Featured Publications
Cumulative 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 ResearchMeSH KeywordsActivities of Daily LivingAgedCholinergic AntagonistsHumansMaleMemory DisordersProspective StudiesConceptsTotal 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 functionTransitions 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 ResearchMeSH KeywordsAgedAged, 80 and overFemaleFrail ElderlyGeriatricsHumansMaleProspective StudiesSeverity of Illness IndexTime FactorsConceptsFrailty stateOlder personsCommunity-living older personsCommunity-living personsLow physical activitySlow walking speedFrailty transitionsMuscle weaknessProspective studyGreater frailtyNatural courseLess frailtyPhysical activityDaily livingFrailtyWalking speedsWeight lossNonfrailMonthsPersonsParticipantsPrefrailCriteriaPrevention
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 monthMonthsRelationship 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
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 impact
2021
Association Between Potentially Inappropriate Medications and 30-Day Post–Hospital Discharge Outcomes in US Veterans
Allore HG, Gnjidic D, Skanderson M, Han L. Association Between Potentially Inappropriate Medications and 30-Day Post–Hospital Discharge Outcomes in US Veterans. Annals Of Pharmacotherapy 2021, 56: 256-263. PMID: 34282638, PMCID: PMC8770754, DOI: 10.1177/10600280211032072.Peer-Reviewed Original ResearchMeSH KeywordsAgedHospitalsHumansInappropriate PrescribingPatient DischargePotentially Inappropriate Medication ListProspective StudiesVeteransConceptsAdjusted hazard ratioRisk of mortalityHospital dischargeMean ageAcute care hospital readmissionPrimary care clinic visitsCohort's mean agePrevalence of PIMsInappropriate medication useRisk of readmissionHospital discharge outcomesEmergency room visitsHealth care utilizationAdverse drug eventsCentral nervous systemCause mortalityInappropriate medicationsPIM useClinic visitsHazard ratioProspective cohortDischarge outcomesHospital readmissionMedication useOlder inpatientsFunctional Disability Among Older Versus Younger Adults With Advanced Non–Small-Cell Lung Cancer
Presley CJ, Arrato NA, Janse S, Shields PG, Carbone DP, Wong ML, Han L, Gill TM, Allore HG, Andersen BL. Functional Disability Among Older Versus Younger Adults With Advanced Non–Small-Cell Lung Cancer. JCO Oncology Practice 2021, 17: e848-e858. PMID: 33939536, PMCID: PMC8258136, DOI: 10.1200/op.20.01004.Peer-Reviewed Original ResearchMeSH KeywordsAdultAnxietyAnxiety DisordersCarcinoma, Non-Small-Cell LungHumansLung NeoplasmsMaleMiddle AgedProspective StudiesConceptsBaseline disabilityFunctional disabilityAdvanced NSCLCBrain metastasesLung cancerHigher oddsUsual activitiesDepressive symptomsEastern Cooperative Oncology Group performance statusAdvanced non-small cell lung cancerNon-small cell lung cancerDisability groupsECOG PS 0Poor ECOG PSCell lung cancerFunctional status scoresECOG PSPatient characteristicsPerformance statusProspective cohortPS 0Systemic treatmentEuroQol-5DPsychologic symptomsDisease characteristicsFunctional 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 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 livingCohort 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 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 monthIllnessFactors 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
2019
Dietary Fat Intake and Cognitive Function among Older Populations: A Systematic Review and Meta-Analysis
Cao G, Li M, Han L, Tayie F, Yao S, Huang Z, Ai P, Liu Y, Hu Y, Xu B. Dietary Fat Intake and Cognitive Function among Older Populations: A Systematic Review and Meta-Analysis. The Journal Of Prevention Of Alzheimer's Disease 2019, 6: 204-211. PMID: 31062836, DOI: 10.14283/jpad.2019.9.Peer-Reviewed Original ResearchMeSH KeywordsAge FactorsCognitionCognitive DysfunctionCohort StudiesDietary FatsHumansProspective StudiesRisk FactorsConceptsDietary fat intakeUnsaturated fat intakeProspective cohort studyFat intakeCognitive impairmentMild cognitive impairmentAlzheimer's diseaseCognitive functionCohort studyRelative riskFat consumptionCognitive outcomesConfidence intervalsRandom-effects modelPercentage of energyResultsNine studiesConclusionThis studySystematic reviewMeta-AnalysisDetrimental associationOlder populationIntakeOlder adultsIncident outcomesImpairment
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
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 groups
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