Featured Publications
Association Between Neighborhood Disadvantage and Functional Well-being in Community-Living Older Persons
Gill TM, Zang EX, Murphy TE, Leo-Summers L, Gahbauer EA, Festa N, Falvey JR, Han L. Association Between Neighborhood Disadvantage and Functional Well-being in Community-Living Older Persons. JAMA Internal Medicine 2021, 181: 1297-1304. PMID: 34424276, PMCID: PMC8383163, DOI: 10.1001/jamainternmed.2021.4260.Peer-Reviewed Original ResearchMeSH KeywordsActivities of Daily LivingAgedFemaleFunctional StatusHealthy Life ExpectancyHousing QualityHumansIndependent LivingLongitudinal StudiesMaleMental HealthNeighborhood CharacteristicsPrognosisPsychosocial FunctioningQuality of LifeSocial Determinants of HealthSocioeconomic FactorsUnited StatesConceptsProspective longitudinal cohort studyCommunity-living older personsAge 70 yearsActive life expectancyLongitudinal cohort studyOlder personsCohort studyPrognostic factorsLife expectancyArea deprivation index scoreCommunity-living personsPrecipitating Events ProjectDeprivation index scoreDisabled life expectancyAge 90 yearsArea Deprivation IndexPublic health initiativesPublic health interventionsNeighborhood disadvantageGreater percentageResource-poor environmentsIndividual-level socioeconomic characteristicsMean ageMAIN OUTCOMEDaily livingCognitive Aging Trajectories and Burdens of Disability, Hospitalization and Nursing Home Admission Among Community-living Older Persons
Han L, Gill TM, Jones BL, Allore HG. Cognitive Aging Trajectories and Burdens of Disability, Hospitalization and Nursing Home Admission Among Community-living Older Persons. The Journals Of Gerontology Series A 2015, 71: 766-771. PMID: 26511011, PMCID: PMC4888384, DOI: 10.1093/gerona/glv159.Peer-Reviewed Original ResearchConceptsNursing home admissionBurden of disabilityCommunity-living older personsHome admissionOlder personsGreater burdenCognitive trajectoriesMini-Mental State ExaminationCommunity-living personsCognitive aging trajectoriesNursing home placementPrecipitating Events ProjectLow incidence rateEquation Poisson modelsRapid cognitive declineBaseline cognitive functionAging trajectoriesGroup-based trajectory modelsThird of participantsADL disabilityHigher baseline cognitive functionInstrumental ADLIncidence rateDaily livingHospitalizationTransitions Between Frailty States Among Community-Living Older Persons
Gill TM, Gahbauer EA, Allore HG, Han L. Transitions Between Frailty States Among Community-Living Older Persons. JAMA Internal Medicine 2006, 166: 418-423. PMID: 16505261, DOI: 10.1001/archinte.166.4.418.Peer-Reviewed Original ResearchConceptsFrailty stateOlder personsCommunity-living older personsCommunity-living personsLow physical activitySlow walking speedFrailty transitionsMuscle weaknessProspective studyGreater frailtyNatural courseLess frailtyPhysical activityDaily livingFrailtyWalking speedsWeight lossNonfrailMonthsPersonsParticipantsPrefrailCriteriaPrevention
2023
Relationship Between Distressing Symptoms and Changes in Disability After Major Surgery Among Community-living Older Persons
Gill T, Han L, Feder S, Gahbauer E, Leo-Summers L, Becher R. Relationship Between Distressing Symptoms and Changes in Disability After Major Surgery Among Community-living Older Persons. Annals Of Surgery 2023, 279: 65-70. PMID: 37389893, PMCID: PMC10761592, DOI: 10.1097/sla.0000000000005984.Peer-Reviewed Original ResearchConceptsMajor surgeryDistressing symptomsElective surgeryFunctional outcomeOlder personsCommunity-living older personsMultiple distressing symptomsSocioeconomic disadvantageCommunity-living personsTiming of surgerySerious health eventsNumber of disabilitiesSurgerySignificant associationSymptomsHealth eventsRate ratioPotential targetDisabilityUnit increaseDeleterious effectsOutcomesPersonsMultimorbidityAdmissionDistressing symptoms after major surgery among community‐living older persons
Gill T, Han L, Murphy T, Feder S, Gahbauer E, Leo‐Summers L, Becher R. Distressing symptoms after major surgery among community‐living older persons. Journal Of The American Geriatrics Society 2023, 71: 2430-2440. PMID: 37010784, PMCID: PMC10524276, DOI: 10.1111/jgs.18357.Peer-Reviewed Original ResearchConceptsCommunity-living older personsMajor surgeryDistressing symptomsArea Deprivation IndexOlder personsSocioeconomic disadvantageCommunity-living personsTiming of surgeryProspective longitudinal studyYears of ageQuality of lifeSymptom burdenNonelective surgeryPresurgery valuesElective surgeryMultivariable analysisFunctional outcomeNonelective proceduresChronic conditionsSurgerySymptomsProportional increaseMedicaid eligibilityDeprivation indexMonths
2022
Factors Associated With Days Away From Home in the Year After Major Surgery Among Community-living Older Persons
Gill TM, Becher RD, Murphy TE, Gahbauer EA, Leo-Summers L, Han L. Factors Associated With Days Away From Home in the Year After Major Surgery Among Community-living Older Persons. Annals Of Surgery 2022, 278: e13-e19. PMID: 35837967, PMCID: PMC9840715, DOI: 10.1097/sla.0000000000005528.Peer-Reviewed Original ResearchConceptsHealth care facilitiesMajor surgeryAge 85 yearsCare facilitiesOlder personsRisk factorsNumber of daysLower peak expiratory flowCommunity-living older personsShort Physical Performance BatteryIndependent risk factorCommunity-living personsPhysical Performance BatteryPeak expiratory flowCandidate risk factorsQuality of lifeHospital dischargeMultivariable analysisExpiratory flowMedian numberPerformance BatteryMusculoskeletal surgerySurgeryMean differenceHospital
2021
Functional Effects of Intervening Illnesses and Injuries After Critical Illness in Older Persons
Gill TM, Han L, Gahbauer EA, Leo-Summers L, Murphy TE, Ferrante LE. Functional Effects of Intervening Illnesses and Injuries After Critical Illness in Older Persons. Critical Care Medicine 2021, 49: 956-966. PMID: 33497167, PMCID: PMC8140984, DOI: 10.1097/ccm.0000000000004829.Peer-Reviewed Original ResearchMeSH KeywordsActivities of Daily LivingAgedAged, 80 and overBody Mass IndexCognitionCritical IllnessEmergency Service, HospitalFemaleFrail ElderlyHealth StatusHospitalizationHumansLongitudinal StudiesMaleMental HealthPhysical Functional PerformanceProspective StudiesSelf EfficacySocioeconomic FactorsWounds and InjuriesConceptsEmergency department visitsCritical illnessDepartment visitsICU admissionFunctional outcomeFunctional statusFunctional declineOlder personsAdjusted hazard ratioAdverse functional outcomesCommunity-living personsTraditional risk factorsCommunity-living participantsCorresponding odds ratiosFunctional effectsProspective longitudinal studyHazard ratioRisk factorsOdds ratioHospitalizationPremorbid functionInjuryIllnessRestricted activityAnalytic sample
2020
Functional Effects of Intervening Illnesses and Injuries After Hospitalization for Major Surgery in Community-living Older Persons
Gill TM, Han L, Gahbauer EA, Leo-Summers L, Murphy TE, Becher RD. Functional Effects of Intervening Illnesses and Injuries After Hospitalization for Major Surgery in Community-living Older Persons. Annals Of Surgery 2020, 273: 834-841. PMID: 33074902, PMCID: PMC8370041, DOI: 10.1097/sla.0000000000004438.Peer-Reviewed Original ResearchConceptsMajor surgeryED visitsRestricted activityFunctional statusFunctional declineOlder personsCommunity-living older personsAdjusted hazard ratioAdverse functional outcomesCommunity-living personsEmergency department visitsTraditional risk factorsCorresponding odds ratiosFunctional effectsIllness/injuryHazard ratioDepartment visitsFunctional recoveryFunctional outcomeRisk factorsOdds ratioHospitalizationSurgeryInjuryVisitsRisk Factors for Disability After Emergency Department Discharge in Older Adults
Nagurney JM, Han L, Leo‐Summers L, Allore HG, Gill TM. Risk Factors for Disability After Emergency Department Discharge in Older Adults. Academic Emergency Medicine 2020, 27: 1270-1278. PMID: 32673434, PMCID: PMC7749835, DOI: 10.1111/acem.14088.Peer-Reviewed Original ResearchConceptsLower extremity weaknessDisability burdenRisk factorsOlder adultsED visitsPhysical frailtyLongitudinal multivariable modelsEmergency department dischargeModifiable risk factorsCommunity-living personsCandidate risk factorsEmergency department experienceED dischargeNonmodifiable factorsMultivariable analysisRisk stratificationFunctional outcomeIndependent associationMultivariable modelOngoing longitudinal studyMonthly interviewsAnalytic sampleFunctional activityAdultsVisitsRisk Factors and Precipitants of Severe Disability Among Community-Living Older Persons
Gill TM, Han L, Gahbauer EA, Leo-Summers L, Murphy TE. Risk Factors and Precipitants of Severe Disability Among Community-Living Older Persons. JAMA Network Open 2020, 3: e206021. PMID: 32484551, PMCID: PMC7267844, DOI: 10.1001/jamanetworkopen.2020.6021.Peer-Reviewed Original ResearchMeSH KeywordsActivities of Daily LivingAgedAged, 80 and overConnecticutDisability EvaluationDisabled PersonsEmergency Service, HospitalFemaleGlobal Burden of DiseaseHospitalizationHumansMaleProspective StudiesQuality of LifeRecovery of FunctionRisk FactorsSeverity of Illness IndexWounds and InjuriesConceptsEmergency department visitsRisk factorsCatastrophic disabilitySevere disabilityDepartment visitsProgressive disabilityOlder community-living adultsCommunity-living older personsIndependent risk factorProspective cohort studyCommunity-living personsGreater New HavenCommunity-living adultsPotential risk factorsCandidate risk factorsNon-Hispanic white participantsQuality of lifeLong-term careCohort studyMultivariable analysisMean ageFunctional statusMAIN OUTCOMEPotential precipitantsDaily livingDisability and Recovery After Hospitalization for Medical Illness Among Community‐Living Older Persons: A Prospective Cohort Study
Dharmarajan K, Han L, Gahbauer EA, Leo‐Summers L, Gill TM. Disability and Recovery After Hospitalization for Medical Illness Among Community‐Living Older Persons: A Prospective Cohort Study. Journal Of The American Geriatrics Society 2020, 68: 486-495. PMID: 32083319, PMCID: PMC7735402, DOI: 10.1111/jgs.16350.Peer-Reviewed Original ResearchConceptsAcute medical illnessProspective cohort studyMedical illnessNew disabilityCohort studySelf-managing health conditionsCommunity-living older personsHealth conditionsImmediate transitional periodCommunity-living personsPost-discharge careChronic health conditionsMean recovery timeSubgroup of personsMobility activitiesIncident disabilityHospital dischargePeriod of vulnerabilityMonth 2Follow-up interviewHospitalizationDisability prevalenceOlder personsPrior monthIllnessFactors Associated With Insidious and Noninsidious Disability
Gill TM, Murphy TE, Gahbauer EA, Leo-Summers L, Han L. Factors Associated With Insidious and Noninsidious Disability. The Journals Of Gerontology Series A 2020, 75: 2125-2129. PMID: 31907523, PMCID: PMC7566549, DOI: 10.1093/gerona/glaa002.Peer-Reviewed Original ResearchConceptsRisk factorsIllness/injuryInsidious disabilityLower extremity muscle weaknessNon-Hispanic white raceExtremity muscle weaknessCommunity-living personsEmergency department visitsPoor manual dexterityCox analysisDepartment visitsMultivariable analysisDisability outcomesMuscle weaknessWhite raceDaily livingCognitive impairmentBivariate analysisType of disabilityManual dexterityDisabilityInjuryOutcomesModest differencesDifferent mechanisms
2018
Days Spent at Home in the Last Six Months of Life Among Community-Living Older Persons
Gill TM, Gahbauer EA, Leo-Summers L, Murphy TE, Han L. Days Spent at Home in the Last Six Months of Life Among Community-Living Older Persons. The American Journal Of Medicine 2018, 132: 234-239. PMID: 30447203, PMCID: PMC6349467, DOI: 10.1016/j.amjmed.2018.10.029.Peer-Reviewed Original ResearchConceptsCommunity-living older personsMonths of lifeOrgan failureOlder personsRace/ethnicityEnd of lifeImportant patient-centered outcomesCommunity-living personsPatient-centered outcomesOngoing cohort studyCohort studyAdvanced dementiaHospice facilityMedian numberDeath certificatesSudden deathNursing homesAnalytic sampleNumber of daysDeathDecedentsDaysMonthsAgeSexPrognostic Effect of Changes in Physical Function Over Prior Year on Subsequent Mortality and Long‐Term Nursing Home Admission
Gill TM, Han L, Gahbauer EA, Leo‐Summers L, Allore HG. Prognostic Effect of Changes in Physical Function Over Prior Year on Subsequent Mortality and Long‐Term Nursing Home Admission. Journal Of The American Geriatrics Society 2018, 66: 1587-1591. PMID: 29719039, PMCID: PMC6133765, DOI: 10.1111/jgs.15399.Peer-Reviewed Original ResearchConceptsLong-term nursing home admissionNursing home admissionHome admissionPhysical functionDisability scoresPrognostic effectDaily livingPrior yearCommunity-living personsRisk of deathUseful prognostic informationProspective longitudinal studyAdverse outcomesPrognostic informationMultivariable modelInstrumental activitiesSubsequent mortalityAdmissionBivariate predictorsSubsequent outcomesMonthsDifferent intervalsComprehensive assessmentDeathLongitudinal study
2017
Joint Trajectories of Cognition and Frailty and Associated Burden of Patient-Reported Outcomes
Liu Z, Han L, Gahbauer EA, Allore HG, Gill TM. Joint Trajectories of Cognition and Frailty and Associated Burden of Patient-Reported Outcomes. Journal Of The American Medical Directors Association 2017, 19: 304-309.e2. PMID: 29146224, PMCID: PMC6054444, DOI: 10.1016/j.jamda.2017.10.010.Peer-Reviewed Original ResearchConceptsPatient-reported outcomesNursing home admissionException of hospitalizationMini-Mental State ExaminationFrailty groupHome admissionCumulative burdenSlower cognitive declineCognitive frailtyCognitive declineProgressive frailtyCommunity-living older personsGreater burdenJoint trajectory groupsHigh cumulative burdenCommunity-living personsIncidence density rateLow physical activitySlow walking speedTrajectory groupsEquation Poisson modelsRapid cognitive declineDistinct joint trajectoriesFried phenotypeMuscle weaknessThe subsequent course of disability in older persons discharged to a skilled nursing facility after an acute hospitalization
Liu Z, Han L, Leo-Summers L, Gahbauer EA, Allore HG, Gill TM. The subsequent course of disability in older persons discharged to a skilled nursing facility after an acute hospitalization. Experimental Gerontology 2017, 97: 73-79. PMID: 28782593, PMCID: PMC5793887, DOI: 10.1016/j.exger.2017.08.004.Peer-Reviewed Original ResearchConceptsElective major surgerySkilled nursing facilitiesMajor surgeryAcute hospitalizationCritical illnessOlder personsDisability burdenNursing facilitiesSubsequent courseCommunity-living personsRate ratioType of hospitalizationIndex admissionSecondary outcomesSNF admissionFunctional outcomeMore admissionsHospitalizationSurgeryAdmissionIllnessLongitudinal studyDisabilityMobility activitiesExclusive groups
2014
Establishing a Hierarchy for the Two Components of Restricted Activity
Gill TM, Allore HG, Gahbauer EA, Han L. Establishing a Hierarchy for the Two Components of Restricted Activity. The Journals Of Gerontology Series A 2014, 70: 892-898. PMID: 25391532, PMCID: PMC4481688, DOI: 10.1093/gerona/glu203.Peer-Reviewed Original ResearchConceptsIllness/injuryBed restSevere disabilityHazard ratioCommunity-living personsAdverse functional consequencesPrompt medical attentionMobility activitiesFunctional statusMedical attentionUsual activitiesInjuryOlder personsRestricted activityTelephone interviewsMild disabilityDisabilityBasic activitiesComparable effectsFunctional consequencesExposureRestActivityIllnessYears
2011
The Relationship Between Intervening Hospitalizations and Transitions Between Frailty States
Gill TM, Gahbauer EA, Han L, Allore HG. The Relationship Between Intervening Hospitalizations and Transitions Between Frailty States. The Journals Of Gerontology Series A 2011, 66A: 1238-1243. PMID: 21852286, PMCID: PMC3193526, DOI: 10.1093/gerona/glr142.Peer-Reviewed Original ResearchConceptsFrailty stateGreater frailtyLess frailtyFrail stateOlder personsAdjusted hazard ratioCommunity-living personsLow physical activitySlow walking speedProspective longitudinal studyFrailty statusHazard ratioMuscle weaknessHospitalizationPhysical activityNonfrailPrefrailFrailtyWalking speedsMonthsLongitudinal studyFrailAdverse consequencesExposure rateConsistent effect
2008
Functional Trajectories in Older Persons Admitted to a Nursing Home with Disability After an Acute Hospitalization
Gill TM, Gahbauer EA, Han L, Allore HG. Functional Trajectories in Older Persons Admitted to a Nursing Home with Disability After an Acute Hospitalization. Journal Of The American Geriatrics Society 2008, 57: 195-201. PMID: 19170778, PMCID: PMC2676348, DOI: 10.1111/j.1532-5415.2008.02107.x.Peer-Reviewed Original ResearchConceptsNursing home admissionAcute hospitalizationNursing homesOlder personsHome admissionFunctional trajectoriesFirst nursing home admissionProspective cohort studyCommunity-living personsMonthly telephone interviewsContinuous disabilityCohort studyMedian timePoor outcomeHospitalizationDaily livingPremorbid levelTelephone interviewsAdmissionDisabilityMonthsAdditional researchParticipantsAnalytical sampleNew Haven
2006
Bathing Disability and the Risk of Long-Term Admission to a Nursing Home
Gill TM, Allore HG, Han L. Bathing Disability and the Risk of Long-Term Admission to a Nursing Home. The Journals Of Gerontology Series A 2006, 61: 821-825. PMID: 16912099, DOI: 10.1093/gerona/61.8.821.Peer-Reviewed Original ResearchConceptsLong-term nursing home admissionNursing home admissionHome admissionPersistent disabilityLong-term admissionBathing disabilityPotential confoundersDaily livingCommunity-living older personsCommunity-living personsMonthly telephone interviewsPrevalence of disabilityProportional hazards modelShort-term admissionsLong-term care servicesAdmission increasesProspective studyHazards modelNursing homesAdmissionCare servicesOlder personsTelephone interviewsDisabilityConfounders