About

Arun S. Karlamangla is a Professor-in-Residence in the Department of Medicine at UCLA. His educational background includes a B.Tech in Electronics & Electrical Communication Engineering from the Indian Institute of Technology, Kharagpur, an MSEE in Computer Engineering, and a PhD in Electrical Engineering - Systems from the University of Michigan, Ann Arbor. He also holds an MD in Medicine and completed residency and fellowship training in Internal Medicine and Geriatric Medicine at UCLA. His research focuses on the health and functioning of women across midlife and old age, with particular attention to menopause transition, bone health, cardiovascular health, and systemic inflammation. He has been involved in numerous NIH-funded studies, including the Study of Women's Health Across the Nation (SWAN), and has contributed extensively to understanding the biological and psychosocial factors affecting aging, bone density, and metabolic health in women. His work has earned him several awards and honors, including the UCLA David H Solomon Term Chair and fellowships in Geriatric Medicine, as well as recognition for teaching excellence.

Research topics

• Medicine
• Internal medicine
• Demography
• Biology
• Psychiatry
• Gynecology
• Endocrinology
• Gerontology
• Obstetrics
• Clinical psychology
• Physiology
• Psychology

Selected publications

• Anti-Mullerian Hormone and Collagen Type I C-telopeptide Predict Fast, Imminent Bone Loss in Early Perimenopause: SWAN

  The Journal of Clinical Endocrinology & Metabolism · 2025-12-11 · 1 citations

  articleOpen access

  CONTEXT: Faster menopause-related bone mineral density (BMD) decline predicts more fractures. OBJECTIVE: Examine anti-Mullerian hormone (AMH) and collagen type I C-telopeptide (CTX) as predictors of fast, imminent BMD loss (BMD decline rate, over the next 1-2 years, ≥mean, annual menopause rate). DESIGN: Repeated measures modified Poisson regression estimated the associations of early perimenopausal levels of (1) AMH or CTX (in separate models), or (2) AMH and CTX (in a single model) with fast, imminent BMD loss. SETTING: Study of Women's Health Across the Nation (community-based cohort). PARTICIPANTS: A total of 436 early perimenopausal women. MAIN OUTCOME MEASURES: Fast, imminent BMD loss (at lumbar spine [LS], femoral neck [FN], or total hip [TH]). RESULTS: In separate models, adjusted for age, body mass index, cigarette use, race/ethnicity and study site, lesser AMH or greater CTX individually related to greater fast, imminent BMD loss risk. As predictors in a single model, lesser AMH and greater CTX remained independently associated with fast, imminent BMD loss. Per SD decrement in log-transformed AMH, fast BMD decline risk was 45% (LS), 17% (FN), and 26% (TH) greater (each P < .0001). Per SD increment in log-transformed CTX, fast BMD loss risk was 35% (LS), 23% (FN), and 34% (TH) greater (each P < .0001). Model areas under the curve was greater for models with AMH and CTX vs those for models with AMH or CTX individually (P < .001 for each BMD site-specific comparison). CONCLUSION: Combining AMH and CTX affords stronger prediction of fast, imminent BMD loss than using AMH or CTX individually.

  PublisherOA PDFDOI

• Cardiovascular health over the menopause transition and declines in subjective cognitive function later in life: The Study of Women's Health Across the Nation (SWAN)

  Alzheimer s & Dementia · 2025-12-01

  articleOpen access

  BACKGROUND: Over the menopause transition (MT), many women experience accelerated deterioration in their cardiovascular health (CVH), a critical modifiable risk factor for Alzheimer's disease and related dementia (ADRD). Yet, limited research characterized the link between CVH status over the MT and future subjective cognitive function shown to predict and identify ADRD. We evaluated the associations of 1) changes in the Life's Essential 8 (LE8), an established CVH metric, over the MT and 2) LE8 health behavior and health factor sub-scores with future declines in subjective cognitive function measured by Ecog-12 (higher score indicates greater declines in function). METHODS: SWAN participants without a history of stroke who had data on LE8 (assessed over 3 visits correspoding to pre-, peri-, and postmenopause stages) and Ecog-12 (measured 1 to 2 times later in the study) were included. CVH status at each visit was classfied as low (<50), moderate (50-79), or ideal (80) based on the total LE8 score. Changes in CVH over the MT were defined based on pattern of CVH status over time into one of 5 classifications: low remains low (Low), moderate remains moderate (Moderate), ideal remains ideal (Ideal), Improving, or Worsening CVH. Multivariable linear mixed models were used to assess the associations of 1) pattern of CVH status over the MT and 2) premenopausal health behavior and health factor sub-scores (first LE8) and their changes relative to perimenopause (second LE8) and postmenopause (third LE8) with longitudinal Ecog-12 scores. RESULTS: We evaluated 1140 women aged 55.5±2.6, and 65.7±2.7 and 72.2±2.7 years at the third LE8 (analysis baseline), and first and second Ecog-12 measures, respectively. Compared with women with Ideal CVH, women with Low, Worsening, and Moderate CVH status over the MT had 11%, 7%, and 5% greater declines in subjective cognitive function (log transfromed scale), respectively (Figure 1). Better premenopausal health behavior sub-scores and greater improvements in health behaviors from pre- to perimenopause were associated with less later declines in subjective cognition (Figure 2). CONCLUSIONS: Maintaining good CVH over the MT and adopting healthy behaviors in the transition from pre- to perimenopause were associated with less declines in cognitive function later in life.

  PublisherOA PDFDOI

• Associations of trajectories of estradiol and follicle-stimulating hormone over the menopause transition with future cognition: the SWAN study

  Maturitas · 2025-08-01

  article
  PublisherDOI

• Femoral neck width is associated with unique trajectories of age-related hip structural changes and fracture risk within populations of adult women and men

  Journal of Bone and Mineral Research · 2025-06-28 · 4 citations

  articleOpen access

  Osteoporosis management relies heavily on areal BMD (aBMD) to identify women and men with reduced bone strength. We tested the hypothesis that baseline FN external size is associated with different bone-loss and area-gain trajectories that are not reflected in aBMD-decline but have different biomechanical implications. We analyzed data from 4 longitudinal studies with repeated hip DXA scans of women and men over 10-15 yr of follow-up. Changes in FN BMC, area, and aBMD were compared across height-adjusted baseline FN area tertiles using linear models. Fracture risk differences across the tertiles were tested using Cox proportional-hazard models. Women and men with smaller baseline FN area had smaller BMC-declines and greater area-increases over 10-15 yr. In contrast, those with a larger FN area experienced twice the annual BMC-declines but much smaller area-increases. In general, these structural changes were not reflected in aBMD-changes for either sex. The likelihood of fracturing a hip was 2.5 times greater for women and 2.4-4.2 times greater for men in the larger FN area tertile compared to those in the smaller FN area tertile. Unique patterns of age-related structural changes with different biomechanical implications were identified within populations of women and men. These results challenge the general assumption that age-related structural changes are homogenous within a population and question whether aBMD-declines reflect strength-declines consistently among women and men. How these unique patterns of structural change affect the response of women and men to osteoporosis interventions remains to be determined.

  PublisherOA PDFDOI

• The Relation Between Systemic Inflammation and the Menopause Transition: The Study of Women's Health Across the Nation

  The Journal of Clinical Endocrinology & Metabolism · 2025-03-24 · 9 citations

  articleOpen access

  OBJECTIVE: The menopause transition (MT) may substantially contribute to increased systemic inflammation in later life, regardless of aging. We characterized inflammation trajectories over the MT and determined their associations with premenopausal obesity and race/ethnicity. METHODS: Data comprising 15 follow-up visits from Study of Women's Health Across the Nation participants who had a known date of their final menstrual period (FMP) and at least 3 measures of high-sensitivity C-reactive protein (hs-CRP) (n = 1470) or IL-6 (n = 779) were evaluated using group-based trajectory modeling and piecewise linear mixed-effects models. RESULTS: Based on 21 years of follow-up spanning the MT, we identified 3 trajectory groups for each inflammatory biomarker: (1) Low-Rise (hs-CRP = 27.2%; IL-6 = 36.0%); (2) Medium-Stable (hs-CRP = 41.9%) or Medium-Rise (IL-6 = 45.2%); and (3) High-Decline (hs-CRP = 30.9%) or High-Stable (IL-6 = 18.8%). The Low-Rise for both hs-CRP and IL-6 and the Medium-Rise for IL-6 trajectories showed significant increases as early as 1 year before to as late as 3 years after the FMP. The other trajectories showed either no change, or a decline around the FMP. Chinese and/or Japanese women were more likely to follow the Low-Rise hs-CRP and IL-6 trajectories, whereas Black women were more likely to follow the High-Decline hs-CRP and High-Stable IL-6 trajectories. Being overweight or obese was associated with the High-Decline hs-CRP and High-Stable IL-6 trajectories. CONCLUSIONS: Midlife women experience distinct patterns of change in hs-CRP and IL-6 over the MT. Subgroups entering the MT with low-to-medium inflammation levels, particularly for IL-6, showed rises close to the FMP, supporting a contribution of menopause in progression of systemic inflammation.

  PublisherOA PDFDOI

• Self-efficacy change among diverse family caregivers in dementia care

  The Journals of Gerontology Series B · 2025-11-13

  article

  OBJECTIVES: To determine whether changes in caregiver self-efficacy (beliefs about one's ability to manage dementia-related problems and access help) differed by caregiver race and ethnicity across all participants enrolled in a large pragmatic trial of comprehensive dementia care. METHODS: In the Dementia Care Study (D-CARE), community-dwelling older adults with dementia and their unpaid family caregivers were randomized to receive usual care, community-based, or health system-based comprehensive dementia care. Caregiver self-efficacy was assessed at baseline, 6 months, and 18 months using a 4-item scale (range 4-20, higher scores indicate greater self-efficacy). Among all caregivers, we compared least squares means for overall change in self-efficacy from baseline across racial and ethnic groups (Latino, non-Latino Black, and non-Latino White). RESULTS: Among 2,126 dementia caregivers, 205 self-identified as Latino, 247 as non-Latino Black, and 1,674 as non-Latino White. Mean baseline caregiver self-efficacy scores were between 13.1 and 13.6 for all racial and ethnic groups. The least squares mean for self-efficacy change was between +1.53 and +1.66 from the baseline for all racial and ethnic groups. Caregiver self-efficacy change did not differ significantly by caregiver race and ethnicity. DISCUSSION: Black, Latino, and White dementia caregivers reported similar improvements in caregiver self-efficacy after participating in a comprehensive dementia care trial. Personalized aspects of comprehensive dementia care appear to address the needs of diverse caregiver populations. CLINICAL TRIALS REGISTRATION: NCT03786471.

  PublisherDOI

• High-density Lipoprotein Over Midlife and Future Cognition in Women: The SWAN HDL Ancillary Study

  The Journal of Clinical Endocrinology & Metabolism · 2024-10-05 · 6 citations

  articleOpen access

  CONTEXT: Limited data provides evidence-based insights on the association between the comprehensive metrics of high-density lipoproteins (HDL) and cognitive performance, especially in midlife women for whom the benefit might be the greatest. OBJECTIVE: To assess the associations of serum HDL metrics including HDL lipid content [HDL cholesterol, phospholipid (HDL-PL), triglyceride], proteins/subclasses [apolipoprotein A-1 (apoA-1); small, medium, large, total HDL particle (HDL-P); and HDL size], and cholesterol efflux capacity with cognitive performance in midlife women. METHODS: This prospective cohort study was conducted among 503 midlife women (1234 observations) from the Study of Women's Health Across the Nation HDL ancillary study. Joint models were applied to examine associations of HDL metrics assessed at midlife (50.2 ± 2.9 years, baseline of the current study) and their changes over midlife (6.1 ± 3.9 years of duration) with subsequent cognitive performance [working memory (Digit Span Backward Test), processing speed (Symbol Digit Modalities Test), and episodic memory immediate and delayed recall (East Boston Memory Test)] assessed repeatedly (maximum 5 times) 1.5 ± 1 years later over 7.72 ± 4.10 years of follow-up. RESULTS: Higher total HDL-P and smaller HDL size at midlife were associated with a better subsequent immediate recall, delayed recall, and/or processing speed. Greater increase in HDL-PL, apoA-1, medium HDL-P, and total HDL-P and less increase in HDL size over midlife were associated with a better subsequent immediate and/or delayed recall. CONCLUSION: Enhancing specific serum HDL metrics during midlife could be promising in cognitive restoration, particularly memory, the initial and predominant symptom of Alzheimer's disease.

  PublisherOA PDFDOI

• Self-reported history of physical intimate partner violence and longitudinal cognitive performance in midlife women

  Women s Health · 2024-01-01 · 2 citations

  articleOpen access

  BACKGROUND: Intimate partner violence affects about a third of women in their lifetimes and can result in short- and long-term health consequences, including less favorable performance on measures of cognitive function. OBJECTIVES: We assess whether experiencing physical intimate partner violence in midlife was associated with steeper declines in subsequent tests of cognitive performance. DESIGN: This study used data from 1713 women in the longitudinal cohort Study of Women's Health Across the Nation to relate baseline information on physical intimate partner violence to declines in scores from the Symbol Digit Modalities Test, the East Boston Memory Test and the Digit Span Backwards spanning follow-up visits 7 through 15. METHODS: Separate linear mixed models were constructed for each cognitive test outcome. Analyses were adjusted for race-ethnicity, education, financial strain, depressive symptoms, trouble sleeping, and bodily pain. RESULTS: At Study of Women's Health Across the Nation baseline, 3.1% of participants reported experiencing physical intimate partner violence in the prior year. In adjusted models, women who reported violence evidenced a statistically significant greater annualized decline (-0.17 points, 95% CI: -0.28, -0.06) in working memory (Digit Span Backwards test), compared to women who had not reported prior-year violence at baseline. CONCLUSION: Midlife women with a history of physical intimate partner violence exhibited a persistent decrease in the trajectory of working memory. These longitudinal findings extend previous cross-sectional reports which found that physical intimate partner violence had detrimental effects on working memory. These findings provide additional evidence that intimate partner violence is associated with decreases in working memory performance. They underscore the importance of further research into intimate partner violence and cognition during middle age, a particularly understudied life stage.

  PublisherDOI

• IS UNDETECTABLE ANTIMULLERIAN HORMONE (AMH) REVERSIBLE? AN ANALYSIS OF REBOUND IN AMH AND ESTRADIOL (E2) IN THE STUDY OF WOMEN’S HEALTH ACROSS THE NATION (SWAN)

  Fertility and Sterility · 2024-10-01

  article
  PublisherDOI

• Explaining Adverse Cholesterol Levels and Distinct Gender Patterns in an Indonesian Population Compared with the U.S.

  National Bureau of Economic Research · 2024-05-01

  reportOpen access

  In order to shed light on the biological and social drivers underlying the dramatic rise in cardiovascular disease risk in lower-income settings, links between these risks and body composition, behavioral and socioeconomic factors in Aceh, Indonesia, are contrasted with the United States.We focus on rigorously-validated measures of HDL and non-HDL cholesterol among adults.Indonesians present with adverse cholesterol biomarkers relative to Americans, despite being younger and having lower body mass index.Adjusting for age, these gaps increase in magnitude.Body composition, behaviors, demographic and socioeconomic characteristics that affect cholesterol do not explain between-country HDL differences, but do explain non-HDL differences, after accounting for medication use.On average, gender differences are inconsistent across the two countries and persist after controlling observed characteristics.Leveraging the richness of the Indonesian data to draw comparisons between males and females within the same household, the gender gaps among Indonesians are not explained for HDL cholesterol, but attenuated substantially for non-HDL cholesterol.This finding suggests that unmeasured household resources play an important role in determining non-HDL cholesterol.More generally, they appear to be affected by social and biological forces in complex ways that differ across countries and potentially operate differently for HDL and non-HDL biomarkers.

  PublisherOA PDFDOI

Recent grants

• NIH Grant R01AG033067

  NIH · $1.4M · 2014

• NIH Grant R21DA038163

  NIH · $608k · 2017

• Core 3: Data Collection & Data Management Core

  NIH · $40.3M · 2020–2026

• NIH Grant M01RR000865

  NIH · $41.8M · 2011

• NIH Grant R01AG026105

  NIH · $721k · 2011

Frequent coauthors

• Gail A. Greendale

  University of California, Los Angeles

  176 shared

• Teresa E. Seeman

  University of California, Los Angeles

  136 shared

• Joel S. Finkelstein

  81 shared

• Sherri‐Ann M. Burnett‐Bowie

  Massachusetts General Hospital

  77 shared

• Sioḃán D. Harlow

  University of Michigan–Ann Arbor

  72 shared

• Anthony Morrison

  68 shared

• Patrick M. Sluss

  67 shared

• Karin Darakananda

  University of California, San Francisco

  67 shared

Education

• M.D.

  University of California, Los Angeles

• Other

  University of California, Los Angeles

• B.A.

  University of California, Los Angeles

Awards & honors

• David H Solomon Term Chair (2024)
• Fellow American College of Physicians (2023)
• UCLA Geriatric Medicine Fellowship Director's Award (2022)
• UCLA Multicampus Program in Geriatric Medicine and Gerontolo…
• UCLA Geriatrics Fellowship Class Teaching Award (2007)