Brian Buta

Brian Buta
Johns Hopkins University | JHU · Division of Geriatric Medicine and Gerontology

MHS

About

43
Publications
2,425
Reads
How we measure 'reads'
A 'read' is counted each time someone views a publication summary (such as the title, abstract, and list of authors), clicks on a figure, or views or downloads the full-text. Learn more
1,415
Citations
Introduction
I work at the Center on Aging and Health in the Division of Geriatric Medicine and Gerontology, Johns Hopkins University School of Medicine. My research interests include the etiology and assessment of frailty, intervention and translational studies among older adults, and health promotion and dissemination.

Publications

Publications (43)
Article
Losartan is an oral antihypertensive agent that is rapidly metabolized to EXP3174 (angiotensin-subtype-1-receptor-blocker) and EXP3179 (peroxisome-proliferator-activated-receptor-gamma [PPARγ] agonist), which was shown in animal studies to reduce inflammation, enhance mitochondrial energetics, and improve muscle repair and physical performance. We...
Article
Introduction : Heart failure with preserved ejection fraction (HFpEF) constitutes half of all heart failure (HF). Adverse outcomes in HFpEF individuals are primarily non-cardiac and there are no mortality modifying therapies available. Frailty represents a state of multiorgan system functional and reserve reduction predisposing to adverse outcomes...
Article
With the aging of the world’s population, a large proportion of patients seen in cardiovascular practice are older adults, but many patients also exhibit signs of physical frailty. Cardiovascular disease and frailty are interdependent and have the same physiological underpinning that predisposes to the progression of both disease processes. Frailty...
Article
Objectives: Our primary objective was to examine the distribution of 3-m usual walk, five repeated chair stands, and three static balance stance performances among age and gender subgroups of adults at least 65 years in two national data sets. We secondarily determined whether demographic-function associations varied across data sets, birth cohort...
Article
Background Total knee replacement (TKR) is a common procedure in older adults. Physical resilience may be a useful construct to explain variable outcomes. We sought to define a simple measure of physical resilience and identify risk factors for non-resilient patient outcomes. Methods Secondary analysis of FORCE-TJR cohort study, a prospective regi...
Article
Background: Physical frailty is defined as a syndrome of decreased physiologic reserve conferring vulnerability to functional decline, mortality, and other adverse outcomes upon experiencing stressors. Self-efficacy, which is confidence in one's ability to perform well in a domain of life, is modifiable. Self-efficacy is associated with improved h...
Article
Full-text available
Background Frailty syndrome disproportionately affects older people, including 15% of non-nursing home population, and is known to be a strong predictor of poor health outcomes. There is a growing interest in incorporating frailty assessment into research and clinical practice, which may provide an opportunity to improve in home frailty assessment...
Article
Full-text available
Resilience is defined as the ability of a physiologic system to recover from a stressor that has pushed the system into a state far from its original state of equilibrium. The level of resilience can be understood by whether or not the system’s essential identity and function are retained following the stressor. The study of resilience in older adu...
Article
Full-text available
Accurate prediction of healthcare utilization is an important issue for Medicare managed care organizations. We hypothesized that physical frailty and cognitive impairment increase the risk of healthcare utilization in older adults receiving Medicare coverage, independent of age and multimorbidity. We used the marginal means/rates model to investig...
Article
Full-text available
This talk presents the conceptual framework, study design, and pilot data for the Study of Physical Resilience and agING (SPRING). SPRING aims to develop signatures of physical resilience in older adults who will undergo clinical stressors; validate the signatures’ ability to distinguish those who will respond resiliently; and characterize underlyi...
Article
Full-text available
Total knee replacement (TKR) is a common procedure in older adults with broad variability in outcomes. We sought to identify factors that contribute to resilient outcomes in 7,239 older adults (age 60 or older) who underwent TKR in the TJR-FORCE, a prospective registry of total joint replacement. Outcomes utilized were bodily pain and physical comp...
Article
Full-text available
Physical frailty is defined as a syndrome of decreased physiologic reserve conferring vulnerability to functional decline, mortality and other adverse outcomes in response to a stressor. One potential modifiable risk factor of frailty is self-efficacy, which is confidence in one’s ability to perform well at a task or domain in life. Self-efficacy i...
Article
Full-text available
The Resiliency in Dialysis Initiation (ReDI) Study aims to develop physical resilience signatures in older adults initiating hemodialysis. Study design—comprising a pilot, confirmatory study, and secondary data analyses—will be presented. So also will a method for characterizing resilience phenotypes—using mixed-model analysis of SF-36 subscale tra...
Preprint
Full-text available
Background Frailty syndrome disproportionately affects older people, including 15% of non-nursing home population, and is known to be a strong predictor of poor health outcomes. There is a growing interest in incorporating frailty assessment into research and clinical practice, which may provide an opportunity to improve in home frailty assessment...
Preprint
Full-text available
Background Frailty syndrome disproportionately affects older people, including 15% of non-nursing home population, and is known to be a strong predictor of poor health outcomes. There is a growing interest in incorporating frailty assessment into research and clinical practice, which may provide an opportunity to improve in home frailty assessment...
Article
Background Racial/ethnic frailty prevalence disparities have been documented. Better elucidating how these operate may inform interventions to eliminate them. We aimed to determine whether physical frailty phenotype (PFP) prevalence disparities (1) are explained by health aspects, (2) vary by income, or (3) differ in degree across individual PFP cr...
Article
Full-text available
The fact that frailty and cognitive impairment are associated and often coexist in older adults has led to the popular view of expanding the definition of frailty to include cognitive impairment. However, there is great variability in approaches to and assumptions regarding the integrated phenotypes of physical frailty and cognitive impairment. By...
Article
Full-text available
Frailty is an important concept in the care of older adults, and there is great interest in incorporating user-friendly frailty assessments into research and clinical settings. In-home, sensor-based technologies may provide a more dynamic, sensitive, and accurate assessment of frailty measures. To investigate user perspectives for use of sensor-bas...
Article
Introduction “Frailty” has attracted attention for its promise of identifying vulnerable older adults, hence its potential use to better tailor geriatric health care. There remains substantial controversy, however, regarding its nature and ascertainment. Recent years have seen a proliferation of frailty assessment methods. We argue that the develop...
Article
Full-text available
Purpose of Review This review elucidates the concept of frailty in relationship to reserve and resilience, the relationships and shared pathophysiology between physical frailty and cognitive impairment, the theoretical underpinnings of three integrated phenotypes of physical and cognitive impairments, and the potential of incorporating biomarkers i...
Article
Frailty has long been an important concept in the practice of geriatric medicine and in gerontological research, but integration and implementation of frailty concepts into clinical practice in the United States has been slow. The National Institute on Aging (NIA) Intramural Research Program and the Johns Hopkins Older Americans Independence Center...
Article
Disparities in frailty and resiliency by race and ethnicity may put under-represented older adults at elevated risk for adverse outcomes due to having decreased capacity to resist or recover from health stressors without benefits others may have for compensating capacity losses. Presenters in this session share work from three investigations which...
Article
Introduction: Frailty affects 15% of non-institutionalized older adults in the United States, yet confusion remains in defining and, in turn, assessing frailty. Figurative language, such as metaphor, can help to explain difficult scientific concepts and to form new theories. We aimed to examine the use of figurative language to describe frailty and...
Article
Full-text available
Background: The Fried frailty phenotype, a measure of physiologic reserve defined by 5 components (exhaustion, unintentional weight loss, low physical activity, slow walking speed, and poor grip strength), is associated with poor outcomes among ESRD patients. However, these 5 components may not fully capture physiologic reserve in this population....
Article
Frailty is recognized as a cornerstone of geriatric medicine. It increases the risk of geriatric syndromes and adverse health outcomes in older and vulnerable populations. Although multiple screening instruments have been developed and validated to improve feasibility in clinical practice, frequent lack of agreement between frailty instruments has...
Article
Full-text available
Purpose of Review The purpose of this review is to provide an overview of recent data on the relationship of testosterone with physical function. Recent Findings The safety of testosterone treatment in older men who do not have hypogonadism has increasingly been questioned. In recent years, multiple studies have been performed to better understand...
Article
Full-text available
Purpose of review: To review and summarize the current data for comparative effectiveness of glycemic control in older adults. Recent findings: In the last several years, professional societies have released guidelines for glycemic control in older adults, generally recommending individualized HbA1c goals. However, recent observational studies d...
Article
Full-text available
Frailty is conceptualized as an increased vulnerability of older adults to develop adverse health outcomes when encountering a stressor. However, operationalization has proven challenging, with numerous frailty instruments that include a wide range of age-related domains, such as physical capacity, disease, and disability. Inclusion of diseases and...
Article
Although the field of frailty research has expanded rapidly, it is still a nascent concept within the clinical specialties. Frailty, conceptualized as greater vulnerability to stressors because of significant depletion of physiological reserves, predicts poorer outcomes in several medical specialties, including cardiology, human immunodeficiency vi...
Article
Full-text available
OBJECTIVES: Evidence suggests vitamin D deficiency is associated with developing frailty. However, cardiometabolic factors are related to both conditions and may confound and/or mediate the vitamin D–frailty association. We aimed to determine the association of vitamin D concentration with incidence of frailty, and the role of cardiometabolic disea...
Article
Background: Frailty increases early hospital readmission and mortality risk among kidney transplant (KT) recipients. While frailty represents a high-risk state for this population, the correlates of frailty, the patterns of the 5 frailty components, and the risk associated with these patterns are unclear. Methods: 663 KT recipients were enrolled...
Poster
Frailty is conceptualized as a state of vulnerability that is driven by physiologic declines across multiple systems from impaired homeostasis and reduced capacity to withstand stress. The syndrome of frailty is widely recognized, yet debate remains over how best to measure it in clinical and research settings. In clinical specialties, frailty may...
Article
Full-text available
The medical syndrome of frailty is widely recognized, yet debate remains over how best to measure it in clinical and research settings. This study reviewed the frailty-related research literature by a) comprehensively cataloging the wide array of instruments that have been utilized to measure frailty, and b) systematically categorizing the differen...
Article
Frailty assessment provides a means of identifying older adults most vulnerable to adverse outcomes. Attention to frailty in clinical practice is more likely with better understanding of its prevalence and associations with patient characteristics. We sought to provide national estimates of frailty in older people. A popular, validated frailty phen...
Presentation
Full-text available
This talk provides an overview and description of the domains of cognitive function (e.g., memory) and the types of cognitive items (e.g., Mini- Mental State Examination (MMSE)) used in frailty instruments. Our literature review identified 67 unique frailty instruments. Of these, 34 (50.7%) used some cognitive items. Cognitive domains (and related...
Article
The Fostering African American Improvement in Total Health! (FAITH!) Nutrition Education Program is a theory-based, multicomponent health intervention developed and operated in partnership with an East Baltimore church. The program aims to improve eating habits, as well as knowledge and beliefs about healthy eating, among African American adults in...
Thesis
In the field of aging research, the complexity of investigating the many factors that impact aging, for both robust and frail older adults, is now understood to require a multi-disciplinary approach. Biologists, statisticians, demographers, epidemiologists, and clinicians make up just some of the multifaceted faculty involved in the study of aging,...
Conference Paper
The FAITH! (Fostering African American Improvement in Total Health) Nutrition Education Program is a theory-based, multi-component health intervention developed and operated in partnership with an East Baltimore church. The program aims to improve eating habits, as well as knowledge and beliefs about healthy eating, among African American adults in...

Network

Cited By

Projects