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 differenceHospitalSelf-reported and actigraphic short sleep duration in older adults.
Miner B, Stone KL, Zeitzer JM, Han L, Doyle M, Blackwell T, Gill TM, Redeker NS, Hajduk A, Yaggi H. Self-reported and actigraphic short sleep duration in older adults. Journal Of Clinical Sleep Medicine 2022, 18: 403-413. PMID: 34338629, PMCID: PMC8804982, DOI: 10.5664/jcsm.9584.Peer-Reviewed Original ResearchConceptsShort sleep durationSelf-reported sleep durationSleep durationOsteoporotic fracturesAdverse outcomesOlder personsOlder adultsMen Sleep StudyNormal sleep durationActigraphic sleep durationDaytime sleepinessMultivariable modelShort sleepSleep studiesUnnecessary interventionsSymptom awarenessAverage ageHealth outcomesAge groupsLogistic regressionFalse negativesWomenObesityOutcomesMen
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 ratioHospitalizationSurgeryInjuryVisits0855 Primary Sleep Disorders And The Combined Outcome Of Poor Sleep Quality With Objective Short Sleep Duration In Older Persons
Miner B, Fragoso C, Han L, Stone K, Redeker N, Yaggi H. 0855 Primary Sleep Disorders And The Combined Outcome Of Poor Sleep Quality With Objective Short Sleep Duration In Older Persons. Sleep 2020, 43: a325-a326. DOI: 10.1093/sleep/zsaa056.851.Peer-Reviewed Original ResearchPrimary sleep disordersShort sleep durationPoor sleep qualityHigh-risk phenotypeSleep disordersSleep qualityOlder personsOsteoporotic fracturesMultivariable modelUnadjusted modelsSleep durationClaude D. Pepper Older Americans Independence CenterCombined outcomeObjective short sleep durationPittsburgh Sleep Quality Index scoreSelf-reported chronic conditionsMultivariate logistic regression modelAverage total sleep timeMen Sleep StudyCross-sectional associationsTotal sleep timeQuality Index scoresLogistic regression modelsMedication usePsychiatric comorbidityCohort 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 StatementsConceptsPrecipitating 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 investigatorsDisability 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
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 daysDeathDecedentsDaysMonthsAgeSex
2017
Distressing Symptoms, Disability, and Hospice Services at the End of Life: Prospective Cohort Study
Gill TM, Han L, Leo‐Summers L, Gahbauer EA, Allore HG. Distressing Symptoms, Disability, and Hospice Services at the End of Life: Prospective Cohort Study. Journal Of The American Geriatrics Society 2017, 66: 41-47. PMID: 28895118, PMCID: PMC5777867, DOI: 10.1111/jgs.15041.Peer-Reviewed Original ResearchConceptsProspective cohort studyEnd of lifeHospice admissionCohort studyDistressing symptomsHospice servicesMonths of lifeNumber of disabilitiesMedian durationSubsequent admissionHigh burdenMedicare claimsAdditional disabilitiesAdmissionAdditional monthsSymptomsOlder personsHospiceMonthly interviewsMonthsDisabilityShort durationAdditional strategiesDurationNew HavenThe 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 groups0755 LONGITUDINAL ASSOCIATIONS OF RISK FACTORS WITH INSOMNIA SEVERITY IN OLDER PERSONS
Miner B, Redeker N, Yaggi H, Van Ness P, Han L, Gill T, Fragoso C. 0755 LONGITUDINAL ASSOCIATIONS OF RISK FACTORS WITH INSOMNIA SEVERITY IN OLDER PERSONS. Sleep 2017, 40: a280-a280. DOI: 10.1093/sleepj/zsx050.754.Peer-Reviewed Original ResearchPrimary sleep disordersCommunity-dwelling personsMean ISI scorePrecipitating Events ProjectRisk factorsInsomnia severityRace/ethnicityMedication useSmoking statusCardiorespiratory diseaseFemale sexSleep disordersISI scoresDepressive symptomsCognitive impairmentOlder personsLongitudinal associationsNumber of medicationsInsomnia Severity IndexCardiorespiratory conditionsInsomnia managementTherapeutic priorityNeuropsychologic impairmentSociodemographic factorsSignificant associationEmergency 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
2016
Dyspnea in Community‐Dwelling Older Persons: A Multifactorial Geriatric Health Condition
Miner B, Tinetti ME, Van Ness PH, Han L, Leo‐Summers L, Newman AB, Lee PJ, Fragoso C. Dyspnea in Community‐Dwelling Older Persons: A Multifactorial Geriatric Health Condition. Journal Of The American Geriatrics Society 2016, 64: 2042-2050. PMID: 27549914, PMCID: PMC5073004, DOI: 10.1111/jgs.14290.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overAnkle Brachial IndexBody Mass IndexCausalityComorbidityCross-Sectional StudiesDyspneaEchocardiographyElectric ImpedanceFemaleGeriatric AssessmentHumansIndependent LivingMaleMental CompetencyRespiratory Function TestsRisk FactorsSeverity of Illness IndexStatistics as TopicUnited StatesConceptsBody mass indexSevere dyspneaOlder personsChair standCommunity-dwelling older personsMultivariable logistic regression modelHealth conditionsWhole body muscle massMini-Mental State ExaminationAnkle-brachial indexEpidemiologic Studies Depression ScaleRespiratory muscle weaknessMaximal inspiratory pressureVentricular ejection fractionCardiovascular Health StudyCommunity-dwelling personsDiastolic cardiac dysfunctionLogistic regression modelsGrip weaknessSerum hemoglobinBlood pressureDyspnea severityEjection fractionMedication useCardiac dysfunction
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 persons
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