National Institute on Aging National Institutes of Health

NIA Home Research Programs Intramural

Jack M. Guralnik, M.D., Ph.D., Senior Investigator Chief, Epidemiology and Demography Section Chief, Laboratory of Epidemiology, Demography, and Biometry E-mail: jg48s@nih.gov

Biography: Dr. Guralnik received his M.D. from Jefferson Medical College in Philadelphia and his M.P.H. and Ph.D. from the School of Public Health, University of California, Berkeley. He practiced as a primary care and public health physician prior to his Ph.D. training. He is Board Certified in Public Health and General Preventive Medicine. Before coming to NIH he did research on predictors of healthy aging in the Human Population Laboratory Alameda County Study in Berkeley, California. He has been in the Laboratory of Epidemiology, Demography, and Biometry at the National Institute on Aging since 1985 and has been the Chief of the Epidemiology and Demography Section since 1991.

Research Overview: The Epidemiology and Demography Section plans and conducts epidemiologic studies of the risk factors for specific chronic diseases important in aging and pursues research on the consequences of disease, especially the effects of chronic disease on functional limitations, disability, and the ability to remain independent in the community. Assessing the roles of behavioral, psychosocial, and demographic risk factors in the development of disease and disability is also an important area of research. Particular attention has been focused on the development of mobility disability and how factors such as strength and balance, exercise, and measures of physical performance predict the loss of walking ability. Research interests have been pursued using data from the Established Populations for Epidemiologic Studies of the Elderly (EPESE), the Women's Health and Aging Study (WHAS), the Honolulu-Asia Aging Study, and the InChianti Study.

Physical Activity and Exercise: A major research interest has been in examining the impact of physical activity and exercise on disability and other health outcomes in older people. Past work demonstrated the risk of incident disability related to sedentary lifestyle. Recent work using EPESE data has shown that active life expectancy, the number of years expected to be lived without disability, is strongly influenced by physical activity. We have also recently demonstrated that an active lifestyle is associated with both living to advanced old age and with dying with no major disability in the last year of life. Data from the WHAS have shown that many women with difficulty walking continue to walk for exercise while nearly half of the women without difficulty don't walk at all for exercise. The amount of walking for exercise done by older women is strongly influenced by their level of disease and disability but many psychosocial variables also influence the amount of walking these women do. Recent findings indicate that even very modest amounts of walking are associated with lower rates of disability onset. A randomized clinical trial evaluating the impact of exercise in preventing disability in non-disabled but at-risk older persons is now being planned.

Assessment Methods: A number of research activities are directed at improving our ability to evaluate older persons in epidemiologic studies, including objective measures of physical performance, measures of exercise tolerance, and measures of muscle mass. Previous research that demonstrated that performance measures of functioning predict incident disability in previously non-disabled subjects has been replicated in several EPESE sites. Predictive equations developed from this work give risk estimates for disability onset so that sample size calculations for clinical trials of disability prevention may be made. Recently, a training CD-ROM was produced to instruct physicians and investigators in the standardized battery that has been extensively studied in the EPESE study, the Women's Health and Aging Study, and others. This battery, known as the Short Physical Performance Battery (SPPB) has now been evaluated in the outpatient clinical setting and found to be feasible to administer and highly predictive of adverse clinical events. Research into the use of the SPPB in the hospital setting is now being planned.

The Pathway from Disease to Disability: An important and ongoing area of research has been to develop an understanding of how the consequences of chronic diseases and the physiologic changes associated with aging cause important losses in functional status and affect the ability to remain independent in the community. A large amount of data collected in the WHAS and other studies provides the basis for empirical study of the steps in the causal chain of events in this pathway. A large research effort has gone into understanding muscle strength in older people and how it relates to functional limitations, disability and other outcomes. The impact on progression through the pathway of both specific conditions and co-occurring multiple conditions (co-morbidity) has been a long-standing area of emphasis in our research. A large effort has gone into identifying biochemical markers of subclinical diseases and frailty that are strongly prognostic of mortality and other adverse outcomes. Our previous work demonstrated increased risk of mortality associated with low serum albumin level and also a graded risk of mortality across the full spectrum of serum albumin values. Recent research assessed the impairments and functional limitations that result from diabetes and affect the steps in the pathway from diabetes to disability.

Health Disparities: We have had a long-standing interest in the impact of social class on health and have demonstrated that educational status and income are powerful predictors of disability onset and mortality. We have also shown that active, or disability-free, life expectancy is considerably longer in persons with higher levels of education. Race also plays a role in the health of older persons although its influence, after adjustment for education and income, has not been consistently demonstrated. Research has also been initiated on the impact of neighborhood characteristics on health outcomes. Recent work using data from the British 1946 cohort study has been evaluating the relationship of early life markers of low income and education and how they relate to functional status in middle age.

Psychological Factors and Health: The influence of psychologic factors, particularly depression, in disease and disability outcomes continues to be a major topic of research. The 6-year longitudinal EPESE data permitted a classification of participants with depression into those who at follow-up 6 had new onset depression and those with chronic depression. Subsequent risk of cancer and heart disease was different for people with these categories of depression, with chronic depression being a risk factor for cancer and new onset depression in men being a risk factor for coronary heart disease. The importance of psychological factors and personality is also being explored in disabled women in the WHAS. We have identified a subset of the WHAS participants who have emotional vitality, defined on the basis of assessments of depression, happiness, personal mastery, and anxiety. A recent publication demonstrated that, even after adjustment for a number of indicators of disease and disability status, emotional vitality is protective of functional decline over a 3-year follow-up period.

Pain: Pain is a very common symptom in older persons and its impact on quality of life and disability has received insufficient study. Using extensive data in the WHAS on multiple pain sites we have begun to evaluate the extent of pain, the associations of pain with functioning, and the use of analgesics to treat pain.

Publications:

Beck J, Ferrucci L, Sun K, Walston J, Fried LP, Varadhan R, Guralnik JM, Semba RD. Low serum selenium concentrations are associated with poor grip strength among older women living in the community. Biofactors. 2007;29(1):37-44. Bergman H, Ferrucci L, Guralnik J, Hogan DB, Hummel S, Karunananthan S, Wolfson C. Frailty: an emerging research and clinical paradigm issues and controversies. J Gerontol A Biol Sci Med Sci. 2007;62(7):731-737. Ferrucci L, Guralnik JM, Bandinelli S, Semba RD, Lauretani F, Corsi A, Ruggiero C, Ershler WB, Longo DL. Unexplained anaemia in older persons is characterised by low erythropoietin and low levels of pro-inflammatory markers. Br J Haematol. 2007;136(6):849-855. Frayling TM, Rafiq S, Murray A, Hurst AJ, Weedon MN, Henley W, Bandinelli S, Corsi AM, Ferrucci L, Guralnik JM, Wallace RB, Melzer D. An interleukin-18 polymorphism is associated with reduced serum concentrations and better physical functioning in older people. J Gerontol A Biol Sci Med Sci. 2007;62(1):73-78. Giannelli SV, Patel KV, Windham BG, Pizzarelli F, Ferrucci L, Guralnik JM. Magnitude of underascertainment of impaired kidney function in older adults with normal serum creatinine. J Am Geriatr Soc. 2007;55(6):816-823. Katula JA, Kritchevsky SB, Guralnik JM, Glynn NW, Pruitt L, Wallace K, Walkup MP, Hsu FC, Studenski SA, Gill TM, Groessl EJ, Wallace JM, Pahor M. Lifestyle interventions and independence for Elders pilot study: recruitment and baseline characteristics. J Am Geriatr Soc. 2007;55(5):674-683. Lauretani F, Bandinelli S, Benedetta B, Cherubini A, Iorio AD, Ble A, Giacomini V, Corsi AM, Guralnik JM, Ferrucci L. Omega-6 and omega-3 fatty acids predict accelerated decline of peripheral nerve function in older persons. Eur J Neurol. 2007;14(7):801-808. Leveille SG, Bean J, Ngo L, McMullen W, Guralnik JM. The pathway from musculoskeletal pain to mobility difficulty in older disabled women. Pain. 2007;128(1-2):69-77. McDermott MM, Ferrucci L, Guralnik JM, Tian L, Green D, Liu K, Tan J, Liao Y, Pearce WH, Schneider JR, Ridker P, Rifai N, Hoff F, Criqui MH. Elevated levels of inflammation, d-dimer, and homocysteine are associated with adverse calf muscle characteristics and reduced calf strength in peripheral arterial disease. J Am Coll Cardiol. 2007;50(9):897-905. Ostir GV, Ottenbacher KJ, Fried LP, Guralnik JM. The effect of depressive symptoms on the association between functional status and social participation. Soc Indic Res. 2007;80(2):379-392. Patel KV, Harris TB, Faulhaber M, Angleman SB, Connelly S, Bauer DC, Kuller LH, Newman AB, Guralnik JM. Racial variation in the relationship of anemia with mortality and mobility disability among older adults. Blood. 2007;109(11):4663-4670. Ruo B, Liu K, Tian L, Tan J, Ferrucci L, Guralnik JM, McDermott MM. Persistent depressive symptoms and functional decline among patients with peripheral arterial disease. Psychosom Med. 2007;69(5):415-424. Coppin AK, Ferrucci L, Lauretani F, Phillips C, Chang M, Bandinelli S, Guralnik JM. Low socioeconomic status and disability in old age: evidence from the InChianti Study for the mediating role of physiological impairments. J Gerontol A Biol Sci Med Sci. 2006;61(1):86-91. Ferrucci L, Cherubini A, Bandinelli S, Bartali B, Corsi A, Lauretani F, Martin A, Andres-Lacueva C, Senin U, Guralnik JM. Relationship of plasma polyunsaturated fatty acids to circulating inflammatory markers. J Clin Endocrinol Metab. 2006;91(2):439-446. Giri J, McDermott MM, Greenland P, Guralnik JM, Criqui MH, Liu K, Ferrucci L, Green D, Schneider JR, Tian L. Statin use and functional decline in patients with and without peripheral arterial disease. J Am Coll Cardiol. 2006;47(5):998-1004. Gray SL, Lacroix AZ, Hanlon JT, Penninx BW, Blough DK, Leveille SG, Artz MB, Guralnik JM, Buchner DM. Benzodiazepine use and physical disability in community-dwelling older adults. J Am Geriatr Soc. 2006;54(2):224-230. Lauretani F, Bandinelli S, Bartali B, Iorio AD, Giacomini V, Corsi AM, Guralnik JM, Ferrucci L. Axonal degeneration affects muscle density in older men and women. Neurobiol Aging. 2006;27(8):1145-1154. McDermott MM, Liu K, Ferrucci L, Criqui MH, Greenland P, Guralnik JM, Tian L, Schneider JR, Pearce WH, Tan J, Martin GJ. Physical performance in peripheral arterial disease: a slower rate of decline in patients who walk more. Ann Intern Med. 2006;144(1):10-20. Summary for patients in: Ann Intern Med. 2006;144(1):I20. Russo CR, Lauretani F, Seeman E, Bartali B, Bandinelli S, Di Iorio A, Guralnik J, Ferrucci L. Structural adaptations to bone loss in aging men and women. Bone. 2006;38(1):112-118. Walston J, Xue Q, Semba RD, Ferrucci L, Cappola AR, Ricks M, Guralnik J, Fried LP. Serum antioxidants, inflammation, and total mortality in older women. Am J Epidemiol. 2006;163(1):18-26. Atkinson HH, Cesari M, Kritchevsky SB, Penninx BW, Fried LP, Guralnik JM, Williamson JD. Predictors of combined cognitive and physical decline. J Am Geriatr Soc. 2005;53(7):1197-1202. Blaum CS, Volpato S, Cappola AR, Chaves P, Xue QL, Guralnik JM, Fried LP. Diabetes, hyperglycaemia and mortality in disabled older women: The Women's Health and Ageing Study I. Diabet Med. 2005;22(5):543-550. Ble A, Fink JC, Woodman RC, Klausner MA, Windham BG, Guralnik JM, Ferrucci L. Renal function, erythropoietin, and anemia of older persons: The InCHIANTI Study. Arch Intern Med. 2005;165(19):2222-2227. Ble A, Volpato S, Zuliani G, Guralnik JM, Bandinelli S, Lauretani F, Bartali B, Maraldi C, Fellin R, Ferrucci L. Executive function correlates with walking speed in older persons: the InCHIANTI Study. J Am Geriatr Soc. 2005;53(3):410-415. Ble A, Windham BG, Bandinelli S, Taub DD, Volpato S, Bartali B, Tracy RP, Guralnik JM, Ferrucci L. Relation of plasma leptin to C-reactive protein in older adults (from the Invecchiare nel Chianti Study). Am J Cardiol. 2005;96(7):991-995. Boyd CM, Xue QL, Simpson CF, Guralnik JM, Fried LP. Frailty, hospitalization, and progression of disability in a cohort of disabled older women. Am J Med. 2005;118(11):1225-1231. Brenes GA, Guralnik JM, Williamson J, Fried LP, Penninx BW. Correlates of anxiety symptoms in physically disabled older women. Am J Geriatr Psychiatry. 2005;13(1):15-22. Brenes GA, Guralnik JM, Williamson JD, Fried LP, Simpson C, Simonsick EM, Penninx BW. The influence of anxiety on the progression of disability. J Am Geriatr Soc. 2005;53(1):34-39. Chaves PH, Semba RD, Leng SX, Woodman RC, Ferrucci L, Guralnik JM, Fried LP. Impact of anemia and cardiovascular disease on frailty status of community-dwelling older women: The Women's Health and Aging Studies I and II. J Gerontol A Biol Sci Med Sci. 2005;60(6):729-735. Ferrucci L, Corsi A, Lauretani F, Bandinelli S, Bartali B, Taub DD, Guralnik JM, Longo DL. The origins of age-related pro-inflammatory state. Blood. 2005;105(6):2294-2299. Ferrucci L, Guralnik JM, Woodman RC, Bandinelli S, Lauretani F, Corsi AM, Chaves PH, Ershler WB, Longo DL. Proinflammatory state and circulating erythropoietin in persons with and without anemia. Am J Med. 2005;118(11):1288. Fried LP, Hadley EC, Walston JD, Newman A, Guralnik JM, Studenski S, Harris TB, Ershler WB, Ferrucci L. From bedside to bench: research agenda for frailty. Sci Aging Knowledge Environ. 2005;2005(31):pe24. Geroldi C, Frisoni GB, Paolisso G, Bandinelli S, Lamponi M, Abbatecola AM, Zanetti O, Guralnik JM, Ferrucci L. Insulin resistance in cognitive impairment: the InCHIANTI study. Arch Neurol. 2005;62(7):1067-1072. Guralnik JM, Ershler WB, Schrier SL, Picozzi VJ. Anemia in the elderly: a public health crisis in hematology. Hematology (Am Soc Hematol Educ Program). 2005;528-532. Han B, Phillips C, Ferrucci L, Bandeen-Roche K, Jylha M, Kasper J, Guralnik JM. Change in self-rated health and mortality among community-dwelling disabled older women. Gerontologist. 2005;45(2):216-221. Hillsdon MM, Brunner EJ, Guralnik JM, Marmot MG. Prospective study of physical activity and physical function in early old age. Am J Prev Med. 2005;28(3):245-250. Marsh AP, Rejeski WJ, Hutton SL, Brown CL, Ip E, Guralnik JM. Development of a lateral mobility task to identify individuals at risk for mobility disability and functional decline. J Aging Phys Act. 2005;13(4):363-381. McDermott MM, Guralnik JM, Corsi A, Albay M, Macchi C, Bandinelli S, Ferrucci L. Patterns of inflammation associated with peripheral arterial disease: the InCHIANTI study. Am Heart J. 2005;150(2):276-281. McDermott MM, Guralnik JM, Ferrucci L, Criqui MH, Greenland P, Tian L, Liu K, Tan J. Functional decline in lower-extremity peripheral arterial disease: Associations with comorbidity, gender, and race. J Vasc Surg. 2005;42(6):1131-1137. Melzer D, Gardener E, Guralnik JM. Mobility disability in the middle-aged: cross-sectional associations in the English Longitudinal Study of Ageing. Age Ageing. 2005;34(6):594-602. Onder G, Penninx BW, Ferrucci L, Fried LP, Guralnik JM, Pahor M. Measures of physical performance and risk for progressive and catastrophic disability: results from the Women's Health and Aging Study. J Gerontol A Biol Sci Med Sci. 2005;60(1):74-79. Penninx BW, Pluijm SM, Lips P, Woodman R, Miedema K, Guralnik JM, Deeg DJ. Late-life anemia is associated with increased risk of recurrent falls. J Am Geriatr Soc. 2005;53(12):2106-2111. Rejeski WJ, Fielding RA, Blair SN, Guralnik JM, Gill TM, Hadley EC, King AC, Kritchevsky SB, Miller ME, Newman AB, Pahor M. The Lifestyle Interventions and Independence for Elders (LIFE) pilot study: Design and methods. Contemp Clin Trials. 2005;26(2):141-154. Sayers SP, Guralnik JM, Thombs LA, Fielding RA. Effect of leg muscle contraction velocity on functional performance in older men and women. J Am Geriatr Soc. 2005;53(3):467-471. Seeman TE, Huang MH, Bretsky P, Crimmins E, Launer L, Guralnik JM. Education and APOE-e4 in longitudinal cognitive decline: MacArthur Studies of Successful Aging. J Gerontol B Psychol Sci Soc Sci. 2005;60(2):P74-P83. Shumway-Cook A, Patla A, Stewart AL, Ferrucci L, Ciol MA, Guralnik JM. Assessing environmentally determined mobility disability: self-report versus observed community mobility. J Am Geriatr Soc. 2005;53(4):700-704. Simonsick EM, Guralnik JM, Volpato S, Balfour J, Fried LP. Just get out the door! Importance of walking outside the home for maintaining mobility: Findings from the Women's Health and Aging Study. J Am Geriatr Soc. 2005;53(2):198-203. Volpato S, Leveille SG, Blaum C, Fried LP, Guralnik JM. Risk factors for falls in older disabled women with diabetes: the Women's Health and Aging Study. J Gerontol A Biol Sci Med Sci. 2005;60(12):1539-1545. Woodman R, Ferrucci L, Guralnik J. Anemia in older adults. Curr Opin Hematol. 2005;12(2):123-128. Bartali B, Turrini A, Salvini S, Lauretani F, Russo CR, Corsi AM, Bandinelli S, D'Amicis A, Palli D, Guralnik JM, Ferrucci L. Dietary intake estimated using different methods in two Italian older populations. Arch Gerontol Geriatr. 2004;38(1):51-60. Cavazzini C, Conti M, Bandinelli S, Gangemi S, Gallinella M, Lauretani F, Lucci G, Windham BG, Guralnik JM, Ferrucci L. Screening for poor performance of lower extremity in primary care: the Camucia Project. Aging Clin Exp Res. 2004;16(4):331-336. Cesari M, Pahor M, Bartali B, Cherubini A, Penninx BW, Williams GR, Atkinson H, Martin A, Guralnik JM, Ferrucci L. Antioxidants and physical performance in elderly persons: the Invecchiare in Chianti (InCHIANTI) study. Am J Clin Nutr. 2004;79(2):289-294. Cesari M, Pahor M, Lauretani F, Penninx BW, Bartali B, Russo R, Cherubini A, Woodman R, Bandinelli S, Guralnik JM, Ferrucci L. Bone density and hemoglobin levels in older persons: results from the InCHIANTI study. Osteoporos Int. 2004. Cesari M, Penninx BW, Pahor M, Lauretani F, Corsi AM, Williams GR, Guralnik JM, Ferrucci L. Inflammatory markers and physical performance in older persons: the InCHIANTI Study. J Gerontol A Biol Sci Med Sci. 2004;59(3):M242-M248. Chang M, Cohen-Mansfield J, Ferrucci L, Leveille S, Volpato S, de Rekeneire N, Guralnik JM. Incidence of loss of ability to walk 400 meters in a functionally limited older population. J Am Geriatr Soc. 2004;52(12):2094-2098. Chaves PH, Xue QL, Guralnik JM, Ferrucci L, Volpato S, Fried LP. What constitutes normal hemoglobin concentration in community-dwelling disabled older women? J Am Geriatr Soc. 2004;52(11):1811-1816. Chodosh J, Seeman TE, Keeler E, Sewall A, Hirsch SH, Guralnik JM, Reuben DB. Cognitive decline in high-functioning older persons is associated with an increased risk of hospitalization. J Am Geriatr Soc. 2004;52(9):1456-1462. Cohen-Mansfield J, Marx MS, Biddison JR, Guralnik JM. Socio-environmental exercise preferences among older adults. Prev Med. 2004;38(6):804-811. Ferrucci L, Bandinelli S, Cavazzini C, Lauretani F, Corsi A, Bartali B, Cherubini A, Launer L, Guralnik JM. Neurological examination findings to predict limitations in mobility and falls in older persons without a history of neurological disease. Am J Med. 2004;116(12):807-815. Ferrucci L, Ble A, Bandinelli S, Lauretani F, Suthers K, Guralnik JM. A flame burning within. Aging Clin Exp Res. 2004;16(3):240-243. Ferrucci L, Guralnik JM, Studenski S, Fried LP, Cutler GB Jr, Walston JD; Interventions on Frailty Working Group. Designing randomized, controlled trials aimed at preventing or delaying functional decline and disability in frail, older persons: a consensus report. J Am Geriatr Soc. 2004;52(4):625-634. Guralnik JM, Eisenstaedt RS, Ferrucci L, Klein HG, Woodman RC. The prevalence of anemia in persons age 65 and older in the United States: evidence for a high rate of unexplained anemia. Blood. 2004;104(8):2263-2268. Leveille SG, Fried LP, McMullen W, Guralnik JM. Advancing the taxonomy of disability in older adults. J Gerontol A Biol Sci Med Sci. 2004;59(1):86-93. McDermott MM, Criqui MH, Greenland P, Guralnik JM, Liu K, Pearce WH, Taylor L, Chan C, Celic L, Woolley C, O'Brien MP, Schneider JR. Leg strength in peripheral arterial disease: associations with disease severity and lower-extremity performance. J Vasc Surg. 2004;39(3):523-530. McDermott MM, Guralnik JM, Albay M, Bandinelli S, Miniati B, Ferrucci L. Impairments of muscles and nerves associated with peripheral arterial disease and their relationship with lower extremity functioning: the InCHIANTI Study. J Am Geriatr Soc. 2004;52(3):405-410. McDermott MM, Guralnik JM, Greenland P, Green D, Liu K, Ridker PM, Chan C, Criqui MH, Ferrucci L, Taylor LM, Pearce WH, Schneider JR, Oskin SI. Inflammatory and thrombotic blood markers and walking-related disability in men and women with and without peripheral arterial disease. J Am Geriatr Soc. 2004;52(11):1888-1894. Melzer D, Lan TY, Tom BD, Deeg DJ, Guralnik JM. Variation in thresholds for reporting mobility disability between national population subgroups and studies. J Gerontol A Biol Sci Med Sci. 2004;59(12):1295-1303. Penninx BW, Pahor M, Cesari M, Corsi AM, Woodman RC, Bandinelli S, Guralnik JM, Ferrucci L. Anemia is associated with disability and decreased physical performance and muscle strength in the elderly. J Am Geriatr Soc. 2004;52(5):719-724. Reuben DB, Seeman TE, Keeler E, Hayes RP, Bowman L, Sewall A, Hirsch SH, Wallace RB, Guralnik JM. Refining the categorization of physical functional status: the added value of combining self-reported and performance-based measures. J Gerontol A Biol Sci Med Sci. 2004;59(10):M1056-M1056. Reuben DB, Seeman TE, Keeler E, Hayes RP, Bowman L, Sewall A, Hirsch SH, Wallace RB, Guralnik JM. The effect of self-reported and performance-based functional impairment on future hospital costs of community-dwelling older persons. Gerontologist. 2004;44(3):401-407. Rucker-Whitaker C, Greenland P, Liu K, Chan C, Guralnik JM, Criqui MH, Taylor L, Pearce WH, McGrae-McDermott M. Peripheral arterial disease in African Americans: clinical characteristics, leg symptoms, and lower extremity functioning. J Am Geriatr Soc. 2004;52(6):922-930. Sayers SP, Brach JS, Newman AB, Heeren TC, Guralnik JM, Fielding RA. Use of self-report to predict ability to walk 400 meters in mobility-limited older adults. J Am Geriatr Soc. 2004;52(12):2099-2103. Sayers SP, Jette AM, Haley SM, Heeren TC, Guralnik JM, Fielding RA. Validation of the late-life function and disability instrument. J Am Geriatr Soc. 2004;52(9):1554-1559. Semba RD, Guralnik JM, Chaves P, Ricks MO, Fried LP. Iron status and anemia in a population-based study of women with and without disability living in the community: the Womens Health and Aging Studies. Haematologica. 2004;89(3):357-358. Simpson CF, Boyd CM, Carlson MC, Griswold ME, Guralnik JM, Fried LP. Agreement between self-report of disease diagnoses and medical record validation in disabled older women: factors that modify agreement. J Am Geriatr Soc. 2004;52(1):123-127. Valenti G, Denti L, Maggio M, Ceda G, Volpato S, Bandinelli S, Ceresini G, Cappola A, Guralnik JM, Ferrucci L. Effect of DHEAS on skeletal muscle over the lifespan: The InCHIANTI Study. J Gerontol A Biol Sci Med Sci. 2004;59(5):M466-M472. Volpato S, Pahor M, Ferrucci L, Simonsick EM, Guralnik JM, Kritchevsky SB, Fellin R, Harris TB. Relationship of alcohol intake with inflammatory markers and plasminogen activator inhibitor-1 in well-functioning older adults: the Health, Aging, and Body Composition Study. Circulation. 2004;109(5):607-612. Zoico E, Di Francesco V, Guralnik JM, Mazzali G, Bortolani A, Guariento S, Sergi G, Bosello O, Zamboni M. Physical disability and muscular strength in relation to obesity and different body composition indexes in a sample of healthy elderly women. Int J Obes Relat Metab Disord. 2004;28(2):234-241. Cappola AR, Xue QL, Ferrucci L, Guralnik JM, Volpato S, Fried LP. Insulin-like growth factor I and interleukin-6 contribute synergistically to disability and mortality in older women. J Clin Endocrinol Metab. 2003;88(5):2019-2025. Chang M, Havlik RJ, Corti MC, Chaves PH, Fried LP, Guralnik JM. Relation of heart rate at rest and mortality in the Women's Health and Aging Study. Am J Cardiol. 2003;92(11):1294-1299. Chang M, Leveille S, Cohen-Mansfield J, Guralnik JM. The association of physical-performance level with attitude toward exercise in older adults. J Aging Phys Act. 2003;11:254-264. Cohen-Mansfield J, Marx MS, Guralnik JM. Motivators and barriers to exercise in an older community-dwelling population. J Aging Phys Act. 2003;11:242-253. Daviglus ML, Liu K, Pirzada A, Yan LL, Garside DB, Feinglass J, Guralnik JM, Greenland P, Stamler J. Favorable cardiovascular risk profile in middle age and health-related quality of life in older age. Arch Intern Med. 2003 Nov;163(20):2460-2468. Ferrucci L, Guralnik JM. Inflammation, hormones, and body composition at a crossroad. Am J Med. 2003;115(6):501-502. Ferrucci L, Guralnik JM, Cavazzini C, Bandinelli S, Lauretani F, Bartali B, Repetto L, Longo DL. The frailty syndrome: a critical issue in geriatric oncology. Crit Rev Oncol Hematol. 2003;46(2):127-137. Gray SL, Penninx BW, Blough DK, Artz MB, Guralnik JM, Wallace RB, Buchner DM, LaCroix AZ. Benzodiazepine use and physical performance in community-dwelling older women. J Am Geriatr Soc. 2003;51(11):1563-1570. Guralnik JM, Ferrucci L. Assessing the building blocks of function: utilizing measures of functional limitation. Am J Prev Med. 2003;25(3 Suppl 2):112-121. Guralnik JM, Leveille S, Volpato S, Marx MS, Cohen-Mansfield J. Targeting high-risk older adults into exercise programs for disability prevention. J Aging Phys Act. 2003;11:219-228. Lamb SE, Ferrucci L, Volapto S, Fried LP, Guralnik JM. Risk factors for falling in home-dwelling older women with stroke: The Women's Health and Aging Study. Stroke. 2003;34(2):494-501. Lan TY, Deeg DJ, Guralnik JM, Melzer D. Responsiveness of the index of mobility limitation: comparison with gait speed alone in the Longitudinal Aging Study Amsterdam. J Gerontol A Biol Sci Med Sci. 2003;58(8):721-727. Lauretani F, Russo CR, Bandinelli S, Bartali B, Cavazzini C, Di Iorio A, Corsi AM, Rantanen T, Guralnik JM, Ferrucci L. Age-associated changes in skeletal muscles and their effect on mobility: an operational diagnosis of sarcopenia. J Appl Physiol. 2003;95(5):1851-1860. Leveille SG, Cohen-Mansfield J, Guralnik JM. The impact of chronic musculoskeletal pain on exercise attitudes, self-efficacy, and physical activity. J Aging Phys Act. 2003;11:275-283. Lunney JR, Lynn J, Foley DJ, Lipson S, Guralnik JM. Patterns of functional decline at the end of life. JAMA. 2003;289(18):2387-2392. Marx MS, Cohen-Mansfield J, Guralnik JM. Recruiting community-dwelling elderly at risk for physical disability into exercise research. J Aging Phy Act. 2003;11:229-241. McDermott MM, Green D, Greenland P, Liu K, Criqui MH, Chan C, Guralnik JM, Pearce WH, Ridker PM, Taylor L, Rifai N, Schneider JR. Relation of levels of hemostatic factors and inflammatory markers to the ankle brachial index. Am J Cardiol. 2003;92(2):194-199. McDermott MM, Greenland P, Green D, Guralnik JM, Criqui MH, Liu K, Chan C, Pearce WH, Taylor L, Ridker PM, Schneider JR, Martin G, Rifai N, Quann M, Fornage M. D-dimer, inflammatory markers, and lower extremity functioning in patients with and without peripheral arterial disease. Circulation. 2003;107(25):3191-3198. McDermott MM, Greenland P, Guralnik JM, Liu K, Criqui MH, Pearce WH, Chan C, Schneider J, Sharma L, Taylor LM, Arseven A, Quann M, Celic L. Depressive symptoms and lower extremity functioning in men and women with peripheral arterial disease. J Gen Intern Med. 2003;18(6):461-467. McDermott MM, Greenland P, Liu K, Criqui MH, Guralnik JM, Celic L, Chan C. Sex differences in peripheral arterial disease: leg symptoms and physical functioning. J Am Geriatr Soc. 2003;51(2):222-228. McDermott MM, Guralnik JM, Greenland P, Pearce WH, Criqui MH, Liu K, Taylor L, Chan C, Sharma L, Schneider JR, Ridker PM, Green D, Quann M. Statin use and leg functioning in patients with and without lower-extremity peripheral arterial disease. Circulation. 2003;107(5):757-761. Melzer D, Guralnik JM, Brock D. Prevalence and distribution of hip and knee joint replacements and hip implants in older Americans by the end of life. Aging Clin Exp Res. 2003;15(1):60-66. Melzer D, Lan TY, Guralnik JM. The predictive validity for mortality of the index of mobility-related limitation--results from the EPESE study. Age Ageing. 2003;32(6):619-625. Ostir GV, Cohen-Mansfield J, Leveille S, Volpato S, Guralnik JM. The association of positive and negative affect and exercise self-efficacy in older adults. J Aging Phys Act. 2003;11:265-274. Penninx BW, Guralnik JM, Onder G, Ferrucci L, Wallace RB, Pahor M. Anemia and decline in physical performance among older persons. Am J Med. 2003;115(2):104-110. Rantanen T, Volpato S, Ferrucci L, Heikkinen E, Fried LP, Guralnik JM. Handgrip strength and cause-specific and total mortality in older disabled women: exploring the mechanism. J Am Geriatr Soc. 2003;51(5):636-641. Reuben DB, Keeler E, Seeman TE, Sewall A, Hirsch SH, Guralnik JM. Identification of risk for high hospital use: cost comparisons of four strategies and performance across subgroups. J Am Geriatr Soc. 2003;51(5):615-620. Russo CR, Lauretani F, Bandinelli S, Bartali B, Cavazzini C, Guralnik JM, Ferrucci L. High-frequency vibration training increases muscle power in postmenopausal women. Arch Phys Med Rehabil. 2003;84(12):1854-1857. Russo CR, Lauretani F, Bandinelli S, Bartali B, Di Iorio A, Volpato S, Guralnik JM, Harris T, Ferrucci L. Aging bone in men and women: beyond changes in bone mineral density. Osteoporos Int. 2003;14(7):531-538. Semba RD, Blaum C, Guralnik JM, Moncrief DT, Ricks MO, Fried LP. Carotenoid and vitamin E status are associated with indicators of sarcopenia among older women living in the community. Aging Clin Exp Res. 2003;15(6):482-487. Shumway-Cook A, Patla A, Stewart A, Ferrucci L, Ciol MA, Guralnik JM. Environmental components of mobility disability in community-living older persons. J Am Geriatr Soc. 2003;51(3):393-398. Volpato S, Ferrucci L, Blaum C, Ostir G, Cappola A, Fried LP, Fellin R, Guralnik JM. Progression of lower-extremity disability in older women with diabetes: the Women's Health and Aging Study. Diabetes Care. 2003;26(1):70-75.

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Updated: Thursday October 11, 2007