Featured Publications
Cognitive 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 livingHospitalizationUse of Medications With Anticholinergic Effect Predicts Clinical Severity of Delirium Symptoms in Older Medical Inpatients
Han L, McCusker J, Cole M, Abrahamowicz M, Primeau F, Elie M. Use of Medications With Anticholinergic Effect Predicts Clinical Severity of Delirium Symptoms in Older Medical Inpatients. JAMA Internal Medicine 2001, 161: 1099-1105. PMID: 11322844, DOI: 10.1001/archinte.161.8.1099.Peer-Reviewed Original ResearchConceptsDelirium severityACH medicationsMedication exposureDelirium symptomsMedical inpatientsInpatients 65 yearsModifiable risk factorsOlder medical inpatientsUse of medicationsPresence of dementiaElderly medical inpatientsMixed linear regression modelsAnticholinergic medicationsACh effectsAnticholinergic effectsMedication usePrevalent deliriumDelirium IndexRisk factorsClinical severityMedicationsDeliriumSymptom severityLongitudinal associationsSeverity
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 ResearchMeSH KeywordsAgedAged, 80 and overFemaleHospitalizationHumansLongitudinal StudiesMalePatient DischargeProspective StudiesQuality of LifeConceptsCommunity-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 ResearchMeSH KeywordsAgedAged, 80 and overHospitalizationHospitalsHumansPatient DischargeQuality of LifeRisk FactorsConceptsHealth 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
Cognitive frailty in relation to adverse health outcomes independent of multimorbidity: results from the China health and retirement longitudinal study
Chen C, Park J, Wu C, Xue Q, Agogo G, Han L, Hoogendijk EO, Liu Z, Wu Z. Cognitive frailty in relation to adverse health outcomes independent of multimorbidity: results from the China health and retirement longitudinal study. Aging 2020, 12: 23129-23145. PMID: 33221750, PMCID: PMC7746379, DOI: 10.18632/aging.104078.Peer-Reviewed Original ResearchMeSH KeywordsActivities of Daily LivingAge FactorsAgedAged, 80 and overChinaCognitionCognitive AgingCognitive DysfunctionDisability EvaluationFemaleFrail ElderlyFrailtyFunctional StatusHealth SurveysHospitalizationHumansLongitudinal StudiesMaleMiddle AgedMobility LimitationMultimorbidityPrognosisRetirementRisk AssessmentRisk FactorsConceptsCognitive frailtyInstrumental ADLPhysical frailtyHealth outcomesCognitive impairmentAdverse health outcomesRetirement Longitudinal StudyPhysical frailty assessmentChinese older adultsFrailty assessmentIADL disabilitySecondary preventionDaily livingHigh riskMobility disabilityMultimorbidityFrailtyChina HealthNormal cognitionBaseline cognitionHealthy agingOlder adultsDeathBasic activitiesHospitalizationFunctional 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 ratioHospitalizationSurgeryInjuryVisitsPredictors of Residential Care Admission in Community-Dwelling Older People With Dementia
Jamieson H, Abey-Nesbit R, Nishtala PS, Allore H, Han L, Deely JM, Pickering JW. Predictors of Residential Care Admission in Community-Dwelling Older People With Dementia. Journal Of The American Medical Directors Association 2020, 21: 1665-1670. PMID: 32646821, PMCID: PMC7641960, DOI: 10.1016/j.jamda.2020.04.021.Peer-Reviewed Original ResearchMeSH KeywordsActivities of Daily LivingAgedDementiaHome Care ServicesHospitalizationHumansIndependent LivingConceptsAged residential careSubdistribution hazard ratiosMultivariable competing-risk modelResidential care admissionAbsence of dementiaDay of assessmentOlder New ZealandersRisk prediction modelPoor cognitive performanceCompeting-risks modelInterRAI-HC assessmentInterRAI dataCare admissionHazard ratioObservational studyReduced riskDaily livingExclusion criteriaHigh riskAlcohol consumptionDementiaOlder peopleResidential careSocial isolationCognitive performanceRisk 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 monthIllness
2017
Emergency Department Visits Without Hospitalization Are Associated With Functional Decline in Older Persons
Nagurney JM, Fleischman W, Han L, Leo-Summers L, Allore HG, Gill TM. Emergency Department Visits Without Hospitalization Are Associated With Functional Decline in Older Persons. Annals Of Emergency Medicine 2017, 69: 426-433. PMID: 28069299, PMCID: PMC5365369, DOI: 10.1016/j.annemergmed.2016.09.018.Peer-Reviewed Original ResearchConceptsCommunity-living older personsED visitsDisability scoresControl groupFunctional declineOlder personsBaseline disability scoresCourse of disabilityHigher disability scoresEmergency department visitsNursing home admissionAdjusted risk ratioAcute hospitalizationSecondary outcomesDepartment visitsHome admissionEmergency departmentMean ageFunctional statusRisk ratioHospitalizationUnmatched groupsNursing homesMeaningful declineRelevant covariates
2015
Trajectories of Disability Among Older Persons Before and After a Hospitalization Leading to a Skilled Nursing Facility Admission
Buurman BM, Han L, Murphy TE, Gahbauer EA, Leo-Summers L, Allore HG, Gill TM. Trajectories of Disability Among Older Persons Before and After a Hospitalization Leading to a Skilled Nursing Facility Admission. Journal Of The American Medical Directors Association 2015, 17: 225-231. PMID: 26620073, PMCID: PMC4769913, DOI: 10.1016/j.jamda.2015.10.010.Peer-Reviewed Original ResearchConceptsSkilled nursing facility admissionsNursing facility admissionsDisability trajectoriesMinimal disabilityOlder personsFacility admissionModerate disabilityCommunity-dwelling older personsMinimal improvementDistinct disability trajectoriesSevere disability scoresProspective cohort studyTrajectories of disabilityShort-term outcomesMild disabilityLikelihood of improvementDisability scoresFirst hospitalizationSecondary outcomesCohort studyMean ageMAIN OUTCOMEDaily livingAdmissionMost older personsThe role of intervening hospital admissions on trajectories of disability in the last year of life: prospective cohort study of older people
Gill TM, Gahbauer EA, Han L, Allore HG. The role of intervening hospital admissions on trajectories of disability in the last year of life: prospective cohort study of older people. The BMJ 2015, 350: h2361. PMID: 25995357, PMCID: PMC4443433, DOI: 10.1136/bmj.h2361.Peer-Reviewed Original ResearchMeSH KeywordsActivities of Daily LivingAgedCohort StudiesConnecticutDementiaDisability EvaluationDisabled PersonsDisease ProgressionFemaleFrail ElderlyGeriatric AssessmentHospitalizationHumansMaleMultiple Organ FailureNeoplasmsPrognosisProspective StudiesSeverity of Illness IndexTerminal CareUnited StatesConceptsCourse of disabilityProspective cohort studyHospital admissionTrajectories of disabilitySeverity of disabilityCatastrophic disabilitySevere disabilityCohort studyAcute hospital admissionPalliative care approachMultiple hospital admissionsAdvance care planningPersonal care needsEnd of lifeDisability scoresOlder patientsPotential confoundersOccurrence of admissionMultivariable modelCare planningMAIN OUTCOMECare approachDaily livingCare needsAdmission
2013
Dynamics of functional aging based on latent-class trajectories of activities of daily living
Han L, Allore H, Murphy T, Gill T, Peduzzi P, Lin H. Dynamics of functional aging based on latent-class trajectories of activities of daily living. Annals Of Epidemiology 2013, 23: 87-92. PMID: 23305692, PMCID: PMC3558979, DOI: 10.1016/j.annepidem.2012.11.010.Peer-Reviewed Original ResearchConceptsDaily livingFunctional agingCommunity-living adultsEquation Poisson modelsMost older adultsADL disabilityHigher disabilityPersistent disabilitySubstantial morbidityInstrumental ADLADL independenceDisability trajectoriesLatent class trajectoriesCumulative burdenRestricted activityLow burdenSevere disabilityMorbidityPredominant trajectoriesOlder adultsDisabilityTime trendsFunctional autonomyADLGrowth mixture models
2012
Risk factors and precipitants of long-term disability in community mobility: a cohort study of older persons.
Gill TM, Gahbauer EA, Murphy TE, Han L, Allore HG. Risk factors and precipitants of long-term disability in community mobility: a cohort study of older persons. Annals Of Internal Medicine 2012, 156: 131-40. PMID: 22250144, PMCID: PMC3278794, DOI: 10.7326/0003-4819-156-2-201201170-00009.Peer-Reviewed Original ResearchConceptsLong-term disabilityRisk factorsOlder personsCohort studyCommunity mobilityShort Physical Performance BatteryMultivariate hazard ratiosProspective cohort studyPhysical Performance BatteryMultiple risk factorsCandidate risk factorsSpecific risk factorsNational InstituteLong-term mobility disabilityHazard ratioAbsolute riskPerformance BatteryPotential precipitantsMobility disabilityRestricted activityOlder ageObserved associationsInitial onsetStrong associationQuarter mile
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 ResearchMeSH KeywordsAgedAged, 80 and overFemaleFrail ElderlyHealth StatusHospitalizationHumansMaleProspective StudiesConceptsFrailty stateGreater frailtyLess frailtyFrail stateOlder personsAdjusted hazard ratioCommunity-living personsLow physical activitySlow walking speedProspective longitudinal studyFrailty statusHazard ratioMuscle weaknessHospitalizationPhysical activityNonfrailPrefrailFrailtyWalking speedsMonthsLongitudinal studyFrailAdverse consequencesExposure rateConsistent effect
2009
Factors Associated With Recovery of Prehospital Function Among Older Persons Admitted to a Nursing Home With Disability After an Acute Hospitalization
Gill TM, Gahbauer EA, Han L, Allore HG. Factors Associated With Recovery of Prehospital Function Among Older Persons Admitted to a Nursing Home With Disability After an Acute Hospitalization. The Journals Of Gerontology Series A 2009, 64A: 1296-1303. PMID: 19661289, PMCID: PMC2773809, DOI: 10.1093/gerona/glp115.Peer-Reviewed Original ResearchMeSH KeywordsAcute DiseaseAge FactorsAgedAged, 80 and overCohort StudiesContinuity of Patient CareDisability EvaluationDisabled PersonsFemaleFollow-Up StudiesGeriatric AssessmentHomes for the AgedHospitalizationHumansKaplan-Meier EstimateLongitudinal StudiesMaleMultivariate AnalysisNursing HomesPatient DischargeProbabilityProportional Hazards ModelsRecovery of FunctionRisk FactorsTime FactorsUnited StatesConceptsNursing home admissionPrehospital functionHome admissionAcute hospitalizationSignificant weight lossNursing homesGross motor coordinationMotor coordinationOlder personsManual dexterityWeight lossMonthly telephone interviewsOngoing cohort studyCohort studyFunctional recoveryPrehospital levelMore admissionsDaily livingHospitalizationAdmissionCognitive impairmentMultivariate analysisTelephone interviewsPotential predictorsAnalytic sample
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 Haven12-Month Cognitive Outcomes of Major and Minor Depression in Older Medical Patients
Han L, McCusker J, Cole M, Abrahamowicz M, Čapek R. 12-Month Cognitive Outcomes of Major and Minor Depression in Older Medical Patients. American Journal Of Geriatric Psychiatry 2008, 16: 742-751. PMID: 18757768, DOI: 10.1097/jgp.0b013e31817c6ad7.Peer-Reviewed Original ResearchConceptsMini-Mental State ExaminationOlder medical patientsMinor depressionPoor cognitive functionMedical patientsDepression diagnosisCognitive functionStudy entryIndependent risk factorProspective cohort studyApparent cognitive impairmentFourth Edition criteriaAcute care hospitalsDiagnostic Interview ScheduleMixed effects regression modelsAntidepressant treatmentCohort studyCare hospitalHospital admissionMedical inpatientsRegression modelsPhysical functionRisk factorsCardiovascular diseaseEdition criteria