propose new causal inference and machine learning methods using Medicare data (>20k eligible patients) to unbiasedly explain disparate longitudinal post-fracture DAH trajectories (1-year follow-up) among older patients with ADRD. Specifically, we aim to develop a novel toolkit to address these foundational analytic challenges and identify influential comorbidity clusters and baseline effect modifiers contributing to trajectory differences in these high priority clinical conditions. All developed methods aim to help (1) improve post-fracture recovery for ADRD older adults and (2) empower investigators in UM-OAIC to conduct causal trajectory analysis in broad applications. Both aims below focus on older adults living with ADRD and experiencing a hip fracture
 
11. Project Title: CD38 accelerates frailty and mitochondrial dysfunction in people with HIV (CATCH)
  Leader: Poonam Mathur, DO, MPH
  The availability of effective antiretroviral therapy (ART) for people with HIV (PWH) has increased in the last 20 years, resulting in increased life expectancy. As of 2016, nearly 50% of PWH in the United States were older than 50 years of age. Within this older population of PWH, age-associated comorbidities, such as frailty, are disproportionately higher than otherwise predicted. Frailty in PWH increases the risk of adverse outcomes and disproportionately affects this population. The Multicenter AIDS Cohorts Study (MACS) found that frailty is increased 5-fold in PWH compared to HIV-negative individuals, and up to 50% of PWH over the age of 50 are frail8. Though lifestyle factors also play a role, one reason for this discrepancy is cellular aging that is accelerated in PWH compared to HIV-negative individuals. Therefore, a goal of current HIV research is to identify cellular mechanisms of aging that can serve as potential therapeutic targets, decreasing the development of comorbidities and ultimately improving quality of life. A hallmark of HIV-induced immune activation, described by our group and others, is increased expression of CD38 on the surface of immune cells. Increased CD38 expression on CD4+ and CD8+ T cells from HIV infection is not completely reversed with the use of ART and viral suppression. CD38 is also an ectoenzyme primarily responsible for catalyzing intracellular nicotinamide adenine dinucleotide (NAD+). Our published data confirm that CD38 and intracellular NAD+ levels are inversely correlated. Since NAD+ is essential for cellular metabolism decline in NAD+ level is associated with increased mitochondrial dysfunction. Mitochondrial dysfunction is a determinant of cellular aging. Therefore, in aging PWH, exacerbated CD38 expression may drive non-AIDS related comorbidities like frailty via reduced intracellular NAD+ levels and mitochondrial dysfunction. Our central hypothesis is that frailty in PWH is associated with the CD38-NAD+ axis and mediated by mitochondrial dysfunction. Our long-term goal is to implicate CD38 as an immunological mechanism that contributes to frailty and demonstrate that the CD38-NAD+ axis is a therapeutic target for mitigating cellular aging and end-organ disease in PWH. We plan to test our hypothesis with the following aims: Aim 1: To compare oxygen consumption in T cells of PWH by frailty status. Hypothesis: Frailty status is associated with oxygen consumption (a measure of mitochondrial function) in PWH older than 50 years of age. Approach: We will enroll 30 PWH (virally suppressed, on ART) 50-75 years of age from our existing STRONG cohort at UMB’s THRIVE clinic. We will enroll 10 PWH who are robust, 10 PWH who are pre-frail, and 10 PWH who are frail. We will 1) confirm frailty using the Fried’s Frailty Phenotype, 2) assess strength using grip strength, and 3) measure endurance using the 6-minute walk and chair rise tests. We will also collect research blood samples from all participants to associate frailty with mitochondrial function. We will isolate CD4+ and CD8+ T cells (using flow cytometry) to measure oxygen consumption rate (OCR) and extracellular acidification rate (ECAR) using the Seahorse assay. Aim 2: To determine if frailty in PWH is associated with the CD38-NAD+ axis. Hypothesis: The CD38-NAD+ axis is associated with the Frailty assessments from Aim 1. Approach: The same CD4+ and CD8+ T cells isolated in Aim 1 will be used to measure CD38 expression on the cells and intracellular NAD+ levels. Then we will associate CD38 and NAD+ with the OCR, ECAR, and Frailty assessments measured in Aim 1 to determine if the effects of the CD38-NAD+ axis on frailty is mediated through oxygen consumption.
 
DEVELOPMENT PROJECTS (1 Development Projects Listed)
1. Project Title: The Role of Inflammaging in Modulating Recovery from an Acute Injury: A Preclinical Rodent Model Study
  Leader: Chris Ward, PhD and Joe Stains, PhD
  Core(s):
  A consequence of advancing age is immune system dysregulation that results in increased levels of pro-inflammatory markers in blood, cells and tissues and has been termed inflammaging. Inflammaging has been implicated in the exacerbation of many diseases and the onset and progression of musculoskeletal frailty. Indeed, chronic, systemic low grade inflammation is common in many diseases, such as metabolic syndrome, cardiovascular disease, kidney disease, type 2 diabetes (T2D), and cancer. Here, we propose the hypothesis that chronic low-grade inflammation (such as during aging, metabolic dysfunction, or other chronic disease states) primes the system for worse outcomes following an acute insult (i..e., femoral fracture). The consequence of this priming is worsening of outcomes both locally including the time to heal the injury, and systemically (e.g., exacerbated osteo-sarcopenia, impaired cognitive capacity, predisposition to cardiac dysfunction, and death). Having established in vivo and ex vivo musculoskeletal and cardiovascular outcome measures in rodent models, here we propose a Developmental Project (DP) to establish rodent models to study how chronic, low grade inflammation impacts the functional recovery from injury. Our goal is to create a pre-clinical platform to test interventions for improving a board array of local and systemic outcomes (in the same cohort of animals), not only for skeletal fracture but other insults such as stroke, volumetric muscle loss, muscle injury, and other conditions in a background of chronic low grade inflammation. To test this hypothesis, we will establish pre-clinical murine models of chronic low grade inflammation and examine the local and systemic outcomes after the compounding of an acute insult relative to healthy mice receiving only the acute insult. Initially we will two models of chronic low grade inflammation (1. a model of d-galactose feeding that mimics premature aging; 2. A new model of Type 2 diabetes that utilizes a high fat diet with an acute single dose of streptozotocin that more closely approximates type 2 diabetes). In Aim 1, we will characterize the systemic changes that happen in these models and benchmark these models to the changes observed in aged rodents. In Aim 2, we will introduce the variable of an acute skeletal injury (non-displaced femoral fracture) injury to these models of chronic inflammation.
 
RESEARCH (0 Projects Listed)
PUBLICATIONS
2024
  1. Trajectories of Recovery Following Traumatic Brain Injury Among Older Medicare Beneficiaries.
    Albrecht JS, Chen C, Falvey JR
    J Neurotrauma, 2024 Feb 19
    https://doi.org/10.1089/neu.2023.0502 | PMID: 38279868
    Citations: 0 | AltScore: 0.25
  2. Impact of dementia and socioeconomic disadvantage on days at home after traumatic brain injury among older Medicare beneficiaries: A cohort study.
    Albrecht JS, Scherf A, Ryan KA, Falvey JR
    Alzheimers Dement, 2024 Jan 31, 20(4): 2364-2372
    https://doi.org/10.1002/alz.13666 | PMID: 38294135 | PMCID: PMC11032564
    Citations: 1 | AltScore: 0.75
  3. Sustained IL-6 and sTNF-aR1 levels after hip fracture predict 5-year mortality: A prospective cohort study from the Baltimore Hip Studies.
    C?mara SMA, Hochberg MC, Miller R, Ryan AS, Orwig D, Gruber-Baldini AL, Guralnik J, Magder LS, Feng Z, Falvey JR, Beamer BA, Magaziner J
    J Am Geriatr Soc, 2024 Jun 12
    https://doi.org/10.1111/jgs.19018 | PMID: 38864591
    Citations: 0 | AltScore: 4.6
  4. The effects of myosteatosis on skeletal muscle function in older adults.
    Dondero K, Friedman B, Rekant J, Landers-Ramos R, Addison O
    Physiol Rep, 2024 May, 12(9): e16042
    https://doi.org/10.14814/phy2.16042 | PMID: 38705872 | PMCID: PMC11070439
    Citations: 2 | AltScore: 7.6
  5. Demystifying the Digital Divide: Disparities in Telerehabilitation Readiness Among Older Adults in the United States.
    Falvey JR, Sun N, Miller MJ, Pravdo A, Mullins CD
    Arch Phys Med Rehabil, 2024 Mar 28
    pii: S0003-9993(24)00901-8. https://doi.org/10.1016/j.apmr.2024.03.009 | PMID: 38554795
    Citations: 0 | AltScore: 5.75
  6. Risk factors and treatment interventions associated with incomplete thrombus resolution and pulmonary hypertension after pulmonary embolism.
    Fang A, Mayorga-Carlin M, Han P, Cassady S, John T, LaRocco A, Etezadi V, Jones K, Nagarsheth K, Toursavadkohi S, Jeudy J, Anderson D, Griffith B, Sorkin JD, Sarkar R, Lal BK, Cires-Drouet RS
    J Vasc Surg Venous Lymphat Disord, 2024 Jan, 12(1): 101665
    https://doi.org/10.1016/j.jvsv.2023.08.006 | PMID: 37595746 | PMCID: PMC10939011
    Citations: 0 | AltScore: NA
  7. Exercise for patients with chronic kidney disease: from cells to systems to function.
    Gollie JM, Ryan AS, Sen S, Patel SS, Kokkinos PF, Harris-Love MO, Scholten JD, Blackman MR
    Am J Physiol Renal Physiol, 2024 Mar 1, 326(3): F420-F437
    https://doi.org/10.1152/ajprenal.00302.2023 | PMID: 38205546
    Citations: 0 | AltScore: 35.2
  8. Ability of Caprini and Padua risk-assessment models to predict venous thromboembolism in a nationwide Veterans Affairs study.
    Hayssen H, Sahoo S, Nguyen P, Mayorga-Carlin M, Siddiqui T, Englum B, Slejko JF, Mullins CD, Yesha Y, Sorkin JD, Lal BK
    J Vasc Surg Venous Lymphat Disord, 2024 Mar, 12(2): 101693
    https://doi.org/10.1016/j.jvsv.2023.101693 | PMID: 37838307 | PMCID: PMC10922503
    Citations: 1 | AltScore: NA
  9. Strength Training Is Associated With Less Knee Osteoarthritis: Data From the Osteoarthritis Initiative.
    Lo GH, Richard MJ, McAlindon TE, Kriska AM, Price LL, Rockette-Wagner B, Eaton CB, Hochberg MC, Kwoh CK, Nevitt MC, Driban JB
    Arthritis Rheumatol, 2024 Mar, 76(3): 377-383
    https://doi.org/10.1002/art.42732 | PMID: 37870119 | PMCID: PMC10922276
    Citations: 1 | AltScore: 155.1
  10. Evaluation of Dynamic Effects of Depressive Symptoms on Physical Function in Knee Osteoarthritis.
    Mehta R, Hochberg M, Shardell M, Ryan A, Dong Y, Beamer BA, Peer J, Stuart EA, Schuler M, Gallo JJ, Rathbun AM
    Arthritis Care Res (Hoboken), 2024 Jan 10, 76(5): 673-681
    https://doi.org/10.1002/acr.25295 | PMID: 38200641 | PMCID: PMC11039384
    Citations: 0 | AltScore: 12.6
  11. Association of chronotropic incompetence with reduced cardiorespiratory fitness in older adults with HIV.
    Oursler KK, Briggs BC, Lozano AJ, Harris NM, Parashar A, Ryan AS, Marconi VC, FIT VET Project Team
    AIDS, 2024 May 1, 38(6): 825-833
    https://doi.org/10.1097/QAD.0000000000003840 | PMID: 38578959 | PMCID: PMC11003719
    Citations: 1 | AltScore: NA
  12. An exercise stress test for contrast-enhanced duplex ultrasound assessment of lower limb muscle perfusion in patients with peripheral arterial disease.
    Prior SJ, Chrencik MT, Christensen E, Kundi R, Ryan AS, Addison O, Lal BK
    J Vasc Surg, 2024 Feb, 79(2): 397-404
    https://doi.org/10.1016/j.jvs.2023.10.005 | PMID: 37844848 | PMCID: PMC10969459
    Citations: 1 | AltScore: NA
  13. Duloxetine plus exercise for knee osteoarthritis and depression: A feasibility study.
    Rathbun AM, Mehta R, Ryan AS, Dong Y, Beamer B, Golden J, Gallo JJ, Luborsky M, Shardell MD, Peer JE, Hochberg MC
    Osteoarthr Cartil Open, 2024 Mar, 6(1): 100426
    https://doi.org/10.1016/j.ocarto.2023.100426 | PMID: 38130375 | PMCID: PMC10733673
    Citations: 0 | AltScore: 2.35
  14. Time-varying treatment effect modification of oral analgesic effectiveness by depressive symptoms in knee osteoarthritis: an application of structural nested mean models in a prospective cohort.
    Rathbun AM, Shardell MD, Gallo JJ, Ryan AS, Stuart EA, Schuler MS, Dong Y, Beamer B, Mehta R, Peer JE, Hochberg MC
    Int J Epidemiol, 2024 Feb 1, 53(1):
    pii: dyad152. https://doi.org/10.1093/ije/dyad152 | PMID: 37934603
    Citations: 0 | AltScore: NA
  15. Effects of Multicomponent Home-Based Intervention on Muscle Composition, Fitness and Bone Density after Hip Fracture.
    Ryan AS, Beamer BA, Gruber-Baldini AL, Craik RL, Golden J, Guralnik J, Hochberg MC, Mangione KK, Orwig D, Rathbun AM, Magaziner J
    J Gerontol A Biol Sci Med Sci, 2024 Mar 7, 79(5):
    pii: glae078. https://doi.org/10.1093/gerona/glae078 | PMID: 38452133 | PMCID: PMC11025556
    Citations: 0 | AltScore: NA
  16. Sex differences in insulin regulation of skeletal muscle glycogen synthase and changes during weight loss and exercise in adults.
    Ryan AS, Li G, McMillin S, Ortmeyer HK
    Obesity (Silver Spring), 2024 Apr, 32(4): 667-677
    https://doi.org/10.1002/oby.23987 | PMID: 38414363 | PMCID: PMC10965371
    Citations: 0 | AltScore: 7.2
  17. Psychometric Properties of the Resilience Scale in Older Adults Post-Hip Fracture.
    Seong H, Resnick B, Holmes S, Galik E, Breman RB, Fortinsky RH, Zhu S
    J Aging Health, 2024 Mar, 36(3-4): 220-229
    https://doi.org/10.1177/08982643231184098 | PMID: 37311566
    Citations: 0 | AltScore: 1
  18. Promotion of Successful Weight Management in Overweight and Obese Veterans (POWER-VET): Trial Design and Methods.
    Serra MC, Ortmeyer HK, Ryan AS, POWER-VET Project Team
    Contemp Clin Trials, 2024 Feb, 137: 107412
    https://doi.org/10.1016/j.cct.2023.107412 | PMID: 38104857 | PMCID: PMC10922382
    Citations: 0 | AltScore: NA
  19. Analyzing risk factors for post-acute recovery in older adults with Alzheimer's disease and related dementia: A new semi-parametric model for large-scale medicare claims.
    Shen B, Ren H, Shardell M, Falvey J, Chen C
    Stat Med, 2024 Feb 28, 43(5): 1003-1018
    https://doi.org/10.1002/sim.9982 | PMID: 38149345 | PMCID: PMC10922471
    Citations: 0 | AltScore: NA
  20. Lower limb vertical stiffness and frontal plane angular impulse during perturbation-induced single limb stance and their associations with gait in individuals post-stroke.
    Shen KH, Borrelli J, Gray VL, Rogers MW, Hsiao HY
    J Biomech, 2024 Jan, 163: 111917
    https://doi.org/10.1016/j.jbiomech.2023.111917 | PMID: 38184906 | PMCID: PMC10932872
    Citations: 0 | AltScore: 0.5
  21. Abatacept and non-melanoma skin cancer in patients with rheumatoid arthritis: a comprehensive evaluation of randomised controlled trials and observational studies.
    Simon TA, Dong L, Suissa S, Michaud K, Pedro S, Hochberg M, Boers M, Askling J, Frisell T, Strangfeld A, Meissner Y, Khaychuk V, Dominique A, Maldonado MA
    Ann Rheum Dis, 2024 Jan 11, 83(2): 177-183
    https://doi.org/10.1136/ard-2023-224356 | PMID: 37932010 | PMCID: PMC10850629
    Citations: 1 | AltScore: 16.75
  22. Age-Related Differences in Motor Skill Transfer with Brief Memory Reactivation.
    Tomlin KB, Johnson BP, Westlake KP
    Brain Sci, 2024 Jan 9, 14(1):
    https://doi.org/10.3390/brainsci14010065 | PMID: 38248280 | PMCID: PMC10813682
    Citations: 0 | AltScore: 2.35
  23. Interactive Relations of Body Mass Index, Cardiorespiratory Fitness, and Sex to Cognitive Function in Older Adults.
    Turnquist BE, MacIver PH, Katzel LI, Waldstein SR
    Arch Clin Neuropsychol, 2024 Mar 14
    pii: acae018. https://doi.org/10.1093/arclin/acae018 | PMID: 38486431
    Citations: 0 | AltScore: NA
  24. Effect of junctional reflux on the venous clinical severity score in patients with insufficiency of the great saphenous vein (JURY study).
    Vemuri C, Gibson KD, Pappas PJ, Sadek M, Ting W, Obi AT, Mouawad NJ, Etkin Y, Gasparis AP, McDonald T, Sahoo S, Sorkin JD, Lal BK
    J Vasc Surg Venous Lymphat Disord, 2024 Mar, 12(2): 101700
    https://doi.org/10.1016/j.jvsv.2023.101700 | PMID: 37956904 | PMCID: PMC10939725
    Citations: 2 | AltScore: NA
 
2023
  1. Estimating 3D supraspinatus intramuscular fatty infiltration in older adults: a pilot study.
    Addona J, Ahmed SR, Almardawi R, Garcia Zapata L, Awan OA, Davis DL
    Acta Radiol, 2023 May, 64(5): 1880-1885
    https://doi.org/10.1177/02841851221139597 | PMID: 36423232 | PMCID: PMC10939010
    Citations: 3 | AltScore: NA
  2. Association Between Race and Receipt of Home- and Community-Based Rehabilitation After Traumatic Brain Injury Among Older Medicare Beneficiaries.
    Albrecht JS, Kumar A, Falvey JR
    JAMA Surg, 2023 Apr 1, 158(4): 350-358
    https://doi.org/10.1001/jamasurg.2022.7081 | PMID: 36696119 | PMCID: PMC9878433
    Citations: 2 | AltScore: 40.1
  3. Causal Factors for Osteoarthritis: A Scoping Review of Mendelian Randomization Studies.
    Alhassan E, Nguyen K, Hochberg MC, Mitchell BD
    Arthritis Care Res (Hoboken), 2023 Oct 17, 76(3): 366-375
    https://doi.org/10.1002/acr.25252 | PMID: 37846209 | PMCID: PMC10922494
    Citations: 2 | AltScore: 1
  4. Traumatic Brain Injury and Risk of Long-Term Nursing Home Entry among Older Adults: An Analysis of Medicare Administrative Claims Data.
    Bailey MD, Gambert S, Gruber-Baldini A, Guralnik J, Kozar R, Qato DM, Shardell M, Albrecht JS
    J Neurotrauma, 2023 Jan, 40(1-2): 86-93
    https://doi.org/10.1089/neu.2022.0003 | PMID: 35793112 | PMCID: PMC10162579
    Citations: 4 | AltScore: NA
  5. Predictors of mobility status one year post hip fracture among community-dwelling older adults prior to fracture: A prospective cohort study.
    Bajracharya R, Guralnik JM, Shardell MD, Hochberg MC, Orwig DL, Magaziner JS
    J Am Geriatr Soc, 2023 Mar 14, 71(8): 2441-2450
    https://doi.org/10.1111/jgs.18327 | PMID: 36918363 | PMCID: PMC10440300
    Citations: 0 | AltScore: 9.7
  6. Plasma neurofilament light and brain volumetric outcomes among middle-aged urban adults.
    Beydoun MA, Noren Hooten N, Beydoun HA, Weiss J, Maldonado AI, Katzel LI, Davatzikos C, Gullapalli RP, Seliger SL, Erus G, Evans MK, Zonderman AB, Waldstein SR
    Neurobiol Aging, 2023 Sep, 129: 28-40
    https://doi.org/10.1016/j.neurobiolaging.2023.04.013 | PMID: 37257406 | PMCID: PMC10524231
    Citations: 1 | AltScore: 9.5
  7. Plasma neurofilament light as blood marker for poor brain white matter integrity among middle-aged urban adults.
    Beydoun MA, Noren Hooten N, Weiss J, Maldonado AI, Beydoun HA, Katzel LI, Davatzikos C, Gullapalli RP, Seliger SL, Erus G, Evans MK, Zonderman AB, Waldstein SR
    Neurobiol Aging, 2023 Jan, 121: 52-63
    https://doi.org/10.1016/j.neurobiolaging.2022.10.004 | PMID: 36371816 | PMCID: PMC9733693
    Citations: 6 | AltScore: 14.5
  8. The timing and amplitude of the muscular activity of the arms preceding impact in a forward fall is modulated with fall velocity.
    Borrelli J, Creath R, Rogers MW
    J Biomech, 2023 Mar, 150: 111515
    https://doi.org/10.1016/j.jbiomech.2023.111515 | PMID: 36867953 | PMCID: PMC10257944
    Citations: 1 | AltScore: NA
  9. A method for simulating forward falls and controlling impact velocity.
    Borrelli J, Creath RA, Rogers MW
    MethodsX, 2023 Dec, 11: 102399
    https://doi.org/10.1016/j.mex.2023.102399 | PMID: 37830002 | PMCID: PMC10565865
    Citations: 0 | AltScore: NA
  10. Establishing a clinical care pathway to expedite rehabilitation transitions for stroke patients with dysphagia and enteral feeding needs.
    Braun R, Han K, Arata J, Gourab K, Gonzalez-Fernandez M
    Am J Phys Med Rehabil, 2023 Dec 13, 103(5): 390-394
    https://doi.org/10.1097/PHM.0000000000002387 | PMID: 38112750 | PMCID: PMC11031280
    Citations: 0 | AltScore: 0.25
  11. Associations between living alone, social interactions, and physical performance differ by sex: Results from the Baltimore Hip Studies.
    C?mara SMA, Falvey JR, Orwig D, Gruber-Baldini AL, Auais M, Feng Z, Guralnik J, Magaziner J
    J Am Geriatr Soc, 2023 May 12, 71(9): 2788-2797
    https://doi.org/10.1111/jgs.18403 | PMID: 37171145 | PMCID: PMC10524112
    Citations: 3 | AltScore: 17.3
  12. A Cartographic Tool to Predict Disease Risk-associated Pseudo-Dynamic Networks from Tissue-specific Gene Expression.
    Chen C, Shen B, Zhang L, Yu T, Wang M, Wu R
    Bio Protoc, 2023 Jan 5, 13(1):
    pii: e4583. https://doi.org/10.21769/BioProtoc.4583 | PMID: 36789091 | PMCID: PMC9901473
    Citations: 0 | AltScore: NA
  13. Left ventricular systolic dysfunction during acute pulmonary embolism.
    Cires-Drouet R, LaRocco A, Soldin D, John T, Toursavadkohi S, Nagarsheth K, Dahi S, Marsella J, Mayorga-Carlin M, Sorkin JD, Jones K, Haase D, Hong SN, Lal BK, Griffith B, Ramani G, Taylor B
    Thromb Res, 2023 Mar, 223: 1-6
    https://doi.org/10.1016/j.thromres.2023.01.011 | PMID: 36689804 | PMCID: PMC10989403
    Citations: 0 | AltScore: 5.35
  14. Synergistic Strategies to Accelerate the Development of Function-Promoting Therapies: Lessons From Operation Warp Speed and Oncology Drug Development.
    Correa-de Araujo R, Evans WJ, Fielding RA, Krishnan V, Carter RH, Appleby J, Guralnik J, Klickstein LB, Marks P, Moore AA, Peschin S, Bhasin S
    J Gerontol A Biol Sci Med Sci, 2023 Jun 16, 78(Suppl 1): 94-100
    https://doi.org/10.1093/gerona/glad028 | PMID: 37325963 | PMCID: PMC10272982
    Citations: 1 | AltScore: NA
  15. Shoulder Dysfunction and Mobility Limitation in Aging.
    Davis DL
    Adv Geriatr Med Res, 2023, 5(3):
    pii: e230008. https://doi.org/10.20900/agmr20230008 | PMID: 38105787 | PMCID: PMC10723811
    Citations: 1 | AltScore: 0.5
  16. Shoulder pain, health-related quality of life and physical function in community-dwelling older adults.
    Davis DL, Almardawi R, Beamer BA, Ryan AS, Terrin ML
    Front Aging, 2023, 4: 1176706
    https://doi.org/10.3389/fragi.2023.1176706 | PMID: 37483647 | PMCID: PMC10359925
    Citations: 0 | AltScore: 1.5
  17. Association of Shoulder Dysfunction with Mobility Limitation Among Older Adults in the Baltimore Longitudinal Study of Aging.
    Davis DL, Sun K, Simonsick EM
    Gerontol Geriatr Med, 2023 Jan-Dec, 9: 23337214231179843
    https://doi.org/10.1177/23337214231179843 | PMID: 37324643 | PMCID: PMC10262607
    Citations: 1 | AltScore: 1
  18. A comparison of associations of body mass index and dual-energy x-ray absorptiometry measured percentage fat and total fat with global serum metabolites in young women.
    Dorgan JF, Ryan AS, LeBlanc ES, Van Horn L, Magder LS, Snetselaar LG, Zhang Y, Dallal CM, Jung S, Shepherd JA
    Obesity (Silver Spring), 2023 Feb, 31(2): 525-536
    https://doi.org/10.1002/oby.23619 | PMID: 36642094 | PMCID: PMC9937438
    Citations: 1 | AltScore: 1.25
  19. Frailty and Aging in HIV- Status Post 13 Years of National Awareness.
    Eke UA, Mohanty K, Gruber-Baldini AL, Ryan AS
    J Frailty Aging, 2023, 12(1): 49-58
    https://doi.org/10.14283/jfa.2022.45 | PMID: 36629084 | PMCID: PMC10082638
    Citations: 0 | AltScore: 1.5
  20. Growing Deficit in New Cancer Diagnoses 2 Years Into the COVID-19 Pandemic: A National Multicenter Study.
    Englum BR, Sahoo S, Mayorga-Carlin M, Hayssen H, Siddiqui T, Turner DJ, Sorkin JD, Lal BK
    Ann Surg Oncol, 2023 Dec, 30(13): 8509-8518
    https://doi.org/10.1245/s10434-023-14217-5 | PMID: 37695458 | PMCID: PMC10939008
    Citations: 2 | AltScore: 2
  21. Association of Subjective and Objective Measures of Sleep With Gut Microbiota Composition and Diversity in Older Men: The Osteoporotic Fractures in Men Study.
    Estaki M, Langsetmo L, Shardell M, Mischel A, Jiang L, Zhong Y, Kaufmann C, Knight R, Stone K, Kado D
    J Gerontol A Biol Sci Med Sci, 2023 Oct 9, 78(10): 1925-1932
    https://doi.org/10.1093/gerona/glad011 | PMID: 36655399 | PMCID: PMC10562887
    Citations: 1 | AltScore: 0.5
  22. Associations of Days Spent at Home Before Hip Fracture With Postfracture Days at Home and 1-Year Mortality Among Medicare Beneficiaries Living With Alzheimer's Disease or Related Dementias.
    Falvey JR, Chen C, Johnson A, Ryan KA, Shardell M, Ren H, Reider L, Magaziner J
    J Gerontol A Biol Sci Med Sci, 2023 Dec 1, 78(12): 2356-2362
    https://doi.org/10.1093/gerona/glad158 | PMID: 37402643 | PMCID: PMC10692421
    Citations: 2 | AltScore: 16.05
  23. Severe neighborhood deprivation and nursing home staffing in the United States.
    Falvey JR, Hade EM, Friedman S, Deng R, Jabbour J, Stone RI, Travers JL
    J Am Geriatr Soc, 2023 Mar, 71(3): 711-719
    https://doi.org/10.1111/jgs.17990 | PMID: 36929467 | PMCID: PMC10023834
    Citations: 3 | AltScore: 417.9
  24. Effects of Weight Loss and Aerobic Exercise Training on Adi-Pose Tissue Zinc a2-Glycoprotein and Associated Genes in Obesity.
    Ge SX, Li G, Ryan AS
    Cells, 2023 Sep 27, 12(19):
    https://doi.org/10.3390/cells12192366 | PMID: 37830580 | PMCID: PMC10571564
    Citations: 0 | AltScore: 0.5
  25. Patterns, Predictors, and Intercenter Variability in Empiric Gram-Negative Antibiotic Use Across 928 United States Hospitals.
    Goodman KE, Baghdadi JD, Magder LS, Heil EL, Sutherland M, Dillon R, Puzniak L, Tamma PD, Harris AD
    Clin Infect Dis, 2023 Feb 8, 76(3): e1224-e1235
    https://doi.org/10.1093/cid/ciac504 | PMID: 35737945 | PMCID: PMC9907550
    Citations: 9 | AltScore: 11.35
  26. Calcium and bicarbonate signaling pathways have pivotal, resonating roles in matching ATP production to demand.
    Greiser M, Karbowski M, Kaplan AD, Coleman AK, Verhoeven N, Mannella CA, Lederer WJ, Boyman L
    Elife, 2023 Jun 5, 12:
    https://doi.org/10.7554/eLife.84204 | PMID: 37272417 | PMCID: PMC10284600
    Citations: 2 | AltScore: 55.45
  27. Association of parity with body mass index and cardiometabolic risk in high-parous women.
    He S, McArdle PF, Ryan KA, Daue M, Xu H, Barry KH, Magder LS, Shuldiner AR, Pollin TI, Mitchell BD
    Menopause, 2023 May 9, 30(7): 703-708
    https://doi.org/10.1097/GME.0000000000002194 | PMID: 37159869 | PMCID: PMC10313795
    Citations: 1 | AltScore: 2.75
  28. Diagnostic rate estimation from Medicare records: Dependence on claim numbers and latent clinical features.
    Hogans B, Siaton B, Sorkin J
    J Biomed Inform, 2023 Sep, 145: 104463
    https://doi.org/10.1016/j.jbi.2023.104463 | PMID: 37517509 | PMCID: PMC10576984
    Citations: 1 | AltScore: NA
  29. Effect of Multicomponent Home-Based Training on Gait and Muscle Strength in Older Adults After Hip Fracture Surgery: A Single Site Randomized Trial.
    Huang MZ, Rogers MW, Pizac D, Gruber-Baldini AL, Orwig D, Hochberg MC, Beamer BA, Creath RA, Savin DN, Conroy VM, Mangione KK, Craik R, Zhang LQ, Magaziner J
    Arch Phys Med Rehabil, 2023 Feb, 104(2): 169-178
    https://doi.org/10.1016/j.apmr.2022.08.974 | PMID: 36087806 | PMCID: PMC10039715
    Citations: 1 | AltScore: 0.5
  30. Longitudinal characteristics of physical frailty and its components in men and women post hip fracture.
    Huang Y, Orwig D, Hayssen H, Lu W, Gruber-Baldini AL, Chiles Shaffer N, Magaziner J, Guralnik JM
    J Am Geriatr Soc, 2023 Sep 19, 72(1): 170-180
    https://doi.org/10.1111/jgs.18595 | PMID: 37725439 | PMCID: PMC11082781
    Citations: 0 | AltScore: 2.95
  31. Age-related differences in lower limb muscle activation patterns and balance control strategies while walking over a compliant surface.
    Jeon W, Ramadan A, Whitall J, Alissa N, Westlake K
    Sci Rep, 2023 Oct 2, 13(1): 16555
    https://doi.org/10.1038/s41598-023-43728-0 | PMID: 37783842 | PMCID: PMC10545684
    Citations: 1 | AltScore: NA
  32. Dietary Composition, Meal Timing, and Cancer-Related Fatigue: Insights From the Women's Healthy Eating and Living Study.
    Kleckner AS, Kleckner IR, Renn CL, Rosenblatt PY, Ryan AS, Zhu S
    Cancer Nurs, 2023 Nov 30
    https://doi.org/10.1097/NCC.0000000000001305 | PMID: 38032743 | PMCID: PMC11136880
    Citations: 0 | AltScore: 0.75
  33. Abnormal coordination of upper extremity during target reaching in persons post stroke.
    Koh K, Oppizzi G, Kehs G, Zhang LQ
    Sci Rep, 2023 Aug 8, 13(1): 12838
    https://doi.org/10.1038/s41598-023-39684-4 | PMID: 37553412 | PMCID: PMC10409717
    Citations: 0 | AltScore: NA
  34. Geriatric Syndromes and Health-Related Quality of Life in Older Adults with Chronic Kidney Disease.
    Liu CK, Miao S, Giffuni J, Katzel LI, Fielding RA, Seliger SL, Weiner DE
    Kidney360, 2023 Apr 1, 4(4): e457-e465
    https://doi.org/10.34067/KID.0000000000000078 | PMID: 36790849 | PMCID: PMC10278840
    Citations: 0 | AltScore: 5.85
  35. Comparison of evaluation metrics of deep learning for imbalanced imaging data in osteoarthritis studies.
    Liu S, Roemer F, Ge Y, Bedrick EJ, Li ZM, Guermazi A, Sharma L, Eaton C, Hochberg MC, Hunter DJ, Nevitt MC, Wirth W, Kent Kwoh C, Sun X
    Osteoarthritis Cartilage, 2023 Sep, 31(9): 1242-1248
    https://doi.org/10.1016/j.joca.2023.05.006 | PMID: 37209993 | PMCID: PMC10524686
    Citations: 1 | AltScore: 1.75
  36. Longitudinal analysis of physical function in older adults: The effects of physical inactivity and exercise training.
    Manning KM, Hall KS, Sloane R, Magistro D, Rabaglietti E, Lee CC, Castle S, Kopp T, Giffuni J, Katzel L, McDonald M, Miyamoto M, Pearson M, Jennings SC, Bettger JP, Morey MC
    Aging Cell, 2023 Sep 8, 23(1): e13987
    https://doi.org/10.1111/acel.13987 | PMID: 37681737 | PMCID: PMC10776115
    Citations: 3 | AltScore: 239.379999999999
  37. Missense variants in SORT1 are associated with LDL-C in an Amish population.
    Mitok KA, Schueler KL, King SM, Orr J, Ryan KA, Keller MP, Krauss RM, Mitchell BD, Shuldiner AR, Attie AD
    J Lipid Res, 2023 Dec, 64(12): 100468
    https://doi.org/10.1016/j.jlr.2023.100468 | PMID: 37913995 | PMCID: PMC10711479
    Citations: 0 | AltScore: 13.2
  38. Associations of sex, Alzheimer's disease and related dementias, and days alive and at home among older Medicare beneficiaries recovering from hip fracture.
    Mutchie HL, Orwig DL, Gruber-Baldini AL, Johnson A, Magaziner J, Falvey JR
    J Am Geriatr Soc, 2023 Jul 4, 71(10): 3134-3142
    https://doi.org/10.1111/jgs.18492 | PMID: 37401789 | PMCID: PMC11087867
    Citations: 2 | AltScore: 2.6
  39. Open reduction internal fixation of rib fractures: a biomechanical comparison between the RibLoc U Plus(?) system and anterior plate in rib implants.
    Oppizzi G, Xu D, Patel T, Diaz JJ, Zhang LQ
    Eur J Trauma Emerg Surg, 2023 Feb, 49(1): 383-391
    https://doi.org/10.1007/s00068-022-02075-x | PMID: 36018371 | PMCID: PMC10148598
    Citations: 1 | AltScore: 1.5
  40. The Role of Companion Dogs in the VA Maryland Health Care System Whole Health(y) GeroFit Program.
    Ortmeyer HK, Giffuni J, Etchberger D, Katzel L
    Animals (Basel), 2023 Sep 28, 13(19):
    https://doi.org/10.3390/ani13193047 | PMID: 37835653 | PMCID: PMC10571922
    Citations: 1 | AltScore: NA
  41. Multicomponent Home-based Physical Therapy Versus Usual Care for Recovery After Hip Fracture.
    Prasad NK, Bajracharya R, Wijesinha M, Rathbun A, Orwig D, Magder L, Gruber-Baldini A, Mangione K, Craik RL, Magaziner J
    Arch Phys Med Rehabil, 2023 Dec, 104(12): 2011-2018
    https://doi.org/10.1016/j.apmr.2023.05.001 | PMID: 37610404 | PMCID: PMC10840126
    Citations: 0 | AltScore: 1.5
  42. Prevalence and socio-economic determinates of food insecurity in Veterans: findings from National Health and Nutrition Examination Survey.
    Robbins R, Porter Starr KN, Addison O, Parker EA, Wherry SJ, Ikpe S, Serra MC
    Public Health Nutr, 2023 Mar 13, 26(7): 1478-1487
    https://doi.org/10.1017/S1368980023000538 | PMID: 36912105 | PMCID: PMC10346074
    Citations: 0 | AltScore: 1.35
  43. Role of imaging for eligibility and safety of a-NGF clinical trials.
    Roemer FW, Hochberg MC, Carrino JA, Kompel AJ, Diaz L, Hayashi D, Crema MD, Guermazi A
    Ther Adv Musculoskelet Dis, 2023, 15: 1759720X231171768
    https://doi.org/10.1177/1759720X231171768 | PMID: 37284331 | PMCID: PMC10240557
    Citations: 1 | AltScore: NA
  44. Sex differences in muscle SIRT1 and SIRT3 and exercise + weight loss effects on muscle sirtuins.
    Ryan AS, Li G
    Exp Biol Med (Maywood), 2023 Feb, 248(4): 302-308
    https://doi.org/10.1177/15353702221142619 | PMID: 36740765 | PMCID: PMC10159525
    Citations: 4 | AltScore: 1
  45. Prediction of bleeding in patients being considered for venous thromboembolism prophylaxis.
    Sahoo S, Hayssen H, Englum B, Mayorga-Carlin M, Siddiqui T, Nguyen P, Kankaria A, Yesha Y, Sorkin JD, Lal BK
    J Vasc Surg Venous Lymphat Disord, 2023 Nov, 11(6): 1182-1191.e13
    https://doi.org/10.1016/j.jvsv.2023.07.007 | PMID: 37499868 | PMCID: PMC11017967
    Citations: 1 | AltScore: 3.2
  46. Association of Continued Use of SGLT2 Inhibitors From the Ambulatory to Inpatient Setting With Hospital Outcomes in Patients With Diabetes: A Nationwide Cohort Study.
    Singh LG, Ntelis S, Siddiqui T, Seliger SL, Sorkin JD, Spanakis EK
    Diabetes Care, 2023 Dec 5, 47(6): 933-940
    pii: dc231129. https://doi.org/10.2337/dc23-1129 | PMID: 38051789
    Citations: 2 | AltScore: 30
  47. Plasma metabolomic signatures of dual decline in memory and gait in older adults.
    Tian Q, Shardell MD, Kuo PL, Tanaka T, Simonsick EM, Moaddel R, Resnick SM, Ferrucci L
    Geroscience, 2023 Aug, 45(4): 2659-2667
    https://doi.org/10.1007/s11357-023-00792-8 | PMID: 37052768 | PMCID: PMC10651620
    Citations: 4 | AltScore: 0.75
  48. Further characterization of Shigella-specific (memory) B cells induced in healthy volunteer recipients of SF2a-TT15, a Shigella flexneri 2a synthetic glycan-based vaccine candidate.
    Toapanta FR, Hu J, Meron-Sudai S, Mulard LA, Phalipon A, Cohen D, Sztein MB
    Front Immunol, 2023, 14: 1291664
    https://doi.org/10.3389/fimmu.2023.1291664 | PMID: 38022674 | PMCID: PMC10653583
    Citations: 0 | AltScore: 0.5
  49. Community Mobility Among Older Adults Who Are Socioeconomically Disadvantaged: Addressing the Poverty Penalty.
    Twardzik E, Guralnik JM, Falvey JR
    Phys Ther, 2023 Dec 29
    pii: pzad182. https://doi.org/10.1093/ptj/pzad182 | PMID: 38157292
    Citations: 0 | AltScore: 6.2
  50. Chemotherapy-related symptoms and exercise adherence in older patients with myeloid neoplasms.
    Wang K, Consagra W, Jensen-Battaglia M, Kleckner A, Kleckner IR, Loh KP
    Support Care Cancer, 2023 Sep 12, 31(10): 572
    https://doi.org/10.1007/s00520-023-08039-0 | PMID: 37698745 | PMCID: PMC10883479
    Citations: 0 | AltScore: 4.8
  51. Effect of Long-term Exercise Training on Physical Performance and Cardiorespiratory Function in Adults With CKD: A Randomized Controlled Trial.
    Weiner DE, Liu CK, Miao S, Fielding R, Katzel LI, Giffuni J, Well A, Seliger SL
    Am J Kidney Dis, 2023 Jan, 81(1): 59-66
    https://doi.org/10.1053/j.ajkd.2022.06.008 | PMID: 35944747 | PMCID: PMC9780154
    Citations: 10 | AltScore: 59
  52. Some home-based self-managed rehabilitation interventions can improve arm activity after stroke: A systematic review and narrative synthesis.
    Westlake K, Akinlosotu R, Udo J, Goldstein Shipper A, Waller SM, Whitall J
    Front Neurol, 2023, 14: 1035256
    https://doi.org/10.3389/fneur.2023.1035256 | PMID: 36816549 | PMCID: PMC9932529
    Citations: 1 | AltScore: 0.5
  53. Multi-Joint Assessment of Proprioception Impairments Post Stroke.
    Xu D, Kang SH, Lee SJ, Oppizzi G, Zhang LQ
    Arch Phys Med Rehabil, 2023 Sep 13, 105(3): 480-486
    pii: S0003-9993(23)00524-5. https://doi.org/10.1016/j.apmr.2023.08.029 | PMID: 37714505 | PMCID: PMC10922066
    Citations: 0 | AltScore: 0.75
  54. The Hidden Toll of Incarceration: Exploring the Link Between Incarceration Histories and Pain Among Older Adults in the United States.
    Yang Y, Lutz G, Zhang Y, Chen C, Kheirbek RE
    Innov Aging, 2023, 7(10): igad116
    https://doi.org/10.1093/geroni/igad116 | PMID: 38094938 | PMCID: PMC10714910
    Citations: 1 | AltScore: 3.35
  55. Deciphering the causal relationship between blood pressure and regional white matter integrity: A two-sample Mendelian randomization study.
    Ye Z, Mo C, Liu S, Gao S, Feng L, Zhao B, Canida T, Wu YC, Hatch KS, Ma Y, Mitchell BD, Hong LE, Kochunov P, Chen C, Zhao B, Chen S, Ma T
    J Neurosci Res, 2023 Sep, 101(9): 1471-1483
    https://doi.org/10.1002/jnr.25205 | PMID: 37330925 | PMCID: PMC10444533
    Citations: 3 | AltScore: 2.25
  56. Mediation Analysis for High-Dimensional Mediators and Outcomes with an Application to Multimodal Imaging Data.
    Zhao Z, Chen C, Mani Adhikari B, Hong LE, Kochunov P, Chen S
    Comput Stat Data Anal, 2023 Sep, 185:
    pii: 107765. https://doi.org/10.1016/j.csda.2023.107765 | PMID: 37251499 | PMCID: PMC10210585
    Citations: 0 | AltScore: NA
  57. Changes in Older Adult Trauma Quality When Evaluated Using Longer-Term Outcomes vs In-Hospital Mortality.
    Zogg CK, Cooper Z, Peduzzi P, Falvey JR, Castillo-Angeles M, Kodadek LM, Staudenmayer KL, Davis KA, Tinetti ME, Lichtman JH
    JAMA Surg, 2023 Dec 1, 158(12): e234856
    https://doi.org/10.1001/jamasurg.2023.4856 | PMID: 37792354 | PMCID: PMC10551815
    Citations: 0 | AltScore: 4.6
  58. The Interaction Between Geriatric & Neighborhood Vulnerability: Delineating Pre-Hospital Risk Among Older Adult Emergency General Surgery Patients.
    Zogg CK, Falvey JR, Kodadek LM, Staudenmayer KL, Davis KA
    J Trauma Acute Care Surg, 2023 Nov 13, 96(3): 400-408
    https://doi.org/10.1097/TA.0000000000004191 | PMID: 37962136 | PMCID: PMC10922165
    Citations: 0 | AltScore: 7.3


EXTERNAL ADVISORY BOARD MEMBERS

Bret Goodpaster, PhD
Sanford Burnham Prebys Medical Discovery Institute
Serving since 2011 (13 years)

Karen Bandeen-Roche, PhD
Johns Hopkins University
Serving since 2011 (13 years)

Mark Redfern, PhD
University of Pittsburgh
Serving since 2011 (13 years)

Stephen Kritchevsky, PhD (chair)
Wake Forest University Baptist Medical Center
Serving since 2011 (13 years)

Cynthia Boyd, MD, MPH
Johns Hopkins University
Serving since 2016 (8 years)

LaDora Thompson, PhD, PT
Boston University
Serving since 2018 (6 years)

Julius Dewald, PT, PhD
Northwestern University
Serving since 2022 (2 years)

RECOGNITION AND AWARDS (2023-2024)
Andrea Levine, MD, MS (2023)
  • Educator of the year award in pulmonary and critical care medicine
  • Woodward Award for Educator of the Year for the Department of Medicine
  • COVID-19 Healthcare Hero award from The Daily Record
Barbara Resnick, PhD, RN, CRNP (2024)
  • Legacy Award from the American Academy of Nurse Practitioners
Brajesh Lal, MD (2024)
  • Lifetime Achievement Distinguished Service Award- Association of VA Surgeons
Brittany Burch, PhD, MSN, RN (2024)
  • MOTIVE study: Mather Institute Innovative Research on Aging Bronze Award
Chixiang Chen, PhD (2024)
  • Association for Clinical and Translational Statisticians (ACTStat) Early Career Award
Jason Falvey, PT, DPT, PhD (2024)
  • APTA Acute Care Lecture Award, Academy of Acute Care Physical Therapy, American Physical Therapy Association for excellence and leadership in acute care physical therapy
  • Eugene Michael New Investigator Award, American Physical Therapy Association
Jeanine Ursitti, PhD (2023)
  • Best Poster award at the OAIC National meeting
Shari Waldstein, PhD (2023)
  • Martica Hall Outstanding Mentor Award, Academy of Behavioral Medicine Research
  • Inducted as Fellow, American Psychosomatic Society
Shari Waldstein, PhD (2024)
  • Donald Creighton Outstanding Faculty Award, UMBC Graduate Student Association

MINORITY RESEARCH

General Brief Description of Minority Activities:
Not defined.

Minority Trainee(s):
  • Abdou Simon Senghor, PhD , Postdoctoral Fellow, University of Maryland, School of Pharmacy
    Abdou is interested in bioethics and is mentored by Dr. C. Daniel Mullins.
  • Alan Rathbun, PhD, MPH, Assistant Professor of Epidemiology and Public Health, University of Maryland School of Medicine
    Dr. Rathbun is a musculoskeletal epidemiologist whose current research career is focused in musculoskeletal disorders, epidemiological theory, research study design, causal inference, and applied biostatistics. He currently has a K01 award and a UM-OAIC pilot award and is collaborating with OAIC investigators on both of these projects.
  • Anne Haman, Pre-Doctoral Student, University of Maryland, School of Nursing
    Ms. Harman is studying social Isolation among older adults in senior housing and currently works with her mentor Dr. Barbara Resnick on senior housing clinic work.
  • Bianka Onwumbiko, PhD Candidate, PhD Student, Human Services Psychology (Behavioral Medicine), Psychology Department, University of Maryland Baltimore County
    Ms. Onwumbiko’s interests include the role of epigenetic modifications such as DNA methylation in the relations of structural discrimination to racial health disparities. Her master’s thesis project examines whether DNA methylation based immunosenescence mediates the relation of self-identified race to an MRI measure of accelerated brain aging among African American and White women and men. Dr. Shari Waldstein currently serves as her mentor and master’s thesis chair.
  • Bisola Amodu, Clinical Research Coordinator and Pre-Med student, Department of Neurology, University of Maryland School of Medicine
    She is being mentored by Dr. Robynne Braun for training and education in the conduct of clinical trials and trained in the use of TMS for stroke recovery research.
  • Candace Hall, MA, PhD Candidate, PhD student, University of Maryland, School of Pharmacy
    She is interested in patient-centered research and community-engaged research and is mentored by Dr. C. Daniel Mullins.
  • Derik Davis, MD, Associate Professor of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine
    Dr. Davis’ current research career is focused in musculoskeletal radiology examining the effects of increased visceral adipose tissue (VAT) and reduced skeletal muscle (SMM) on cardiovascular disease (CVD), diabetes and functional outcomes in older adults. He collaborates with UM-OAIC studies performing radiology imaging and reading with Dr. Alice Ryan. He also has a R03 grant “Shoulder Pain, Rotator Cuff Tear, Coordination, and Mobility in Aging” funded by NIA.
  • Derrick Larkins, DPT, PhD Candidate, PhD Student in the Department of Physical Therapy and Rehabilitation Science, University of Maryland, School of Medicine
    Dr. Odessa Addison is his primary mentor, and he is interested in musculoskeletal ultrasound.
  • Frances Alfonzo, PhD Candidate, PhD Student, Human Services Psychology (Clinical Psychology & Behavioral Medicine), Psychology Department, University of Maryland Baltimore County
    Ms. Alfonzo’s interests include relations of diabetes and pre-diabetes status to neurocognitive function and brain health. Her master’s thesis project will examine potential interactive relations of prediabetes status and self-identified race to magnetic resonance imaging (MRI) markers of subclinical cerebrovascular disease in midlife urban dwelling adults. Dr. Shari Waldstein currently serves as her mentor and master’s thesis chair.
  • Henry Asante Antwi, BS, MBA, PhD Candidate , PhD Student, University of Maryland, School of Pharmacy
    His interest is patient-centered research and community-engaged research. His mentor is Dr. C. Daniel Mullins.
  • Hinza Batool Malik, MS, PhD Candidate, PhD Student, Human Services Psychology (Clinical Psychology & Behavioral Medicine), Psychology Department, University of Maryland Baltimore County
    Ms. Malik is interested in studying the impact of medical conditions (e.g., cardiovascular disease and traumatic brain injury) and lifestyle factors (e.g., exercise) on neurocognition and neuroimaging correlates of brain health across the lifespan, with a particular focus on social determinants of health to identify for whom the risk is exacerbated and why. She is currently examining relations of cardiometabolic risk factors to magnetic resonance imaging markers of brain health. Dr. Shari Waldstein serves as her mentor and will chair her dissertation.
  • Ikmat Adesanya, BSN, MPH, Graduate Research Associate, PhD Student in Nursing, University of Maryland, School of Nursing
    Her dissertation is focused on self-management of HIV and type 2 diabetes comorbidity to improve the quality of life of the patients. This is related to aging because individuals living with HIV now live longer due to advancement in treatment and care. She is currently mentored by Dr. Amber Kleckner.
  • Jason Ashe, PhD, Post-Doctoral Fellow, Recent graduate of UMBC’s Human Services Psychology (Community Psychology & Behavioral Medicine), Psychology Department
    After working with Dr. Waldstein as a graduate student, Dr. Ashe is now engaged in post-doctoral training in the Health Disparities Research Section of the National Institute on Aging’s Intramural Research Program. He conducts research on the role of religiosity and spirituality in buffering the deleterious impact of discrimination on cardiometabolic, inflammatory, and other aging-related endpoints in African American communities. Dr. Waldstein serves as his Co-Mentor.
  • Jennifer Kirk, BA, PhD, Recent Graduate-Gerontology PhD Student, Department of Epidemiology and Public Health, University of Maryland, School of Medicine
    Her research focus is disparities in bone health among older adults. She conducted analyses using Medicare administrative claims data to estimate the impact of comorbid OSA on healthcare utilization among older adults with depression. Her dissertation title was "Individual, Neighborhood, and Provider-level Factors Associated with Racial and Ethnic Disparities in Osteoporosis Screening and Treatment." Dr. Jennifer Albrecht served as the chair of her dissertation committee and her mentor and Dr. Denise Orwig is her co-mentor.
  • Lindsey Mathis, PT, DPT, PhD Candidate, PhD Student in Department of Physical Therapy and Rehabilitation Science, University of Maryland School of Medicine
    Her area of interest is: Disparities in Disability Outcomes Among Older Adults with Cardiopulmonary Disease. Dr. Jason Falvey serves as her primary mentor.
  • Marcel Lanza, PhD, Assistant Professor of Physical Therapy and Rehabilitation Science, University of Maryland School of Medicine
    Dr. Lanza’s area of research interest includes falls and stepping recovery and its relationship to muscle. He was recently awarded a UM-OAIC pilot study "The Effects of Neuromuscular Activity and Muscle Structure on Stepping Performance in Older Adults". He is co-mentored by Drs. Odessa Addison, Vicki Gray and Alice Ryan.
  • Minerva Mayorga-Carlin MPH , Doctoral Student, University of Maryland, School of Medicine
    Ms. Mayorga- Carlin examines outcomes of carotid artery stenosis and her primary mentor is Dr. Brajesh Lal.
  • Patrice Forrester, PhD, MSW , Postdoctoral Fellow, University of Maryland, School of Pharmacy
    Her interest is in patient-centered research and community-engaged research and she is mentored by Dr. C. Daniel Mullins.
  • Pedro Rodriquez-Rivera, PhD Candidate , PhD student; Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland, School of Medicine
    He is using our ABCD dataset to study substance use on brain development and preparing for his dissertation later this year. Dr. Linda Chang is the Chair of his PhD thesis committee.
  • Peter MacIver, PhD Candidate, PhD Student, Human Services Psychology (Clinical Psychology & Behavioral Medicine), Psychology Department, University of Maryland Baltimore County
    Mr. Maciver’s interests include disparities in relations of cardiovascular risk factors to cognitive function and MRI-assessed subclinical brain pathology as a function of race and socioeconomic status. His master’s thesis examined relations of arterial stiffening (assessed by pulse wave velocity) to cognitive function and associated socio-demographic variation. His dissertation will examine relations of anxiety to cerebral perfusion as a function of race and sex. Dr. Shari Waldstein currently serves as his mentor and dissertation chair.
  • Ruth Akinlosotu, PT, MPH, PhD Candidate, PhD student, Predoctoral Scholar, Department of Physical Therapy and Rehabilitation Science, University of Maryland School of Medicine
    She worked with Dr. Rainer von Coelln on the analysis of Dynaport data generated during his UM-OAIC pilot project. She received a NIH R36 dissertation award to promote diversity. She is mentored by Dr. Kelly Westlake.
  • Shaline Escarfulleri, PhD Candidate, PhD Student, Human Services Psychology (Clinical Psychology & Behavioral Medicine), Psychology Department, University of Maryland, Baltimore County
    Ms. Escarfulleri’s interests include the role of emotion regulation in the relation of stress exposure and negative affect to cardiometabolic risk factors and neurocognition as a function of socioeconomic status. Her master’s thesis project examines whether the relation of SES to carotid intimal medial thickening is partially mediated by negative affect. Dr. Shari Waldstein currently serves as her mentor and master’s thesis chair.
  • Shalini Sahoo, MA , Doctoral Student, University of Maryland, School of Medicine
    Ms. Sahoo is studying the impact of the COVID pandemic on cancer diagnosis and severity and her primary mentor is Dr. Brajesh Lal.

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