Elsa S Strotmeyer

Research interests

• Aging epidemiology
• Diabetes-related complications in older adults
• Neuromuscular and musculoskeletal function
• Fall injuries and mobility
• Medicare claims in epidemiologic studies

I am a tenured Professor of Epidemiology, with expertise in the epidemiology of aging. I serve as Director of the NIA T32 Epidemiology of Aging Training Grant, and leader of the Research Education Component (REC) as well as an Executive Committee member of the University of Pittsburgh’s Claude D. Pepper Center. My research that focuses on metabolic risk factors and diabetes-related conditions in aging associated with neuromuscular and musculoskeletal declines in the etiology of fall injuries, mobility, disability and mortality. I have pioneered the study of the complex inter-relationships of peripheral nerves, neuromuscular and musculoskeletal function in aging and diabetes. My research has demonstrated high rates of peripheral nerve and neuromuscular impairments in diabetes and with aging which are critical to lower extremity performance, bone loss, falls and fracture. In older adults, peripheral nerve impairments result in a 2-fold increased risk of mobility limitation which is independent of diabetes and account for approximately 25% of poor performance in older adults with diabetes. My findings that type 2 diabetes is associated with 64% higher fracture risk, independent of the generally higher bone mineral density (BMD) and higher weight, in older adults, has been cited >400 times. I was the first to find that bone loss was related to poor peripheral nerve function and am a multi-PI with Dr. Cauley of an R01 to investigate detailed muscle associations with bone parameters from high resolution peripheral quantitative computed tomography (HR-pQCT) in the Study of Muscle, Mobility and Aging (SOMMA) and have served as a Co-I for SOMMA since its inception. My R01 using cohort and Medicare Fee-For-Service (FFS) data has created algorithms for fall injuries in claims. These findings led to a current R01 examining time trends for incident non-fracture fall injuries (NFFI) and fractures, across 20 years of 4 pooled longitudinal cohorts with ~12,000 women and men, a third of which are minority older adults; and will determine if incident NFFI predict future risk of major geriatric outcomes. My ongoing work includes novel methods to assess leg power capturing neuromuscular function; risk factors to improve neuromuscular function in older adults; and cross cohort epidemiologic studies.

I am a Fellow in the Gerontological Society of America (GSA) and American Society for Bone and Mineral Research (ASBMR). I was a past Health Sciences Chair of the GSA (2018-20) and have served on the ASBMR Advocacy & Science Policy Committee. I am the Co-Chair of the Cross Cohort Collaboration (CCC) Steering Committee, which promotes scientific collaboration across approximately 20 NIH funded cohorts. I serve as an Associate Editor and Editorial Board member for the Journal of Gerontology: Medical Sciences.

Contributions to Public Health 

(*senior author publications)

• Diabetes and neuromuscular impairments impact bone: I made major contributions to how diabetes and related metabolic factors affect bone and fracture. My research showing type 2 diabetes associated with 64% higher fracture risk, independent of the generally higher bone mineral density (BMD) and higher weight in older adults with type 2 diabetes, has been cited >400 times. I was the first to find that bone loss was related to poor peripheral nerve function. I have a Multi-PI R01 on novel muscle associations with bone parameters from high resolution peripheral quantitative computed tomography (HR-pQCT).
  • Strotmeyer ES, Cauley JA, Schwartz AV, Nevitt MC, Resnick HE, Bauer DC, Tylavsky FA, de Rekeneire N, Harris TB, Newman AB. Nontraumatic fracture risk with diabetes mellitus and impaired fasting glucose in older white and black adults: the Health, Aging, and Body Composition Study. Arch Intern Med. 2005;25;165(14):1612-7.
  • Strotmeyer ES, Cauley JA, Schwartz AV, de Rekeneire N, Resnick HE, Zmuda JM, Shorr RI, Tylavsky FA, Vinik AI, Harris TB, Newman AB; Health ABC Study. Reduced peripheral nerve function is related to lower hip BMD and calcaneal QUS in older white and black adults: the Health, Aging and Body Composition Study. J Bone Miner Res. 2006;21(11):1803-10.
• Neuromuscular impairments are associated with disability and fall injuries: My R01 in the Health ABC Study utilized state-of-the art measures to capture sensory and motor nerve declines and impairments associated with these to current and future musculoskeletal function and mobility. My R01 renewal linked participant cohort data on peripheral nerve impairments to Medicare claims in order to investigate subsequent risk of treated fall injuries. These projects were novel as these nerve impairments had not been previously viewed as a major risk factor for geriatric outcomes. I found that peripheral nerve impairments are common in older adults and even at a level of subclinical decline are associated with risk for incident mobility disability and fall injuries.
  • Ward RE, Boudreau RM, Caserotti P, Harris TB, Zivkovic S, Goodpaster BH, Satterfield S, Kritchevsky SB, Schwartz AV, Vinik AI, Cauley JA, Simonsick EM, Newman AB, Strotmeyer ES*; Health, Aging and Body Composition Study. Sensory and motor peripheral nerve function and incident disability. J Am Geriatr Soc. 2014;62(12):2273-9. PMCID:PMC4270855.
  • Barbour KE, Sagawa N, Boudreau RM, Winger ME, Cauley JA, Nevitt MC, Fujii, Patel KV, Strotmeyer ES*. Knee osteoarthritis and the risk of medically treated injurious falls among older adults: the Health ABC Study. Arthritis Care Res (Hoboken). 2018 Aug 21. PMID:30133173 | PMCID: PMC6384154
  • Winger ME, Caserotti P, Cauley JA, Boudreau RM, Piva SR, Cawthon PM, Orwoll ES, Ensrud KE, Kado DM, Strotmeyer ES*; Osteoporotic Fractures in Men (MrOS) Research Group. Lower leg power and grip strength are associated with increased fall injury risk in older men: the Osteoporotic Fractures in Men (MrOS) Study. J Gerontol A Biol Sci Med Sci. 2023 Mar 1;78(3):479-485. doi: 10.1093/gerona/glac122. PMID: 35662329; PMCID: PMC9977249.
• Diabetes, related metabolic factors, and complications, predict physical performance: I found that peripheral nerve impairments are associated with muscle function and physical performance. My study described for the first time the longitudinal peripheral nerve decline with aging and identified novel modifiable risk factors such as the metabolic syndrome and renal function.
  • Lange-Maia BS, Newman AB, Cauley JA, Jakicic JM, Boudreau RM, Caserotti P, Glynn NW, Harris TB, Kritchevsky SB, Schwartz AV, Satterfield S, Simonsick EM, Vinik AI, Zivkovic S, Strotmeyer ES*. Sensorimotor peripheral nerve function and the longitudinal relationship with endurance walking in the Health, Aging and Body Composition Study. Arch Phys Med Rehabil. 2016;97(1):45-52. PMCID:PMC4696894.
  • Napoleone JM, Boudreau RM, Lange-Maia BS, El Khoudary SR, Ylitalo KR, Kriska AM, Karvonen-Gutierrez CA, Strotmeyer ES*. Metabolic syndrome trajectories and objective physical performance in mid-to-early late life: The Study of Women’s Health Across the Nation (SWAN). J Gerontol A Biol Sci Med Sci. 2021 Jul 3;glab188. doi: 10.1093/gerona/glab188. PMID: 34216218; PMCID: PMC8824556.
• Methods to establish associations with neuromuscular function in old age: I have developed, refined, and implemented physiologic assessments of neuromuscular function in late life for epidemiologic studies, including gold-standard measures showing test reproducibility in several randomized clinical trials and large epidemiologic studies for peripheral nerve assessment, including motor and sensory nerve conduction, and leg power tests including jump mechanography on a force plate and repeated stair climb laps. Using these more precise techniques for nerve and muscle function, I demonstrated that muscle function is dependent on the integrity of the peripheral nerves and that key neuromuscular tests differentially associate with physical performance in older adults.
  • Lange-Maia BS, Cauley JA, Newman AB, Boudreau RM, Jakicic JM, Glynn NW, Zivkovic S, Dam T, Caserotti P, Cawthon PM, Orwoll ES, Strotmeyer ES*. Sensorimotor peripheral nerve function and physical activity in older men. J Aging Phys Act. 2016;24(4):559-566. PMCID:PMC5333760
  • Strotmeyer ES, Winger ME, Cauley JA, Boudreau RM, Cusick D, Collin RF, Chalhoub D, Buehring B, Orwoll E, Harris TB, Caserotti P. Normative values of muscle power using force plate jump tests in men aged 77-101 years: The Osteoporotic Fractures in Men (MrOS) Study. 2018;22(10):1167-1175. doi: 10.1007/s12603-018-1081-x. PMID: 30498822; PMCID: PMC8963464.
  • Winger ME, Caserotti P, Cauley JA, Boudreau RM, Piva SR, Cawthon PM, Harris TB, Barrett-Connor E, Fink HA, Kado DM, Strotmeyer ES*. Associations between novel jump test measures, grip strength, and physical performance: the Osteoporotic Fractures in Men (MrOS) Study. Aging Clin Exp Res. 2020 Apr;32(4):587-595. doi: 10.1007/s40520-019-01421-1. PMID: 31853832; PMCID: PMC7716274.
• Study design and measurement relevant to assessing functional ability in old age: I have strong expertise with the conduct, management and data analysis in large multi-center studies, with a focus on survival, retention and recruitment rates in the oldest old. I developed and validated unique algorithms to efficiently and reliably identify non-fracture fall injuries (NFFI) and fractures from heath care claims in my R01, which led to a subsequent R01 to examine risk factors and trends for incident fall injuries over 20 years of 4 pooled longitudinal cohorts in 12,000 women and men; and if incident NFFI predicts risk of major geriatric outcomes.
  • Strotmeyer ES, Arnold AM, Boudreau RM, Ives DG, Cushman M, Robbins JA, Harris TB, Newman AB. Long-term retention of older adults in the Cardiovascular Health Study: implications for studies of the oldest old. J Am Geriatr Soc. 2010 Apr;58(4):696-701. PMCID:PMC2903735.
  • Xue L, Boudreau RM, Donohue JM, Zgibor JC, Marcum ZA, Costacou T, Newman AB, Waters TM, Strotmeyer ES*.  Persistent polypharmacy and fall injury risk: the Health, Aging and Body Composition Study. BMC Geriatrics. 2021 Dec 15;21(1):710. doi: 10.1186/s12877-021-02695-9. PMID: 34911467; PMCID: PMC8675466.
  • Xue L, Napoleone JM, Winger ME, Boudreau RM, Cauley JA, Donohue JM, Newman AB, Waters TM, Strotmeyer ES*. Medicare FFS Spending for Fall Injury and Non-Fall Events: The Health ABC Study. Innov Aging. In press, 2024.

Highlights of major research areas and recent publications.

A complete list of published work is included in My Bibliography

ORCID