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.