Featured Publications
Use 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
2022
Military sexual trauma and incident hypertension: a 16-year cohort study of young and middle-aged men and women
Gaffey AE, Rosman L, Sico JJ, Haskell SG, Brandt CA, Bathulapalli H, Han L, Dziura J, Skanderson M, Burg MM. Military sexual trauma and incident hypertension: a 16-year cohort study of young and middle-aged men and women. Journal Of Hypertension 2022, 40: 2307-2315. PMID: 35983872, DOI: 10.1097/hjh.0000000000003267.Peer-Reviewed Original ResearchConceptsIncident hypertensionRisk factorsPsychiatric disordersMultivariate Cox proportional hazards modelVeterans Health Administration dataGreater riskCox proportional hazards modelTrauma-related psychiatric disordersMiddle-aged veteransCardiovascular risk factorsBaseline blood pressureElevated cardiovascular riskLarge prospective cohortHealth Administration dataMiddle-aged menProportional hazards modelSex-specific analysesPosttraumatic stress disorderMilitary sexual traumaCardiovascular riskCohort studyProspective cohortBlood pressureTreatment attenuatesCardiovascular impactFactors 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 differenceHospitalRisk Factors Associated with Healthcare Utilization for Spine Pain
Higgins DM, Han L, Kerns RD, Driscoll MA, Heapy AA, Skanderson M, Lisi AJ, Mattocks KM, Brandt C, Haskell SG. Risk Factors Associated with Healthcare Utilization for Spine Pain. Pain Medicine 2022, 23: 1423-1433. PMID: 34999899, DOI: 10.1093/pm/pnab351.Peer-Reviewed Original ResearchConceptsSpine pain careSpine painHealthcare utilizationPain careRisk factorsPain episodesObservation periodNew episodesMultivariable logistic regression modelPotential risk factorsOutpatient visit dataLogistic regression analysisMental health conditionsBaseline observation periodLogistic regression modelsBaseline characteristicsOutpatient visitsClinical correlatesContinued careLower oddsPainVisit dataContinued episodesHealth conditionsCare
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 livingFactors 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
Functional trajectories before and after a new cancer diagnosis among community-dwelling older adults
Presley CJ, Han L, Leo-Summers L, Hurria A, Gross CP, Davidoff AJ, Allore HG, Gill TM. Functional trajectories before and after a new cancer diagnosis among community-dwelling older adults. Journal Of Geriatric Oncology 2018, 10: 60-67. PMID: 29937422, PMCID: PMC6526705, DOI: 10.1016/j.jgo.2018.05.017.Peer-Reviewed Original ResearchConceptsNew cancer diagnosesFunctional trajectoriesRisk factorsCancer diagnosisDistinct functional trajectoriesTotal disability scorePotential risk factorsGroup-based trajectory modelsParticipants 70Disability scoresOlder adultsMonthly assessmentsDiagnosisMobility activitiesIdentified participantsDisabilityParticipantsYears
2017
0755 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 association
2013
Risk Factors for Restricting Back Pain in Older Persons
Makris UE, Fraenkel L, Han L, Leo-Summers L, Gill TM. Risk Factors for Restricting Back Pain in Older Persons. Journal Of The American Medical Directors Association 2013, 15: 62-67. PMID: 24239445, PMCID: PMC3872215, DOI: 10.1016/j.jamda.2013.09.013.Peer-Reviewed Original ResearchConceptsPersistent/recurrentCandidate risk factorsRisk factorsBack painOlder personsFemale sexComprehensive home-based assessmentsMultivariable Cox modelProspective cohort studyMonthly telephone interviewsMore chronic conditionsWeak grip strengthHome-based assessmentHip weaknessCohort studyCumulative incidenceIncident episodesMultivariable analysisProspective studyGrip strengthChronic conditionsPainCox modelDepressive symptomsRestricted activity
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
2008
12-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
2006
The Temporal Relationship Between Depression Symptoms and Cognitive Functioning in Older Medical Patients—Prospective or Concurrent?
Han L, McCusker J, Abrahamowicz M, Cole M, Capek R. The Temporal Relationship Between Depression Symptoms and Cognitive Functioning in Older Medical Patients—Prospective or Concurrent? The Journals Of Gerontology Series A 2006, 61: 1319-1323. PMID: 17234828, DOI: 10.1093/gerona/61.12.1319.Peer-Reviewed Original ResearchConceptsMini-Mental State ExaminationHamilton Depression Rating ScaleHDRS scoresDepression symptomsCognitive impairmentInpatients 65 yearsIndependent risk factorTime pointsOlder medical patientsDepression Rating ScaleOld-age depressionLower MMSE scoresSame time pointsCognitive functioningSubsequent time pointsOne-point increaseTemporal relationshipCardiovascular riskMMSE changeIllness severityMedical patientsRisk factorsMMSE scoresDepressive symptomsEpidemiological studies
2004
Modifiable Risk Factors for Nursing Home-Acquired Pneumonia
Quagliarello V, Ginter S, Han L, Van Ness P, Allore H, Tinetti M. Modifiable Risk Factors for Nursing Home-Acquired Pneumonia. Clinical Infectious Diseases 2004, 40: 1-6. PMID: 15614684, DOI: 10.1086/426023.Peer-Reviewed Original ResearchConceptsModifiable risk factorsElderly nursing home residentsInadequate oral careNursing home residentsCox proportional hazards modelCases of pneumoniaRisk factorsProportional hazards modelOral careHome residentsSurveillance periodHazards modelCandidate modifiable risk factorNursing Home-Acquired PneumoniaPneumonia prevention strategiesRisk of pneumoniaPrimary outcomeSwallowing difficultiesIndependent associationAttributable fractionPneumoniaNursing homesPrevention strategiesElderly residentsSame covariates
2003
The Prognostic Significance of Subsyndromal Delirium in Elderly Medical Inpatients
Cole M, McCusker J, Dendukuri N, Han L. The Prognostic Significance of Subsyndromal Delirium in Elderly Medical Inpatients. Journal Of The American Geriatrics Society 2003, 51: 754-760. PMID: 12757560, DOI: 10.1046/j.1365-2389.2003.51255.x.Peer-Reviewed Original ResearchConceptsElderly medical inpatientsMedical inpatientsPrognostic significanceLonger acute care hospital staysAcute care hospital stayCore symptomsAcute care hospitalsPostdischarge mortalityRevised (DSM-III-R) criteriaHospital stayCohort studyCare hospitalRisk factorsSubsyndromal deliriumDementia statusImportant syndromeDeliriumPhysiological severityMore symptomsAdmissionMental disordersSymptomsPatientsFirst weekInpatients
2001
Environmental Risk Factors for Delirium in Hospitalized Older People
McCusker J, Cole M, Abrahamowicz M, Han L, Podoba J, Ramman‐Haddad L. Environmental Risk Factors for Delirium in Hospitalized Older People. Journal Of The American Geriatrics Society 2001, 49: 1327-1334. PMID: 11890491, DOI: 10.1046/j.1532-5415.2001.49260.x.Peer-Reviewed Original ResearchConceptsEnvironmental risk factorsRisk factorsPhysical restraintDelirium symptomsSeverity scoreHospital unitsObservational prospective clinical studyPrior cognitive impairmentSymptoms of deliriumConfusion Assessment MethodModifiable risk factorsGeneral community hospitalProspective clinical studyPatients age 65Potential environmental risk factorsSymptom severity scoresHospitalized older peopleDelirium severity scoresMedical wardsPatient characteristicsDelirium IndexIntensive careInitial severityCommunity hospitalClinical studies