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 livingEvaluation of Complementary and Integrative Health Approaches Among US Veterans with Musculoskeletal Pain Using Propensity Score Methods
Han L, Goulet JL, Skanderson M, Bathulapalli H, Luther SL, Kerns RD, Brandt CA. Evaluation of Complementary and Integrative Health Approaches Among US Veterans with Musculoskeletal Pain Using Propensity Score Methods. Pain Medicine 2018, 20: 90-102. PMID: 29584926, PMCID: PMC6329442, DOI: 10.1093/pm/pny027.Peer-Reviewed Original ResearchConceptsIntegrative health approachesPS matchingCIH exposureMusculoskeletal painPropensity score methodsSelf-rated pain intensityHealth approachHigher pain intensity ratingsPain intensity outcomesChronic musculoskeletal painPain intensity ratingsIPTW modelsRetrospective cohortPain intensityChronic painClinical visitsInitial diagnosisChiropractic careUS veteransBaseline differencesTreatment weightingExposure groupPainScore methodTreatment effectivenessCognitive 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 associationsSeverityCumulative Anticholinergic Exposure Is Associated with Poor Memory and Executive Function in Older Men
Han L, Agostini JV, Allore HG. Cumulative Anticholinergic Exposure Is Associated with Poor Memory and Executive Function in Older Men. Journal Of The American Geriatrics Society 2008, 56: 2203-2210. PMID: 19093918, PMCID: PMC3952110, DOI: 10.1111/j.1532-5415.2008.02009.x.Peer-Reviewed Original ResearchConceptsTotal anticholinergic burdenCumulative anticholinergic exposureOlder menAnticholinergic medicationsAnticholinergic burdenAnticholinergic exposureCumulative exposureVeterans Affairs primary care clinicsExecutive functionAnticholinergic medication useDeleterious adverse effectsProspective cohort studySeverity of hypertensionCommunity-dwelling menPrimary care clinicsDaily Living ScalePotential risk factorsPrescription of drugsAnticholinergic scoreCohort studyMultiple medicationsAnticholinergic effectsMedication useCare clinicsPhysical functionTOP CITED PAPERS IN INTERNATIONAL PSYCHOGERIATRICS: 6c. TRACKING COGNITIVE DECLINE IN ALZHEIMER'S DISEASE USING THE MINI-MENTAL STATE EXAMINATION: A META-ANALYSIS (“MINI” IS NOT NECESSARILY TRIVIAL!)
Han L, Ames D. TOP CITED PAPERS IN INTERNATIONAL PSYCHOGERIATRICS: 6c. TRACKING COGNITIVE DECLINE IN ALZHEIMER'S DISEASE USING THE MINI-MENTAL STATE EXAMINATION: A META-ANALYSIS (“MINI” IS NOT NECESSARILY TRIVIAL!). International Psychogeriatrics 2009, 21: 1037-1040. PMID: 19747422, DOI: 10.1017/s1041610209990883.Peer-Reviewed Original ResearchOpioid dosing trends over eight years among US Veterans with musculoskeletal disorders after returning from service in support of recent conflicts
Han L, Allore H, Goulet J, Bathulapali H, Skanderson M, Brandt C, Haskell S, Krebs E. Opioid dosing trends over eight years among US Veterans with musculoskeletal disorders after returning from service in support of recent conflicts. Annals Of Epidemiology 2017, 27: 563-569.e3. PMID: 28890282, PMCID: PMC5647654, DOI: 10.1016/j.annepidem.2017.08.015.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAnalgesics, OpioidChronic PainDrug PrescriptionsElectronic PrescribingFemaleHumansMaleMental HealthMiddle AgedMusculoskeletal DiseasesOpioid-Related DisordersPrescription DrugsStress Disorders, Post-TraumaticUnited StatesUnited States Department of Veterans AffairsVeteransVeterans HealthYoung AdultConceptsHigh-dose prescribingOpioid prescriptionsMental health diagnosesMusculoskeletal disordersDaily morphine equivalentsHealth diagnosisHigh-dose therapyLong-term opioidsHigh-dose prescriptionsAverage daily dosePosttraumatic stress disorderMorphine equivalentsDose therapyDaily dosePatient characteristicsChronic painUS veteransOdds ratioPrescribingStress disorderBaseline periodGeographic confoundingVeteransPrescriptionOpioidsTransitions 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 lossNonfrailMonthsPersonsParticipantsPrefrailCriteriaPreventionUse of Self-Matching to Control for Stable Patient Characteristics While Addressing Time-Varying Confounding on Treatment Effect: A Case Study of Older Intensive Care Patients
Han L, Pisani MA, Araujo KL, Allore HG. Use of Self-Matching to Control for Stable Patient Characteristics While Addressing Time-Varying Confounding on Treatment Effect: A Case Study of Older Intensive Care Patients. International Journal Of Statistics In Medical Research 2016, 5: 8-16. PMID: 27123153, PMCID: PMC4844076, DOI: 10.6000/1929-6029.2016.05.01.2.Peer-Reviewed Original ResearchDelirium severity scoresIntensive care unitSeverity scoreOld intensive care patientsIntensive care patientsOlder medical patientsDose of haloperidolStable patient characteristicsICU stayBaseline characteristicsAcute outcomesPatient characteristicsCare patientsCare unitMeasures of exposureMedical patientsAntipsychotic medicationFull cohortPatientsStable baselineAnalytic sampleTreatment effectsHaloperidolCohortScoresAre China’s oldest-old living longer with less disability? A longitudinal modeling analysis of birth cohorts born 10 years apart
Liu Z, Han L, Feng Q, Dupre ME, Gu D, Allore HG, Gill TM, Payne CF. Are China’s oldest-old living longer with less disability? A longitudinal modeling analysis of birth cohorts born 10 years apart. BMC Medicine 2019, 17: 23. PMID: 30704529, PMCID: PMC6357399, DOI: 10.1186/s12916-019-1259-z.Peer-Reviewed Original ResearchConceptsPartial life expectancyLess disabilityBirth cohortOldest old livingLife expectancyAge groupsHigher healthcare costsDisability-free life expectancySuccessive birth cohortsOldest-old individualsOctogenarian womenMultistate life tablesSubgroup analysisAge 80Healthcare costsRural residenceUrban-rural disparitiesOctogenariansCohortHealth inequalitiesPersonal assistanceDisability transitionsDisabilityNonagenariansSociodemographic heterogeneity
2024
Use of Hospice and End-of-Life Care Quality Among Medical Centers with High Versus Lower Specialist Palliative Care Reach Among People with Heart Failure: An Observational Study
Feder S, Han L, Zhan Y, Abel E, Akgün K, Fried T, Ersek M, Redeker N. Use of Hospice and End-of-Life Care Quality Among Medical Centers with High Versus Lower Specialist Palliative Care Reach Among People with Heart Failure: An Observational Study. Journal Of Palliative Medicine 2024 PMID: 39515377, DOI: 10.1089/jpm.2024.0182.Peer-Reviewed Original ResearchSpecialist palliative careVeterans Affairs Medical CenterEnd of lifeCare qualityInpatient hospiceEnd of life outcomesUse of hospiceInpatient hospice careMedical CenterMultilevel logistic regressionFamilies of patientsAffairs Medical CenterHospice carePalliative careRetrospective cohort studyAdvanced heart failureBlack adultsHospiceCohort studyFacility rateLogistic regressionStudy outcomesObservational studyCareHeart failureFactors Associated With Influenza Vaccination in a National Veteran Cohort
Chen A, Farmer M, Han L, Runels T, Bade B, Crothers K, Bastian L, Bazan I, Bean-Mayberry B, Brandt C, Akgün K. Factors Associated With Influenza Vaccination in a National Veteran Cohort. AJPM Focus 2024, 4: 100290. PMID: 39611140, PMCID: PMC11602634, DOI: 10.1016/j.focus.2024.100290.Peer-Reviewed Original ResearchOdds of vaccinationInfluenza vaccineFemale veteransAmerican Indian/Alaskan Native raceFactors associated with influenza vaccinationReceipt of influenza vaccinationDocumenting influenza vaccinationReduced oddsRetrospective cohort studyElectronic health record dataMale veteransHealth record dataAmbulatory care utilizationInfluenza seasonRuralMale sexWhite male veteransWhite veteransAssociated with raceCohort studyBlack veteransBlack raceEthnic groupsRacial disparitiesInfluenzaImpact of complementary health approaches on opioid prescriptions among veterans with musculoskeletal disorders – A retrospective cohort study
Han L, Goulet J, Skanderson M, Redd D, Brandt C, Zeng-Treitler Q. Impact of complementary health approaches on opioid prescriptions among veterans with musculoskeletal disorders – A retrospective cohort study. Journal Of Pain 2024, 26: 104695. PMID: 39384145, DOI: 10.1016/j.jpain.2024.104695.Peer-Reviewed Original ResearchIntegrative health approachesHealth approachOpioid prescriptionsMusculoskeletal disordersAdministration electronic health recordComplementary health approachesPrimary care visitsElectronic health recordsPharmacy dispensing recordsCIH approachesCare visitsDispensed opioid prescriptionsHealth recordsRetrospective cohort studyDispensing recordsPatient's painAnalytic sampleIndex diagnosisExposure groupCohort studyVeteransOpioid initiationQuasi-experimental investigationCIHPrescriptionAssociation Between Restricting Symptoms and Disability After Critical Illness Among Older Adults.
Jain S, Han L, Gahbauer E, Leo-Summers L, Feder S, Ferrante L, Gill T. Association Between Restricting Symptoms and Disability After Critical Illness Among Older Adults. Critical Care Medicine 2024, 52: 1816-1827. PMID: 39298623, DOI: 10.1097/ccm.0000000000006427.Peer-Reviewed Original ResearchActivities of daily livingAssociated with increased disabilityDaily livingOlder adultsRestricting symptomsInstrumental activities of daily livingCommunity-living older adultsICU hospitalizationMultivariable Poisson regression modelsCommunity-living adultsOlder ICU survivorsAge of participantsPoisson regression modelsSurvive critical illnessCritical illnessQuality of lifeInstrumental activitiesICU survivorsProspective longitudinal studyLength of stayPost-ICUIncreased disabilityMonthly interviewsICU length of stayPre-ICURisk of Serious Adverse Gastrointestinal Events with Potassium Binders in Hospitalized Patients: A National Study
Holleck J, Han L, Skanderson M, Bastian L, Gunderson C, Brandt C, Perkal M, Chang J, Akgün K. Risk of Serious Adverse Gastrointestinal Events with Potassium Binders in Hospitalized Patients: A National Study. Journal Of General Internal Medicine 2024, 1-7. PMID: 39103605, DOI: 10.1007/s11606-024-08979-1.Peer-Reviewed Original ResearchAdjusted odds ratiosSodium zirconium cyclosilicateU.S. Department of Veterans Affairs healthcare systemDepartment of Veterans Affairs healthcare systemVA Corporate Data WarehouseVeterans Affairs Healthcare SystemCorporate Data WarehousePotassium bindersHospitalized patientsGI eventsHealthcare systemOdds ratioAdverse GI eventsSodium polystyrene sulfonateNational studyPotassium-binding drugsComparative riskAdverse gastrointestinal eventsGI adverse eventsTreatment of hyperkalemiaZirconium cyclosilicateGastrointestinal eventsPatiromerAdverse eventsFunctional disability and receipt of informal care among Chinese adults living alone with cognitive impairment
Liu X, Li C, Jin S, Cao X, Hoogendijk E, Han L, Xu X, Allore H, Feng Q, Zhang Q, Liu Z. Functional disability and receipt of informal care among Chinese adults living alone with cognitive impairment. Experimental Gerontology 2024, 194: 112490. PMID: 38876449, DOI: 10.1016/j.exger.2024.112490.Peer-Reviewed Original ResearchActivities of daily livingBurden of functional disabilityInformal careFunctional disabilityActivities of daily living disabilityCognitive impairmentChinese adultsInstrumental Activities of Daily Living (IADLReceipt of informal careNormal cognitionLong-term care servicesIADL disabilityInstrumental activitiesMobility disabilityProvision of long-term care servicesChina HealthFunctional healthCare servicesDaily livingMatched comparatorsOdds ratioMonthly hoursVulnerable subpopulationsCareDisabilityLeveraging Electronic Health Records to Assess Residential Mobility Among Veterans in the Veterans Health Administration
Wang K, Hendrickson Z, Miller M, Abel E, Skanderson M, Erdos J, Womack J, Brandt C, Desai M, Han L. Leveraging Electronic Health Records to Assess Residential Mobility Among Veterans in the Veterans Health Administration. Medical Care 2024, 62: 458-463. PMID: 38848139, DOI: 10.1097/mlr.0000000000002017.Peer-Reviewed Original ResearchConceptsVeterans Health AdministrationElectronic health recordsResidential addressesHealth recordsHealth AdministrationLeveraging electronic health recordsInfluence health care utilizationVeterans Health Administration dataAssociations of sociodemographicsHealth care utilizationHealth care systemPatient's residential addressCross-sectional analysisGeneralized logistic regressionCare utilizationHealth systemResidential mobilitySubstance use disordersCare systemPatient's residenceLogistic regressionVeteransMultinomial outcomesHealthOddsVariation in Uptake of Specialist Palliative Care Among People with Advanced Heart Failure Across VA Medical Centers
Zhan Y, Han L, Abel E, Akgun K, Redeker N, Feder S. Variation in Uptake of Specialist Palliative Care Among People with Advanced Heart Failure Across VA Medical Centers. Journal Of Pain And Symptom Management 2024, 67: e551-e552. DOI: 10.1016/j.jpainsymman.2024.02.339.Peer-Reviewed Original ResearchSpecialist palliative careVA Medical CenterDepartment of Veterans AffairsPalliative careVeterans AffairsRandom intercept multilevel logistic regressionPalliative care deliveryDelivery characteristicsMedical CenterMultilevel logistic regressionCare deliveryICD-9/10 codesAdvanced heart failureRetrospective cohort studyHealth careModifiable factorsCareTeam staffingCohort studyHeart failureLogistic regressionImplementation effortsIdentified factorsICD-9/10Study findingsVariation in Specialist Palliative Care Reach and Associated Factors Among People With Advanced Heart Failure in the Department of Veterans Affairs
Feder S, Han L, Zhan Y, Abel E, Akgün K, Fried T, Ersek M, Redeker N. Variation in Specialist Palliative Care Reach and Associated Factors Among People With Advanced Heart Failure in the Department of Veterans Affairs. Journal Of Pain And Symptom Management 2024, 68: 22-31.e1. PMID: 38561132, PMCID: PMC11168897, DOI: 10.1016/j.jpainsymman.2024.03.022.Peer-Reviewed Original ResearchOutpatient specialist palliative careSpecialist palliative careVeterans Affairs Medical CenterPalliative careSpecialist palliative care consultationRandom intercept multilevel logistic regressionDepartment of Veterans AffairsMultilevel logistic regressionAffairs Medical CenterClinical practice guidelinesICD-9/10 codesAdvanced heart failureRetrospective cohort studyVeterans AffairsOutpatient palliativeOutpatient deliveryPractice guidelinesCohort studyLogistic regressionCardiology involvementDelivery characteristicsAssociated factorsMedical CenterIdentified factorsICD-9/10
2023
USING MULTI-LEVEL MODELING TO EXAMINE RACIAL DISPARITIES IN PALLIATIVE CARE AMONG OLDER ADULTS WITH HEART FAILURE
Han L, Abel E, Zhan Y, Akgün K, Feder S. USING MULTI-LEVEL MODELING TO EXAMINE RACIAL DISPARITIES IN PALLIATIVE CARE AMONG OLDER ADULTS WITH HEART FAILURE. Innovation In Aging 2023, 7: 1149-1150. PMCID: PMC10736640, DOI: 10.1093/geroni/igad104.3689.Peer-Reviewed Original ResearchAdvanced heart failureVeterans Affairs Medical CenterSpecialist palliative careHeart failureOlder adultsWhite raceGuideline-concordant careICD-9/10 codesService delivery characteristicsAHF cohortSPC servicesPalliative careBlack raceMedical CenterLogistic regressionSocioeconomic disparitiesFacility characteristicsRacial disparitiesPersistent disparitiesAdultsRandom interceptDelivery characteristicsConventional logistic regressionCareEquitable access