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 living
2023
Changes in Restricting Symptoms after Critical Illness among Community-Living Older Adults.
Jain S, Han L, Gahbauer E, Leo-Summers L, Feder S, Ferrante L, Gill T. Changes in Restricting Symptoms after Critical Illness among Community-Living Older Adults. American Journal Of Respiratory And Critical Care Medicine 2023, 208: 1206-1215. PMID: 37769149, PMCID: PMC10868351, DOI: 10.1164/rccm.202304-0693oc.Peer-Reviewed Original ResearchMeSH KeywordsAgedCritical IllnessHumansIntensive Care UnitsLongitudinal StudiesProspective StudiesQuality of LifeConceptsNeighborhood-level socioeconomic disadvantageCritical illnessIntensive care unitHospital dischargeCommunity-living older adultsOlder adultsOlder ICU survivorsPost-ICU careSocioeconomic disadvantageProspective longitudinal studyQuality of lifeICU admissionICU survivorsCare unitFunctional recoverySymptom managementMultiple symptomsThird monthThree monthsSymptomsIllnessRestricted activityVulnerable subgroupsFirst monthMonthsDistressing 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
Catastrophic health expenditure among Chinese adults living alone with cognitive impairment: findings from the CHARLS
Li C, Jin S, Cao X, Han L, Sun N, Allore H, Hoogendijk EO, Xu X, Feng Q, Liu X, Liu Z. Catastrophic health expenditure among Chinese adults living alone with cognitive impairment: findings from the CHARLS. BMC Geriatrics 2022, 22: 640. PMID: 35922775, PMCID: PMC9351200, DOI: 10.1186/s12877-022-03341-8.Peer-Reviewed Original ResearchTrends in the prevalence of vision impairment among the oldest-old Chinese population from 1998 to 2018.
Luo Y, Zhang Q, Han L, Shen Z, Chen Y, Wang K, Huang Z, De Fries CM, Cao G, Su H, Xu H, Chen Z, Ren Z, Hu Y, Xu B. Trends in the prevalence of vision impairment among the oldest-old Chinese population from 1998 to 2018. Journal Of Global Health 2022, 12: 11006. PMID: 35862489, DOI: 10.7189/jogh.12.11006.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overCataractChinaChronic DiseaseGlaucomaHearing LossHumansLongitudinal StudiesPrevalenceRetrospective StudiesConceptsOldest-old Chinese populationImpairment prevalenceVision impairmentChinese populationChronic conditionsHealth behaviorsHearing impairmentChinese Longitudinal Healthy Longevity SurveyProminent public health issueSociodemographic variablesRetrospective longitudinal studyPublic health issueLandolt C chartStudy entryChronic diseasesPrevalence trendsChinese adultsLongevity SurveyCognitive impairmentPrevalence changesPrevalenceUrban residenceOlder peopleHealth issuesImpairmentMultimorbidity measures differentially predicted mortality among older Chinese adults
Yao SS, Xu HW, Han L, Wang K, Cao GY, Li N, Luo Y, Chen YM, Su HX, Chen ZS, Huang ZT, Hu YH, Xu B. Multimorbidity measures differentially predicted mortality among older Chinese adults. Journal Of Clinical Epidemiology 2022, 146: 97-105. PMID: 35259446, DOI: 10.1016/j.jclinepi.2022.03.002.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedChinaChronic DiseaseHealth StatusHumansLongitudinal StudiesMiddle AgedMultimorbidityConceptsNet reclassification indexIntegrated discrimination improvementMultimorbidity measuresMortality prediction modelOlder Chinese adultsMultimorbidity patternsC-statisticCondition countMortality predictionChinese adultsMultimorbidity trajectoriesNet reclassification improvementCox regressionReclassification improvementReclassification indexChronic conditionsDiscrimination improvementMortality riskHigh riskIntegrated discriminationMultimorbidityStudy designMortalityAdultsAgePatterns of cardiometabolic multimorbidity and the risk of depressive symptoms in a longitudinal cohort of middle-aged and older Chinese
Huang ZT, Luo Y, Han L, Wang K, Yao SS, Su HX, Chen S, Cao GY, De Fries CM, Chen ZS, Xu HW, Hu YH, Xu B. Patterns of cardiometabolic multimorbidity and the risk of depressive symptoms in a longitudinal cohort of middle-aged and older Chinese. Journal Of Affective Disorders 2022, 301: 1-7. PMID: 34999125, DOI: 10.1016/j.jad.2022.01.030.Peer-Reviewed Original ResearchConceptsCardiometabolic multimorbidityCardiometabolic diseasesHeart diseaseDepressive symptomsSelf-reported chronic conditionsEpidemiological Studies Depression ScaleAbsence of strokeRisk of depressionRetirement Longitudinal Study 2011Multiple cardiometabolic diseasesDose effectMental health preventionOlder ChineseAdditive effectChronic conditionsDisease combinationsLongitudinal cohortDepression ScaleHigh riskMultimorbidityPerson-centered healthcareDiabetesSymptomsHealth preventionChina Health
2021
Visual trajectories and risk of physical and cognitive impairment among older Chinese adults
Cao G, Wang K, Han L, Zhang Q, Yao S, Chen Z, Huang Z, Luo Y, Hu Y, Xu B. Visual trajectories and risk of physical and cognitive impairment among older Chinese adults. Journal Of The American Geriatrics Society 2021, 69: 2877-2887. PMID: 34111310, DOI: 10.1111/jgs.17311.Peer-Reviewed Original ResearchConceptsOlder Chinese adultsIADL disabilityCognitive impairmentChinese adultsADL disabilityFunctional impairmentCognitive functionMini-Mental State Examination scoreProgressive declineChinese Longitudinal Healthy Longevity SurveyState Examination scoreModerate declineGroup-based trajectory modelsKatz scaleLawton scalePotential confoundersLongevity SurveyImpairmentDecline trajectoriesChinese versionDisabilityLongitudinal studyAdultsRiskExamination scoresFunctional 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 activitiesHospitalizationVision impairment, vision correction, and cognitive decline among middle-aged and older Chinese: results from the China health and retirement longitudinal study
Cao GY, Yao SS, Wang K, Han L, Chen ZS, Huang ZT, Zhang Q, Wang C, Hu YH, Xu B. Vision impairment, vision correction, and cognitive decline among middle-aged and older Chinese: results from the China health and retirement longitudinal study. Aging & Mental Health 2020, 25: 2028-2035. PMID: 33063527, DOI: 10.1080/13607863.2020.1828271.Peer-Reviewed Original ResearchRisk 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 ResearchMeSH KeywordsAgedAged, 80 and overDisabled PersonsEmergency Service, HospitalFemaleHumansLongitudinal StudiesMaleOdds RatioPatient DischargeRisk FactorsConceptsLower 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 activityAdultsVisitsCohort Profile: The Precipitating Events Project (PEP Study)
Gill T, Han L, Gahbauer EA, Leo-Summers L, Murphy TE. Cohort Profile: The Precipitating Events Project (PEP Study). The Journal Of Nutrition, Health & Aging 2020, 24: 438-444. PMID: 32242212, PMCID: PMC7322244, DOI: 10.1007/s12603-020-1341-4.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsMeSH KeywordsActivities of Daily LivingAgedAged, 80 and overFemaleHumansLongitudinal StudiesMaleProspective StudiesConceptsPrecipitating Events ProjectPEP studyComprehensive home-based assessmentsEpidemiology of disabilityAge 70 yearsHealth care utilizationGreater New HavenLarge health planParticipant-level dataHome-based assessmentEnd of lifeCare utilizationDeath certificatesMedicare claimsDepressive symptomsOngoing longitudinal studyDisabling processEligible membersOlder personsHealth plansLongitudinal studyMethodologic researchCompletion ratesOriginal reportQualified investigatorsAssociations Between Somatic Multimorbidity Patterns and Depression in a Longitudinal Cohort of Middle-Aged and Older Chinese
Yao SS, Cao GY, Han L, Huang ZT, Chen ZS, Su HX, Hu Y, Xu B. Associations Between Somatic Multimorbidity Patterns and Depression in a Longitudinal Cohort of Middle-Aged and Older Chinese. Journal Of The American Medical Directors Association 2020, 21: 1282-1287.e2. PMID: 31928934, DOI: 10.1016/j.jamda.2019.11.028.Peer-Reviewed Original ResearchMeSH KeywordsAgedChinaChronic DiseaseDepressionFemaleHumansLongitudinal StudiesMaleMiddle AgedMultimorbidityRisk FactorsConceptsChronic somatic conditionsSomatic multimorbidityDepressive symptomsOlder Chinese adultsSomatic conditionsChinese adultsEpidemiological Studies Depression ScaleLongitudinal associationsRetirement Longitudinal Study 2011Multimorbidity patternsLongitudinal cohortDepression ScaleRespiratory conditionsHigh riskGreater oddsRespiratory patternMental disordersSymptomsChina HealthGreater riskOlder populationOlder adultsSkeletal patternClinical practitionersDepression
2019
Associations between home deaths and end-of-life nursing care trajectories for community-dwelling people: a population-based registry study
Kjellstadli C, Han L, Allore H, Flo E, Husebo BS, Hunskaar S. Associations between home deaths and end-of-life nursing care trajectories for community-dwelling people: a population-based registry study. BMC Health Services Research 2019, 19: 698. PMID: 31615500, PMCID: PMC6794846, DOI: 10.1186/s12913-019-4536-9.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overChildChild, PreschoolContinuity of Patient CareFemaleHome Care ServicesHome NursingHospice CareHospitalsHumansIndependent LivingInfantInfant, NewbornLogistic ModelsLongitudinal StudiesMaleMiddle AgedNorwayNursing CarePalliative CareRegistriesResearch DesignRetrospective StudiesSkilled Nursing FacilitiesTerminal CareYoung AdultConceptsSkilled nursing facilitiesHome deathCommunity-dwelling peoplePlace of deathHome nursingSNF stayAssociation of placeNursing servicesPopulation-based registry studyHome nursing servicesPalliative home careContinuity of careRetrospective longitudinal studyDays of lifeMunicipal healthcare servicesLogistic regression modelsGroup-based trajectory modelsDeath RegistryMultinomial logistic regression modelsNorwegian CauseRegistry studyBackgroundFew studiesNational registryCare trajectoriesNursing hoursPrevalence and Patterns of Multimorbidity in a Nationally Representative Sample of Older Chinese: Results From the China Health and Retirement Longitudinal Study
Yao SS, Cao GY, Han L, Chen ZS, Huang ZT, Gong P, Hu Y, Xu B. Prevalence and Patterns of Multimorbidity in a Nationally Representative Sample of Older Chinese: Results From the China Health and Retirement Longitudinal Study. The Journals Of Gerontology Series A 2019, 75: 1974-1980. PMID: 31406983, DOI: 10.1093/gerona/glz185.Peer-Reviewed Original ResearchMeSH KeywordsAgedChinaFemaleHealth Status DisparitiesHumansLongitudinal StudiesMaleMiddle AgedMultimorbidityPrevalenceRetirementConceptsPatterns of multimorbidityPrevalence of multimorbidityMultimorbidity patternsRetirement Longitudinal StudyOlder ChineseChina HealthPopulation-based studyDemographic characteristicsIndividual chronic diseasesLongitudinal studyCommon multimorbidity patternsLogistic regression modelsParticipants' demographic characteristicsNationally Representative SampleEntire cohortPotential confoundersChronic diseasesRepresentative sampleMultimorbidityAlcohol consumptionMemory-related diseasesUrban-rural differencesPrevalenceInterventional implicationsResidential regionThe Epidemiology of Patient‐Reported Hypersomnia in Persons With Advanced Age
Miner B, Gill TM, Yaggi HK, Redeker NS, Van Ness PH, Han L, Fragoso C. The Epidemiology of Patient‐Reported Hypersomnia in Persons With Advanced Age. Journal Of The American Geriatrics Society 2019, 67: 2545-2552. PMID: 31390046, PMCID: PMC6898735, DOI: 10.1111/jgs.16107.Peer-Reviewed Original ResearchConceptsSelf-reported sleep-disordered breathingRestless legs syndromeMean ESS scoreCommunity-dwelling personsESS scoreCross-sectional associationsAdvanced ageHypersomnia symptomsCentral nervous system depressant medicationsEpworth Sleepiness Scale scoreMini-Mental State Examination scoreEpidemiologic Studies-Depression scoreSelf-reported medical conditionsEpidemiology of patientsLow physical activitySleep-disordered breathingBody mass indexPhysical Activity ScalePrecipitating Events ProjectState Examination scoreInsomnia Severity IndexMultivariable regression modelsDepressant medicationsClinical characteristicsCross-sectional design
2018
Prognostic 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