Contact

Location: Barshop Institute 1000.5

Department

Medicine, Division of Geriatrics, Gerontology & Palliative Medicine

Sara E. Espinoza, MD, MSc

Professor and Associate Chief for Research
Dr. F. Carter Pannill, Jr. Professor of Internal Medicine
Director, San Antonio GRECC, South Texas Veterans Health Care System
Director, San Antonio Claude D. Pepper Older Americans Independence Center

Personal Statement:

I am an Internist/Geriatrician with the Department of Medicine, Division of Geriatrics, and the Sam and Ann Barshop Institute for Longevity and Aging Studies. My research focuses on understanding the geriatric syndrome of frailty through epidemiologic and clinical translational research. I provide clinical care at Audie L. Murphy VA Hospital, where I serve as the Director of the Geriatric Research, Education and Clinical Center (GRECC). In this role, I collaborate with other providers and interdisciplinary team members to design and implement new models of care to improve care for the aging veteran. I am actively engaged in research mentoring and clinical teaching to trainees.

Education

YearDegreeDisciplineInstitution
1995BSPsychology (With Distinction)George Mason University
Fairfax , VA
2000MDMedicineUniversity of Virginia School of Medicine
Charlottesville , VA
2001InternshipInternal MedicineStrong Memorial Hospital-University of Rochester Medical Center
Rochester , NY
2003ResidencyInternal MedicineStrong Memorial Hospital-University of Rochester Medical Center
Rochester , NY
2006Clinical FellowshipGeriatric Medicine and GerontologyThe Johns Hopkins School of Medicine
Baltimore , MD
2010MSClinical InvestigationThe University of Texas Health Science Center at San Antonio
San Antonio , TX

Research

Dr. Sara E. Espinoza’s primary research focuses on the understanding of frailty, a common geriatric syndrome that places older adults to be at high risk for decline. She has conducted epidemiologic and clinical translational research in frailty. Her epidemiologic work was the first to directly compare the prevalence and incidence rates among Mexican Americans and European Americans using 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 has investigated the underlying biological mechanism of frailty. Her work has identified novel inflammatory biomarkers for frailty using proteomics techniques collaborating with basic scientists within the Barshop Institute. This work has led to her current research which focuses on metformin as a potential therapeutic agent for the prevention of frailty in older adults with pre-diabetes. Dr. Espinoza is Co-Leader of the Clinical Core of the San Antonio Older Americans Independence Center. In this role she facilitates the initiation and conduct of all clinical studies supported by the San Antonio Pepper Center. As Associate Director of Clinical Programs for the Geriatric Research, Education, and Clinical Center (GRECC), she provides clinical care at the South Texas Veterans Health Care System 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.

Publications

1.Jiwani, R., Wang, C. P., Orsak, B., MacCarthy, D., Kellogg, D., Powers, B., Wang, J., Padala, P., Padala, K., & Espinoza, S. (2021). A geriatrics walking clinic improves hemoglobin A1c and timed gait in older veterans with type 2 diabetes. Geriatric Nursing, 42(2), 566-569. https://doi.org/10.1016/j.gerinurse.2020.10.001
2.Jiwani, R., Dennis, B., Bess, C., Monk, S., Meyer, K., Wang, J., & Espinoza, S. (2021). Assessing acceptability and patient experience of a behavioral lifestyle intervention using fitbit technology in older adults to manage type 2 diabetes amid COVID-19 pandemic: A focus group study: Focus group analysis of lifestyle intervention. Geriatric Nursing, 42(1), 57-64. https://doi.org/10.1016/j.gerinurse.2020.11.007
3.Wilfred, S. A., Becker, C. B., Kanzler, K. E., Musi, N., Espinoza, S. E., & Kilpela, L. S. (2021). Binge eating among older women: prevalence rates and health correlates across three independent samples. Journal of Eating Disorders, 9(1), [132]. https://doi.org/10.1186/s40337-021-00484-8
4.ASPREE Investigator Group (2021). Effect of aspirin on activities of daily living disability in community-dwelling older adults. Journals of Gerontology - Series A Biological Sciences and Medical Sciences, 76(11), 2007-2014. https://doi.org/10.1093/gerona/glaa316
5.Espinoza, S. E., Lee, J. L., Wang, C. P., Ganapathy, V., MacCarthy, D., Pascucci, C., Musi, N., & Volpi, E. (2021). Intranasal Oxytocin Improves Lean Muscle Mass and Lowers LDL Cholesterol in Older Adults with Sarcopenic Obesity: A Pilot Randomized Controlled Trial. Journal of the American Medical Directors Association, 22(9), 1877-1882.e2. https://doi.org/10.1016/j.jamda.2021.04.015
6.Ekram, A. R. M. S., Woods, R. L., Britt, C., Espinoza, S., Ernst, M. E., & Ryan, J. (2021). The Association between Frailty and All-Cause Mortality in Community-Dwelling Older Individuals: An Umbrella Review. The Journal of frailty & aging, 10(4), 320-326. https://doi.org/10.14283/jfa.2021.20
7.Sachs, B. C., Rapp, S. R., Kistler, C. E., Musi, N., Supiano, M. A., Pajewski, N. M., Callahan, K. E., Alexander, K. P., Shah, R. C., Snyder, H. M., Carrillo, M. C., Espinoza, S., & Williamson, J. D. (2021). The PRagmatic EValuation of evENTs And Benefits of Lipid-lowering in oldEr adults (PREVENTABLE) trial: Study design and procedures for cognitive assessment and adjudication. Alzheimer's and Dementia, 17(S9), [e054022]. https://doi.org/10.1002/alz.054022
8.Jiwani, R., Wang, J., Berndt, A., Ramaswamy, P., Joseph, N. M., Du, Y., Ko, J., & Espinoza, S. (2020). Changes in patient-reported outcome measures with a technology-supported behavioral lifestyle intervention among patients with type 2 diabetes: Pilot randomized controlled clinical trial. JMIR Diabetes, 5(3), [19268]. https://doi.org/10.2196/19268
9.Noël, P. H., Wang, C. P., Finley Garcia, E., Espinoza, S. E., Parchman, M. L., Bollinger, M. J., & Hazuda, H. P. (2020). Provider-Related Linkages Between Primary Care Clinics and Community-Based Senior Centers Associated With Diabetes-Related Outcomes. Journal of Applied Gerontology, 39(6), 635-643. https://doi.org/10.1177/0733464818782853
10.Espinoza, S. E., Musi, N., Wang, C. PIN., Michalek, J., Orsak, B., Romo, T., Powers, B., Conde, A., Moris, M., Bair-Kelps, D., Li, Y., Ganapathy, V., Jergensen, T. E., Kelly, L. C., & Jiwani, R. (2020). Rationale and study design of a randomized clinical trial of metformin to prevent frailty in older adults with prediabetes. Journals of Gerontology - Series A Biological Sciences and Medical Sciences, 75(1), 102-109. https://doi.org/10.1093/gerona/glz078
11.Espinoza, S. E., Orsak, B., Wang, C. P., MacCarthy, D., Kellogg, D., Powers, B., Conde, A., Moris, M., Padala, P. R., & Padala, K. P. (2019). An Individualized Low-Intensity Walking Clinic Leads to Improvement in Frailty Characteristics in Older Veterans. The Journal of frailty & aging, 8(4), 205-209. https://doi.org/10.14283/jfa.2019.16
12.Ipson, B. R., Fletcher, M. B., Espinoza, S. E., & Fisher, A. L. (2018). Identifying Exosome-Derived MicroRNAs as Candidate Biomarkers of Frailty. The Journal of frailty & aging, 7(2), 100-103. https://doi.org/10.14283/jfa.2017.4
13.Deepa, S. S., Bhaskaran, S., Espinoza, S., Brooks, S. V., McArdle, A., Jackson, M. J., Van Remmen, H., & Richardson, A. (2017). A new mouse model of frailty: the Cu/Zn superoxide dismutase knockout mouse. GeroScience, 39(2), 187-198. https://doi.org/10.1007/s11357-017-9975-9
14.Wang, C. P., Lorenzo, C., Habib, S. L., Jo, B., & Espinoza, S. E. (2017). Differential effects of metformin on age related comorbidities in older men with type 2 diabetes. Journal of Diabetes and Its Complications, 31(4), 679-686. https://doi.org/10.1016/j.jdiacomp.2017.01.013
15.Espinoza, S. E., Wang, C. P., Tripathy, D., Clement, S. C., Schwenke, D. C., Banerji, M. A., Bray, G. A., Buchanan, T. A., Henry, R. R., Kitabchi, A. E., Mudaliar, S., Stentz, F. B., Reaven, P. D., DeFronzo, R. A., & Musi, N. (2016). Pioglitazone is equally effective for diabetes prevention in older versus younger adults with impaired glucose tolerance. AGE, 38(5-6), 485-493. https://doi.org/10.1007/s11357-016-9946-6
16.Noël, P. H., Parchman, M. L., Finley, E. P., Wang, C. P., Bollinger, M., Espinoza, S. E., & Hazuda, H. P. (2016). Primary care-public health linkages: Older primary care patients with prediabetes & type 2 diabetes encouraged to attend community-based senior centers. Preventive Medicine Reports, 4, 283-288. https://doi.org/10.1016/j.pmedr.2016.06.023
17.Espinoza, S. E., & Hazuda, H. P. (2015). Frailty prevalence and neighborhood residence in older Mexican Americans: The San Antonio longitudinal study of aging. Journal of the American Geriatrics Society, 63(1), 106-111. https://doi.org/10.1111/jgs.13202
18.Pugh, J. A., Wang, C. P., Espinoza, S. E., Noël, P. H., Bollinger, M., Amuan, M., Finley, E., & Pugh, M. J. (2014). Influence of frailty-related diagnoses, high-risk prescribing in elderly adults, and primary care use on readmissions in fewer than 30 days for veterans aged 65 and older. Journal of the American Geriatrics Society, 62(2), 291-298. https://doi.org/10.1111/jgs.12656
19.Darvin, K., Randolph, A., Ovalles, S., Halade, D., Breeding, L., Richardson, A., & Espinoza, S. E. (2014). Plasma protein biomarkers of the geriatric syndrome of frailty. Journals of Gerontology - Series A Biological Sciences and Medical Sciences, 69 A(2), 182-186. https://doi.org/10.1093/gerona/glt183
20.Liang, H., Tantiwong, P., Sriwijitkamol, A., Shanmugasundaram, K., Mohan, S., Espinoza, S., Defronzo, R. A., Dubé, J. J., & Musi, N. (2013). Effect of a sustained reduction in plasma free fatty acid concentration on insulin signalling and inflammation in skeletal muscle from human subjects. Journal of Physiology, 591(11), 2897-2909. https://doi.org/10.1113/jphysiol.2012.247510
21.Garcia, C. H., Espinoza, S. E., Lichtenstein, M., & Hazuda, H. P. (2013). Health literacy associations between hispanic elderly patients and their caregivers. Journal of Health Communication, 18(SUPPL. 1), 256-272. https://doi.org/10.1080/10810730.2013.829135
22.Espinoza, S. E., Jung, I., & Hazuda, H. (2013). The hispanic paradox and predictors of mortality in an aging biethnic cohort of Mexican Americans and European Americans: The san antonio longitudinal study of aging. Journal of the American Geriatrics Society, 61(9), 1522-1529. https://doi.org/10.1111/jgs.12421
23.Espinoza, S. E., Jung, I., & Hazuda, H. (2012). Frailty transitions in the San Antonio longitudinal study of aging. Journal of the American Geriatrics Society, 60(4), 652-660. https://doi.org/10.1111/j.1532-5415.2011.03882.x
24.Shamsi, K. S., Pierce, A., Ashton, A. S., Halade, D. G., Richardson, A., & Espinoza, S. E. (2012). Proteomic screening of glycoproteins in human plasma for frailty biomarkers. Journals of Gerontology - Series A Biological Sciences and Medical Sciences, 67 A(8), 853-864. https://doi.org/10.1093/gerona/glr224
25.Villarreal, D., Restrepo, M., Healy, J., Howard, B., Tidwell, J., Ross, J., Hartronft, S., Jawad, M., Sanchez-Reilly, S., Reed, K., & Espinoza, S. E. (2011). A model for increasing palliative care in the intensive care unit: Enhancing interprofessional consultation rates and communication. Journal of Pain and Symptom Management, 42(5), 676-679. https://doi.org/10.1016/j.jpainsymman.2011.07.004
26.Patel, N. K., Akkihebbalu, S., Espinoza, S. E., & Chiodo, L. K. (2011). Perceptions of a community-based yoga intervention for older adults. Activities, Adaptation and Aging, 35(2), 151-163. https://doi.org/10.1080/01924788.2011.574256
27.Espinoza, S. E., Jung, I., & Hazuda, H. (2010). Lower frailty incidence in older Mexican Americans than in Older European Americans: The San Antonio longitudinal study of aging. Journal of the American Geriatrics Society, 58(11), 2142-2148. https://doi.org/10.1111/j.1532-5415.2010.03153.x
28.Espinoza, S. E., & Hazuda, H. P. (2008). Frailty in older Mexican-American and European-American adults: Is there an ethnic disparity? Journal of the American Geriatrics Society, 56(9), 1744-1749. https://doi.org/10.1111/j.1532-5415.2008.01845.x
29.Espinoza, S. E., Guo, H., Fedarko, N., DeZern, A., Fried, L. P., Xue, Q. L., Leng, S., Beamer, B., & Walston, J. D. (2008). Glutathione peroxidase enzyme activity in aging. Journals of Gerontology - Series A Biological Sciences and Medical Sciences, 63(5), 505-509. https://doi.org/10.1093/gerona/63.5.505
30.Walston, J., Fedarko, N., Yang, H., Leng, S., Beamer, B., Espinoza, S., Lipton, A., Zheng, H., & Becker, K. (2008). The physical and biological characterization of a frail mouse model. Journals of Gerontology - Series A Biological Sciences and Medical Sciences, 63(4), 391-398. https://doi.org/10.1093/gerona/63.4.391
31.Espinoza, S., & Walston, J. D. (2005). Frailty in older adults: Insights and interventions. Cleveland Clinic journal of medicine, 72(12), 1105-1112. https://doi.org/10.3949/ccjm.72.12.1105
https://scholars.uthscsa.edu/en/persons/sara-e-espinoza