About

Kristine Ensrud, MD, MPH, is a Professor of Epidemiology & Community Health and Medicine at the University of Minnesota. She is a general internist, clinical epidemiologist, and internationally recognized expert in aging with 30 years of experience in the design, conduct, and analysis of prospective cohort studies and randomized trials sponsored by the NIH in older adults. Her research focuses on identifying risk factors for fractures, falls, disability, and mortality in older adults. Ensrud has published over 580 peer-reviewed manuscripts and has mentored more than 35 trainees and junior investigators, receiving the Outstanding Faculty Mentor Award from the University of Minnesota Medical School in 2014. Her expertise includes osteoporosis, fracture prevention, menopause, sleep disorders, and geriatric syndromes. She is also an Affiliate Investigator for the VA Health Services Research Center on Innovation at the Minneapolis VA Health Care System.

Research topics

• Medicine
• Internal medicine
• Gerontology
• Demography
• Physical therapy
• Intensive care medicine
• Psychiatry

Selected publications

• Recommendations for outcome measurement for deprescribing intervention studies

  Journal of the American Geriatrics Society · 2022 · 61 citations

  • Medicine
  • Gerontology
  • Intensive care medicine

  Interpreting results from deprescribing interventions to generate actionable evidence is challenging owing to inconsistent and heterogeneous outcome definitions between studies. We sought to characterize deprescribing intervention outcomes and recommend approaches to measure outcomes for future studies. A scoping literature review focused on deprescribing interventions for polypharmacy and informed a series of expert panel discussions and recommendations. Twelve experts in deprescribing research, policy, and clinical practice interventions participating in the Measures Workgroup of the US Deprescribing Research Network sought to characterize deprescribing outcomes and recommend approaches to measure outcomes for future studies. The scoping review identified 125 papers reflecting 107 deprescribing studies. Common outcomes included medication discontinuation, medication appropriateness, and a broad range of clinical outcomes potentially resulting from medication reduction. Panel recommendations included clearly defining clinically meaningful medication outcomes (e.g., number of chronic medications, dose reductions), ensuring adequate sample size and follow-up time to capture clinical outcomes resulting from medication discontinuation (e.g., quality of life [QOL]), and selecting appropriate and feasible data sources. A new conceptual model illustrates how downstream clinical outcomes (e.g., reduction in falls) should be interpreted in the context of initial changes in medication measures (e.g., reduction in mean total medications). Areas needing further development include implementation outcomes specific to deprescribing interventions and measures of adverse drug withdrawal events. Generating evidence to guide deprescribing is essential to address patient, caregiver, and clinician concerns about the benefits and harms of medication discontinuation. This article provides recommendations and an initial conceptual framework for selecting and applying appropriate intervention outcomes to support deprescribing research.

  PublisherOA PDFDOI

• Muscle Mass Assessed by the D3-Creatine Dilution Method and Incident Self-reported Disability and Mortality in a Prospective Observational Study of Community-Dwelling Older Men

  The Journals of Gerontology Series A · 2020 · 105 citations

  • Medicine
  • Internal medicine
  • Physical therapy

  BACKGROUND: Whether low muscle mass is a risk factor for disability and mortality is unclear. Associations between approximations of muscle mass (including lean mass from dual-energy x-ray absorptiometry [DXA]), and these outcomes are inconsistent. METHODS: Muscle mass measured by deuterated creatine (D3Cr) dilution and appendicular lean mass (ALM, by DXA) were assessed at the Year 14 Visit (2014-2016) of the prospective Osteoporotic Fractures in Men study (N = 1,425, age 77-101 years). Disability in activities of daily living (ADLs), instrumental ADLs, and mobility tasks was self-reported at the Year 14 visit and 2.2 years later; deaths were centrally adjudicated over 3.3 years. Relative risks and 95% confidence intervals (CI) were estimated per standard deviation decrement with negative binomial, logistic regression, or proportional hazards models. RESULTS: In age- and clinical center-adjusted models, the relative risks per decrement in D3Cr muscle mass/wgt was 1.9 (95% CI: 1.2, 3.1) for incident self-reported ADL disability; 1.5 (95% CI: 1.3, 1.9) for instrumental ADL disability; and 1.8 (95% CI: 1.5, 2.2) for mobility disability. In age-, clinical center-, and weight-adjusted models, the relative risks per decrement in D3Cr muscle mass was 1.8 (95% CI: 1.5, 2.2) for all-cause mortality. In contrast, lower DXA ALM was not associated with any outcome. Associations of D3Cr muscle mass with these outcomes were slightly attenuated after adjustment for confounding factors and the potentially mediating effects of strength and physical performance. CONCLUSIONS: Low muscle mass as measured by D3Cr dilution is a novel risk factor for clinically meaningful outcomes in older men.

  DOI

• Putative Cut‐Points in Sarcopenia Components and Incident Adverse Health Outcomes: An <scp>SDOC</scp> Analysis

  Journal of the American Geriatrics Society · 2020 · 218 citations

  • Medicine
  • Gerontology
  • Internal medicine

  OBJECTIVES: ); and slowness (walking speed <.8 m/s) with subsequent adverse outcomes (falls, hip fractures, mobility limitation, and mortality). DESIGN: Individual-level, sex-stratified pooled analysis. We calculated odds ratios (ORs) or hazard ratios (HRs) for incident falls, mobility limitation, hip fractures, and mortality. Follow-up time ranged from 1 year for falls to 8.8 ± 2.3 years for mortality. SETTING: Eight prospective observational cohort studies. PARTICIPANTS: A total of 13,421 community-dwelling men and 4,828 community-dwelling women. MEASUREMENTS Grip strength by hand dynamometry, gait speed, and lean mass by DXA. RESULTS: Low grip strength (absolute or standardized to body size/composition) was associated with incident outcomes, usually independently of slowness, in both men and women. ORs and HRs generally ranged from 1.2 to 3.0 for those below vs above the cut-point. DXA lean mass was not consistently associated with these outcomes. When considered together, those who had both muscle weakness by absolute grip strength (<35.5 kg in men and <20 kg in women) and slowness were consistently more likely to have a fall, hip fracture, mobility limitation, or die than those without either slowness or muscle weakness. CONCLUSION: Older men and women with both muscle weakness and slowness have a higher likelihood of adverse health outcomes. These results support the inclusion of grip strength and walking speed as components in a summary definition of sarcopenia. J Am Geriatr Soc 68:1429-1437, 2020.

  DOI

Recent grants

• NIH Grant R01AG005394

  NIH · $12.0M · 2018

• NIH Grant U01AR045614

  NIH · $4.6M · 2013

• NIH Grant R01AG00539422A1

  NIH · $496k · 2009

• NIH Grant U01AG042145

  NIH · $5.3M · 2020

• NIH Grant R01HL070847

  NIH · $1.3M · 2009

Frequent coauthors

• Jane A. Cauley

  University of Pittsburgh

  943 shared

• Steven R. Cummings

  University of California, San Francisco

  693 shared

• Brent C Taylor

  Minneapolis VA Health Care System

  497 shared

• Peggy M. Cawthon

  University of California, San Francisco

  479 shared

• John T. Schousboe

  HealthPartners

  435 shared

• Katie L. Stone

  California Pacific Medical Center

  396 shared

• Eric Orwoll

  390 shared

• Dennis M. Black

  University of California, San Francisco

  366 shared

Education

• M.D.

  University of Minnesota

• Other

  University of Minnesota

Awards & honors

• 2020 Academy for Excellence in Health Research, University o…
• 2018 Master, American College of Physicians
• 2017 Association of American Physicians
• 2014 Wall of Scholarship, Medical School, University of Minn…
• 2014 Carol J. Bland Outstanding Faculty Mentor Award, UMN Me…

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