Featured Publications
Cognitive 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 livingHospitalizationAre 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 ResearchMeSH KeywordsAged, 80 and overAsian PeopleChinaCohort StudiesDisability EvaluationDisabled PersonsFemaleHealth Status DisparitiesHumansLife ExpectancyLongevityMaleConceptsPartial 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
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 scores
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 activitiesHospitalizationRisk 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 participantsDisabilityParticipantsYearsPrognostic 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 studyDiabetes, Heart Disease, and Dementia: National Estimates of Functional Disability Trajectories
Vroomen J, Han L, Monin JK, Lipska KJ, Allore HG. Diabetes, Heart Disease, and Dementia: National Estimates of Functional Disability Trajectories. Journal Of The American Geriatrics Society 2018, 66: 766-772. PMID: 29521414, PMCID: PMC5906138, DOI: 10.1111/jgs.15284.Peer-Reviewed Original ResearchConceptsHeart diseaseDisability trajectoriesPossible dementiaNational estimatesChronic conditionsGreater oddsPhysician-diagnosed chronic conditionsCognitive statusCommunity-dwelling Medicare beneficiariesMultiple chronic conditionsAging Trends StudyComplex survey designGroup-based trajectory modelingADL disabilityNational HealthProbable dementiaDaily livingMultinomial logistic regressionMedicare beneficiariesDiabetesStudy attritionConcurrent conditionsDementiaSociodemographic characteristicsSevere disabilityDisability Prior to Death Among the Oldest-Old in China
Liu Z, Han L, Wang X, Feng Q, Gill TM. Disability Prior to Death Among the Oldest-Old in China. The Journals Of Gerontology Series A 2018, 73: 1701-1707. PMID: 29408957, PMCID: PMC6230206, DOI: 10.1093/gerona/gly010.Peer-Reviewed Original Research
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 weaknessRestricting Back Pain and Subsequent Disability in Activities of Daily Living Among Community-Living Older Adults
Makris UE, Weinreich MA, Fraenkel L, Han L, Leo-Summers L, Gill TM. Restricting Back Pain and Subsequent Disability in Activities of Daily Living Among Community-Living Older Adults. Journal Of Aging And Health 2017, 30: 1482-1494. PMID: 28863724, PMCID: PMC5832514, DOI: 10.1177/0898264317721555.Peer-Reviewed Original ResearchMeSH KeywordsActivities of Daily LivingAgedAged, 80 and overBack PainCohort StudiesDisability EvaluationFemaleHumansIndependent LivingMaleConceptsCommunity-living older adultsBack painSubsequent disabilityIADL disabilityOlder adultsDaily livingProspective cohort studyCohort studyHazard ratioInstrumental activitiesPainCox modelSubsequent burdenTime-varying covariatesMonthly interviewsStrong associationDisabilityAdultsEADLAssociationIADLLivingActivityMonthsThe 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
The 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 needsAdmissionA Longitudinal, Observational Study with Many Repeated Measures Demonstrated Improved Precision of Individual Survival Curves Using Bayesian Joint Modeling of Disability and Survival
Murphy TE, Allore HG, Han L, Peduzzi PN, Gill TM, Xu X, Lin H. A Longitudinal, Observational Study with Many Repeated Measures Demonstrated Improved Precision of Individual Survival Curves Using Bayesian Joint Modeling of Disability and Survival. Experimental Aging Research 2015, 41: 221-239. PMID: 25978444, PMCID: PMC4452025, DOI: 10.1080/0361073x.2015.1021640.Peer-Reviewed Original Research
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 consequencesExposureRestActivityIllnessYearsRestricting Back Pain and Subsequent Mobility Disability in Community‐Living Older Persons
Makris UE, Fraenkel L, Han L, Leo‐Summers L, Gill TM. Restricting Back Pain and Subsequent Mobility Disability in Community‐Living Older Persons. Journal Of The American Geriatrics Society 2014, 62: 2142-2147. PMID: 25366926, PMCID: PMC4241131, DOI: 10.1111/jgs.13089.Peer-Reviewed Original ResearchConceptsBaseline mobility disabilityBack painMobility disabilityOlder personsCommunity-living older personsPersistent mobility disabilityProspective cohort studyCox regression analysisMonthly telephone interviewsCommunity-living menDisability episodeCohort studyPainCox modelSecondary analysisEvent ratesTelephone interviewsMonthsDisabilityConsecutive monthsRegression analysisAssociationNew HavenPersonsParticipants
2013
Dynamics of functional aging based on latent-class trajectories of activities of daily living
Han L, Allore H, Murphy T, Gill T, Peduzzi P, Lin H. Dynamics of functional aging based on latent-class trajectories of activities of daily living. Annals Of Epidemiology 2013, 23: 87-92. PMID: 23305692, PMCID: PMC3558979, DOI: 10.1016/j.annepidem.2012.11.010.Peer-Reviewed Original ResearchConceptsDaily livingFunctional agingCommunity-living adultsEquation Poisson modelsMost older adultsADL disabilityHigher disabilityPersistent disabilitySubstantial morbidityInstrumental ADLADL independenceDisability trajectoriesLatent class trajectoriesCumulative burdenRestricted activityLow burdenSevere disabilityMorbidityPredominant trajectoriesOlder adultsDisabilityTime trendsFunctional autonomyADLGrowth mixture modelsComparisons Between Older Men and Women in the Trajectory and Burden of Disability Over the Course of Nearly 14 Years
Gill TM, Gahbauer EA, Lin H, Han L, Allore HG. Comparisons Between Older Men and Women in the Trajectory and Burden of Disability Over the Course of Nearly 14 Years. Journal Of The American Medical Directors Association 2013, 14: 280-286. PMID: 23294968, PMCID: PMC3615123, DOI: 10.1016/j.jamda.2012.11.011.Peer-Reviewed Original ResearchConceptsBurden of disabilityOlder menModerate disabilityGender differencesWorse disabilityDisability trajectoriesClinical covariatesDaily livingOlder womenBaseline levelsHigh mortalityGreater burdenSevere disabilityMonthly interviewsLife course approachWomenMild disabilityDisabilityBasic activitiesLongitudinal studyMenMobility activitiesHigh rateHigher initial levelsBurden
2010
Treatment of Death in the Analysis of Longitudinal Studies of Gerontological Outcomes
Murphy TE, Han L, Allore HG, Peduzzi PN, Gill TM, Lin H. Treatment of Death in the Analysis of Longitudinal Studies of Gerontological Outcomes. The Journals Of Gerontology Series A 2010, 66A: 109-114. PMID: 21030467, PMCID: PMC3011957, DOI: 10.1093/gerona/glq188.Peer-Reviewed Original ResearchMeSH KeywordsActivities of Daily LivingAgedDeathDisability EvaluationGeriatricsHumansLongitudinal StudiesProportional Hazards ModelsConceptsFunctional disabilityOlder study populationStudy populationLongitudinal studyOlder personsCommunity-living older personsHealthy survivor effectLongitudinal outcomesSurvivor effectFunctional abilityDeathOutcomesDisabilityLongitudinal modelingTreatmentInformative censoringNoninformative censoringRapid declineStrong relationshipCohortPopulationPersonsStudySurvivorsDecedents