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Sara E. Espinoza, M.D., M.Sc.

Contact

210-617-5311

espinozas2@uthscsa.edu

Departments & Divisions

Institutes & Centers

Sara E. Espinoza, MD

Professor of Medicine

Director, San Antonio GRECC

Dr. Espinoza is an Professor in the Department of Medicine, Division of Geriatrics, Gerontology & Palliative Medicine, and a core faculty member in the Sam and Ann Barshop Institute for Longevity & Aging Studies. She is Co-Director of the San Antonio Claude D. Pepper Older Americans Independence Center and Co-Leader of its Clinical Research and Pharmacology Core. For the South Texas Veterans Health Care System, Dr. Espinoza serves as Director for the Geriatrics Research, Education & Clinical Center.

Dr. Espinoza’s primary research focus is understanding frailty, a geriatric syndrome that increases risk for physical decline. She has conducted epidemiologic and clinical translational research in this area, including clinical trials.  Her epidemiologic work was the first to directly compare prevalence and incidence rates of frailty among Mexican Americans and European Americans in the San Antonio Longitudinal Study of Aging (SALSA) cohort, in collaboration with Dr. Helen Hazuda, Principal Investigator of SALSA. This work identified that diabetes is a strong predictor of future frailty in older adults.  Her translational research identified novel inflammatory biomarkers for frailty using high throughput proteomics techniques, collaborating with other investigators within the Barshop Institute. She is currently leading a randomized clinical trial of metformin for the prevention of frailty in older adults with pre-diabetes (NIH/NIA R01AG052697). She is also the Site PI for the Aspirin in Reducing Events in the Elderly study (ASPREE and ASPREE-XT), a landmark trial which demonstrated that low dose aspirin does not reduce risk for dementia, disability, cardiovascular diseases, or death, but increases bleeding events, in healthy older adults.

As Director of the Geriatric Research, Education, and Clinical Center (GRECC) and Staff Physician, she provides clinical care at Audie L. Murphy VA Hospital and is actively engaged in research mentoring and clinical teaching to students, residents, and fellows. In this role she also oversees several clinical demonstration projects which serve to improve the care provided to older veterans in South Texas.

  • Professional Background

    Education

    • 2010 - MS - Clinical Investigation - University of Texas Health Science Center
    • 2006 - Clinical Fellowship - Geriatric Medicine and Gerontology - The Johns Hopkins School of Medicine
    • 2003 - Residency - Internal Medicine - Strong Memorial Hospital-University of Rochester Medical Center
    • 2001 - Internship - Internal Medicine - Strong Memorial Hospital-University of Rochester Medical Center
    • 2000 - MD - Medicine - University of Virginia School of Medicine
    • 1995 - BS - Psychology (With Distinction) - George Mason University

    Appointments

    • 9/2014 - Associate Professor - UT Health Science Center at San Antonio, Medicine, San Antonio
    • 3/2011 - Associate Director for Clinical Programs - South Texas Veterans Health Care SystemSan Antonio
    • 8/2010 - Assistant Professor - UTHSCSA, Medicine, San Antonio
    • 11/2008 - Section Chief for Research - UTHSCSA, Medicine, San Antonio
    • 7/2006 - Clinical Investigator - South Texas Veterans Health Care SystemSan Antonio
    • 7/2006 - Staff Physician - South Texas Veterans Health Care System, Medicine, San Antonio
    • 7/2006 - Assistant Professor - UTHSCSA, Medicine, San Antonio
    • 9/1/2021 - Professor - UT Health Science Center at San Antonio, Medicine, San Antonio
    • 9/1/2021 - Director, San Antonio GRECC - South Texas Veterans Health Care System

  • Instruction & Training

    • 2/2020 - Present, Post-Doctoral Student Supervision, Monash University
    • 12/2019 - Present, Undergraduate Student Supervision, University of Texas at San Antonio
    • 10/2019 - Present, Ph.D. Candidacy Exam, University of Texas Health Science Center at San Antonio
    • 10/2018 - Present, Funds Of Biomedical Sciences, The University of Texas Health Science Center
    • 1/2018 - Present, Post-Doctoral Student Supervision, University of Texas Health Science Center at San Antonio
    • 5/2017 - Present, Post-Doctoral Student Supervision, University of Texas Health Science Center at San Antonio
    • 1/2016 - Present, Post-Doctoral Student Supervision, University of Texas Health Science Center at San Antonio
    • 3/2015 - Present, Human Development Across the Lifespan, The University of Texas Health Science Center
    • 3/2012 - Present, Patient Orient Clin Res Method, The University of Texas Health Science Center
    • 3/2012 - Present, Patient-Orient Clin Res Method, The University of Texas Health Science Center
    • 7/2010 - Present, Lecturer, Voelcker Biomedical Research Academy, UT Health Science Center San Antonio
    • 7/2009 - Present, Post-Doctoral Student Supervision, University of Texas Health Science Center at San Antonio
    • 4/2009 - Present, Biology of Aging, The University of Texas Health Science Center
    • 6/2007 - Present, Lecturer, Palliative Care Service, South Texas Veterans Health Care System
    • 5/2007 - Present, Lecturer, Medical Students in Aging Research (MSTAR) Program, The University of Texas Health Science Center at San Antonio
    • 5/2007 - 5/2020, Pre-Doctoral Student Supervision, The University of Texas Health Science Center at San Antonio
    • 7/2006 - Present, Rotation Student Supervision, South Texas Veterans Health Care System

  • Research & Grants

    Grants

    Federal

    Funding Agency National Institutes of Health Title Aspirin for the Prevention of Events in the Elderly Extension Status Active Period 6/2019 - 5/2024 Role Principal Investigator Grant Detail This extension phase of ASPREE-XT will examine the long-term effects of aspirin on dementia, disability, cancer, and survival. Funding Agency National Institutes of Health Title University of Texas Adult Clinical Center, NIH Molecular Transducers of Physical Activity Consortium (MoTrPAC) Status Active Period 12/2016 - 11/2022 Role Co-Investigator Grant Detail The purpose of the MoTrPAC is to catalyze the identification and mapping of molecular and cellular transducers underlying the physiological effects of physical activity. Funding Agency National Institute on Aging Title Metformin for Preventing Frailty in High Risk Older Adults Status Active Period 6/2017 - 5/2022 Role Principal Investigator Grant Detail Pre-diabetes/insulin resistance and inflammation are major contributors to frailty. This study will determine whether the use of metformin to modulate pre-diabetes/insulin resistance and inflammation in older adults with pre-diabetes will prevent and/or ameliorate the progression of frailty. Funding Agency Veterans Administration - South Texas Veterans Healthcare System Title GRECC Connect San Antonio Status Active Period 10/2013 - 10/2021 Role Principal Investigator Grant Detail Older adults living in rural areas often do not have access to specialized geriatric care, such as comprehensive geriatric assessment and evaluation and treatment of geriatric syndromes and conditions, such as dementia, falls, chronic pain, and advanced care planning. The goal of this project is to improve the healthcare for medically complex older Veterans enrolled in rural community-based outpatient clinics within Veterans Integrated Service Network 17. This will be accomplished by: 1) providing expert, interdisciplinary clinical consultation to medically complex older veterans via video-teleconferencing (VTEL), and 2) providing case-based training in geriatrics for primary care providers practicing in rural CBOCs using SCAN-ECHO (Specialty Care Access Network Extension for Community Healthcare Outcomes) infrastructure, which will be established by this project. Funding Agency NIDDK Title Diabetes Prevention Program Outcomes Study Status Active Period 2/2018 - 2/2021 Role Co-Investigator Grant Detail   Funding Agency National Institute on Aging Title San Antonio Claude D. Pepper Older Americans Independence Center Status Active Period 6/2015 - 5/2020 Role Co-Investigator Grant Detail The purpose of this program is to conduct clinical research in aging and geriatrics, focused on testing interventions in humans and non-human primates that are hypothesized to slow aging and prevent or delay age-related diseases. Funding Agency Veterans Administration Title Enhancing Quality of Prescribing Practices among older veterans discharged from the Emergency Department (EQUIPPED) Status Active Period 10/2016 - 9/2019 Role Principal Investigator Grant Detail The purpose of this GRECC quality improvement program is to reduce the prescribing of potentially inappropriate medications to older veterans treated and discharged from the emergency department at Audie L. Murphy VA Hospital. The program includes training of ED providers, order sets designed to provide safer alternatives for older adults, and academic detailing/feedback to providers. This project is a collaboration with the lead site at the Atlanta/Birmingham GRECC (Geriatrics Research, Education, and Clinical Center). Funding Agency National Institute on Aging/NIH Title Aspirin in Reducing Events in the Elderly (ASPREE) Status Active Period 4/2010 - 1/2019 Role Principal Investigator Grant Detail A national multi-site randomized controlled trial of aspirin in the elderly. The purpose of this study is to evaluate the effect of 100mg of daily aspirin in patients 65 years of age and older on physical and cognitive functioning. Funding Agency Veterans Affairs Office of Rural Health Title Geriatrics Medication Education at Discharge: Rural Expansion Status Active Period 10/2014 - 9/2017 Role Principal Investigator Grant Detail Funds awarded to expand our successful pharmacy-based transitional care project targeting high risk older veterans transitioning from hospital to home to rural veterans cared for at Audie Murphy VA Hospital. Our prior work has shown that this pharmacist-based transitional care intervention reduces rates of adverse drug events and 30-day hospital readmissions in older veterans. Funding Agency Veterans Affairs Office of Rural Health Title Geriatrics Walking Clinic: Rural Expansion Status Active Period 10/2014 - 9/2017 Role Principal Investigator Grant Detail Funds awarded to expand our successful activity promotion clinic to rural outpatients cared for within rural Community Based Outpatient Clinics within South Texas Veterans Healthcare System. This program is a 6-week walking program to promote increased physical activity in older veterans, delivered by a Registered Nurse and Certified Diabetes Educator and Geriarician. Our work at Audie Murphy VA Hospital has shown the program makes significant improvements in patient timed gait speed, grip strength, and body mass index.

    State

    Funding Agency Institute for the Integration of Medicine and Science Title Intranasal Oxytocin for the Treatment of Sarcopenic Obesity in Older Adults Status Active Period 9/2016 - 8/2017 Role Co-Principal Investigator Grant Detail Obesity is highly prevalent in older adults and is a major cause of sarcopenia and disability in older adults. Oxytocin is a pituitary hormone released during parturition and lactation that is also known to suppress appetite in rodents and humans; and, recent small studies have found that intranasal oxytocin reduces body weight in adults. We propose a pilot study of intranasal oxytocin as a novel approach to promote weight loss and increase muscle mass in older subjects with sarcopenic obesity.

  • Publications

      Abstract

      Espinoza SE, Musi N, Wang C, Michalek J. A randomized controlled trial of metformin for frailty prevention: study design and baseline characteristics; 2019 Jan. (Innovation in Aging; vol. 3, no. Sup 1).

      Jergensen T, Orsak B, Conde A, Romo T, Bair-Kelps D, Ganapathy V, Moris M, Kelly C, Jiwani R, Wang C, Powers B, Musi N, Espinoza S. Metformin for preventing frailty in older adults with pre-diabetes; 2018 May. (Journal of the American Geriatrics Society; vol. 66).

      Delgado E, Rottman-Sagebiel R, Madden K, Espinoza SE. Appropriate prescribing of sulfamethoxazole/trimethoprim in geriatric patients; 2018 May. (Journal of the American Geriatrics Society; vol. 66).

      Espinoza SE, Musi N, Wang C. A randomized placebo-control trial of metformin for frailty prevention in older adults with pre-diabetes; 2018 Jan. (Innovation in Aging; vol. 2, no. Sup 1).

      Espinoza SE, Hazuda HP. Ethnic disaprity in frailty between Mexican American and European American older adults; 2018 Jan. (Innovation in Aging; vol. 2, no. Sup 1).

      Fletcher M, Rottman-Sagebiel R, Cupples N, Wang C, MacCarthy D, Conde A, Moris M, Espinoza S. Potentially inappropriate medication use in older veterans enrolled in a hospital to home transitional care program; 2017 May. (Journal of the American Geriatrics Society; vol. 65).

      Rottman-Sagebiel R, Reilly M, Corbo J, Espinoza S. Fall prevention in community dwelling patients; 2017 May. (Journal of the American Geriatrics Society; vol. 65).

      Brown L, Glass M, Corbo J, Ali N, Davila D, Royall D, Espinoza S. Anticholinergic risk scale was not associated with cognition or disability in older veterans referred to a geriatrics memory clinic; 2017 May. (Journal of the American Geriatrics Society; vol. 65).

      Fletcher M, Ipson B, Espinoza S, Fisher A. Identifying exosome-derived microRNAs as candidate biomarkers of frailty; 2017 May. (Journal of the American Geriatrics Society; vol. 65).

      Rossi M, Thielke S, Caprio T, Barczi S, Espinoza S, Garner K, Moo L, James J. Telemedicine approaches to extend geriatric care to rural areas; 2016 Nov. (The Gerontologist; vol. 56).

      Espinoza SE, Quiben M, Hazuda H. Onset of frailty characteristics in a bi-ethnic cohort: the San Antonio Longitudinal Study of Aging; 2016 Nov. (The Gerontologist; vol. 56).

      Espinoza SE. An individualized walking clinic leads to reduction in Hemoglobin A1c and improvement in timed up and go in older veterans wtih diabetes; 2016 May. (Journal of the American Geriatrics Society; vol. 64).

      Sawey K, Royall D, Powers B, Taylor V, Wang C, Espinoza SE. Increased disability in instrumental activities of daily living is associated with executive impairment in rural veterans referred for geriatrics e-consultation; 2016 May. (Journal of the American Geriatrics Society; vol. 64).

      Arevalo-Flechas L, Noel P, Rottman-Sagebiel R, Cupples N, Conde A, Sanchez-Reilly S, Powers B, Espinoza SE. Presence of a caregiver associated with increased odds of readmission in a cohort of older adults included in a transitional care intervention; 2016 May. (Journal of the American Geriatrics Society; vol. 64).

      Mireles C, Pagan-Ferrer J, Powers B, Orsak B, Conde A, Padala P, Padala K, Kellogg D, Espinoza SE. Improvement in attitudes toward exercise in older adults participating in a geriatrics walking clinic; 2016 May. (Journal of the American Geriatrics Society; vol. 64).

      Cope S, Rottman-Sagebiel R, Cupples N, Wang C, MacCarthy D, Conde A, Gonzalez Y, Moris M, Espinoza SE. A pharmacist-led transitional care program results in reduced 30-day readmission in older veterans: the Geriatrics Medication Education at Discharge Project; 2016 May. (Journal of the American Geriatrics Society; vol. 64).

      Braden H, Rottman-Sagebiel R, Cupples N, Moris M, Gonzalez E, Conde A, MacCarthy D, Wang C, Espinoza SE. Cost savings associated with a pharmacy-based transitional care program for hospitalized older veterans; 2015 May. (Journal of the American Geriatrics Society; vol. 63).

      Espinoza SE, Wang C, MacCarthy D, Orsak B, Padala P, Padala K, Kellogg D. An inidividualized low-intensity walking clinic leads to improvement in frailty characteristics in older veterans; 2015 May. (Journal of the American Geriatrics Society; vol. 63).

      Wang C, Espinoza SE. Differential impact of metformin on diabetes-related comorbidities in older veterans with Type 2 diabetes; 2015 May. (Journal of the American Geriatrics Society; vol. 63).

      Frausto E, Cupples N, Thet A, Rottman-Sagebiel R, Wang C, Espinoza S. A pharmacist based transitional care project leads to safer prescribing in hospitalized older veterans; 2015 May. (Journal of the American Geriatrics Society; vol. 63).

      Espinoza SE, Wang C, Reaven P, DeFronzo R, Tripathy D, Musi N. Pioglitazone is equally effective for preventing diabetes in older compared to younger pre-diabetic adults; 2015 May. (Journal of the American Geriatrics Society; vol. 63).

      Espinoza SE, Wang C, Hazuda HP. Differential impact of diabetes on frailty incidence in older Mexican and European Americans; 2014 Nov. (The Gerontologist; vol. 54).

      Espinoza SE, Rottman-Sagebiel R, MacCarthy D, Moris M, Gonzalez E, Conde A, Wang C. A pharmacy-based transitional care intervention for high-risk older veterans transitioning from hospital to home; 2014 Nov. (The Gerontologist).

      Editorial

      Bandeen-Roche K, Espinoza SE. Getting underneath observed frailty transitions: meaningful change, prevention, and intervention Journal of the American Geriatrics Society 2017 Jan;65:2455-2456.

      Journal Article

      Espinoza SE, Musi N, Wang C, Michalek J, Orsak B, Romo T, Powers B, Conde A, Moris M, Bair-Kelps D, Li Y, Jergensen T, Kelly L, Jiwani R. Rationale and study design of a randomized clinical trial of metformin to prevent frailty in older adults with pre-diabetes Journals of Gerontology Series A Biological and Medical Sciences 2020 Jan;75(1):102-109.

      Pimentel, C, Gately M, Barczi S, Boockvar K, Bowman E, Caprio T, Colon-Emeric C, Dang S, Espinoza S, Garner K, Griffiths P, Howe J, Lum H, Markland A, Rossi M, Thielke S, Valencia-Rodrigo W, Moo L, Hung W. GRECC Connect: Geriatrics telehealth to empower health care providers and improve management of older veterans in rural communities Federal Practitioner 2019 Oct;36(10):464-470.

      Espinoza SE, Orsak B, Wang C, MacCarthy D, Kellogg B, Powers B, Conde A, Moris M, Padala P, Padala K. An inidividualized low-intensity walking clinic leads to improvement in frailty characteristics in older veterans Journal of Frailty and Aging 2019 May;8(4):205-209.

      Espinoza SE, Jiwani R, Wang J, Wang C. Review of interventions for the frailty syndrome and the role of metformin as a potential pharmacologic agent for frailty prevention Clinical Therapeutics 2019 Mar;41(3):376-386.

      Rottman-Sagebiel R, Cupples N, Wang C, Cope S, Pastewait S, Braden H, MacCarthy D, Conde A, Moris M, Gonzalez E, Espinoza SE. A pharmacist-based transitional care program reduces readmissions in older hospitalized adults: a clinical demonstration program Federal Practitioner 2018 Dec;35(12):42-50.

      McNeil J., Wolfe R., Woods R., et al. for the ASPREE Investigator Group (including Espinoza S.). Effect of aspirin on cardiovascular events and bleeding in the healthy elderly New England Journal of Medicine 2018 Sep;.

      Noel, HP, Parchman, ML, Hazuda HP, Wang CP, Espinoza SE, Finley EP, Bollinger M. Provider-related linkages between primary care clinics and community-based senior centers associated with diabetes-related outcomes [Epub ahead of print] Journal of Applied Gerontology 2018 Jun;.

      Espinoza SE, Quiben M, Hazuda H. Distinguishing comorbidity, disability, and frailty Current Geriatrics Reports 2018 Jan;7(4):201-209.

      McNeil J., Woods R., Nelson M. et al. for the ASPREE Investigator Group (including Espinoza S.). Effect of aspirin on disability-free survival in the healthy elderly New England Journal of Medicine 2018 Jan;.

      McNeil J., Nelson M., Woods R. et al for the ASPREE Investigator Group (including Espinoza S.). Effect of aspirin on all-cause mortality in the healthy elderly New England Journal of Medicine 2018 Jan;.

      Ipson B, Fletcher M, Espinoza S, Fisher A. Identifying exosome-derived microRNAs as candidate biomarkers of frailty Journal of Aging and Frailty 2018 Jan;7(2):100-103.

      McNeil J, Woods R, Nelson M et al. on behalf of the ASPREE Investigator Group (Espinoza SE is listed author). Baseline characteristics of participants in the ASPREE (Aspirin in Reducing Events in the Elderly) study Journals of Gerontology Series A Biological and Medical Sciences 2017 Nov;72(11):1586-1593.

      Wang C-P, Lorenzo C, Habib S, Jo B, Espinoza SE. Differential effects of metformin on age related comorbidities in older men with type 2 diabetes Journal of Diabetes and its Complications 2017 Apr;31(4):679-686.

      Deepa S, Bhaskaran S, Espinoza S, Brooks S, McArdle A, Jackson M, Van Remmen H, Richardson A. A New Mouse Model of Frailty: The Cu/Zn Superoxide Dismutase Knockout Mouse Geroscience 2017 Apr;39(2):187-198.

      Ward SA, Raniga P, Ferris NJ, Storey E, Bailey MJ, Brodtmann A, Yates PA, Donnan GA, Trevaks RE, Wolfe, R, Egan GF, McNeil JJ on behalf of ASPREE Investigator Group (Espinoza SE is listed author). ASPREE-NEURO study protocol: a randomized controlled trial to determine the effect of low-dose aspirin on cerebral microbleeds, white matter hyperintensities, cognition, and stroke in the healthy elderly International Journal of Stroke 2017 Jan;12(1):108-113.

      Hazuda HP, Espinoza SE. Prevention of Falls and Frailty in Older Adults with Diabetes Current Geriatrics Reports 2017 Jan;6(3):158-167.

      Espinoza SE, Wang C-P, Tripathy D, Clement SC, Schwenke DC, Banerji MA, Bray G, Buchanan T, Henry R, Kitabchi A, Mudaliar S, Stentz F, Reaven P, DeFronzo RA, Musi N. Pioglitazone is Equally Effective for Diabetes Prevention in Older versus Younger Adults with Impaired Glucose Tolerance Age 2016 Sep;38:485-493. 24.

      Barker AL, McNeill JJ, Seeman E, Ward SA, Sanders KM, Khosla S, Cumming RG, Pasco JA, Bohensky MA, Ebeling PR, Woods RL, Lockery JE, Wolfe R, Talevski J, ASPREE Investigator Group (Espinoza SE is listed author). A randomised controlled trial of low-dose aspirin for the prevention of fractures in healthy older people: protocol for the ASPREE-Fracture substudy Injury Prevention 2016 Jan;22(4):297-301.

      Noel PH, Parchman ML, Finley EP, Wang CP, Bollinger ML, Espinoza SE, Hazuda HP. Primary care-public health linkages: Older primary care patients with prediabetes and type 2 diabetes encouraged to attend community-based senior centers Preventive Medicine Reports 2016 Jan;4:283-288.

      Lowthian JA, Britt CJ, Rance G, Lin FR, Woods RL, Wolfe R, Nelson MR, Dillon HA, Ward S, Reid CM, Lockery JE, Nguyen TT, McNeill JJ, Storey E, ASPREE Investigators (Espinoza SE is listed author). Slowing the progression of age-related hearing loss: rationale and study design of the Aspirin in Hearing, retinal vessels imaging and neurocognition in older generations (ASPREE-HEARING) trial Contemporary Clinical Trials 2016 Jan;46:60-66.

      Aspinall S, Zhao X, Semla T et al. for the Veterans Affairs Community Living Center Pharmacotherapy Research Group (Espinoza S is listed author). Epidemiology of drug-disease interactions in older veteran nursing home residents Journal of the American Geriatrics Society 2015 Jan;63(1):77-84.

      Espinoza SE, Hazuda H. Frailty Prevalence and Neighborhood Residence in Older Mexican Americans: The San Antonio Longitudinal Study of Aging Journal of the American Geriatrics Society 2015 Jan;63:106-111.

      Wang CP, Lorenzo C, Espinoza SE. Frailty Attenuates the Impact of Metformin on Reducing Mortality in Older Adults with Type 2 Diabetes Journal of Endocrinology, Diabetes and Obesity 2014 May;2(2).

      Darvin K, Randolph A, Ovalles S, Halade D, Breeding L, Richardson A, Espinoza SE. Plasma Protein Biomarkers of the Geriatric Syndrome of Frailty Journals of Gerontology Series A: Medical and Biological Sciences 2014 Feb;69A(2):182-186.

      Pugh JA, Wang C-P, Espinoza S, Noel PH, Bollinger M, Amuan M, Finley E, Pugh MJ. Influence of Frailty Diagnoses, Inappropriate Prescribing and Primary Care Utilization on In press: Journal of the American Geriatrics Society 2014 Feb;. ASPREE Investigator Group. Study design of ASPirin in Reducing Events in the Elderly (ASPREE): A randomized, controlled trial Contemporary Clinical Trials 2013 Nov;36(2):555-564.

      Espinoza SE, Jung I, Hazuda HP. The Hispanic Paradox and Predictors of Mortality in an Aging Bi-ethnic Cohort of Mexican Americans and European Americans: The San Antonio Longitudinal Study of Aging Journal of the American Geriatrics Society 2013 Oct;61(9):1522-1529.

      Garcia C, Espinoza SE, Lichtenstein M, Hazuda H. Health Literacy Associations between Hispanic Elderly Patients and their Caregivers Journal of Health Communication 2013 Oct;18:256-272.

      Espinoza SE, Jung I, Hazuda HP. Frailty Transitions in the San Antonio Longitudinal Study of Aging Journal of the American Geriatrics Society 2012 Apr;60(4):652-660.

      Shamsi K, Pierce AP, Ashton A, Halade D, Richardson AG, Espinoza SE. Proteomic Screening of Glycoproteins in Human Plasma for Frailty Biomarkers Journals of Gerontology: Biological Sciences 2012 Jan;67(8):853-864.

      Espinoza SE, Hazuda HP. Frailty in Older Mexican-American and European-American Adults: Is There an Ethnic Disparity? Journal of the American Geriatrics Society 2008 Sep;56(9):1744-1749.

      Walston JD, Fedarko N, Yang H, Leng S, Beamer B, Espinoza SE, Lipton A, Zheng H, Becker K. The Physical and Molecular Characterization of a Frail Mouse Model Journal of Gerontology: Medical Sciences 2008 Apr;63(4):391-398.

      Espinoza SE, Fried LP. Risk Factors for Frailty in the Older Adult Clinical Geriatrics 2007 Jun;15(6):37-44. Espinoza SE, Walston JD. Frailty in Older Adults: Insights and Interventions Cleveland Clinic Journal of Medicine 2005 Dec;72(12):1105-1112.