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 lossNonfrailMonthsPersonsParticipantsPrefrailCriteriaPreventionAre 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
Leveraging 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 outcomesHealthOdds
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 ResearchConceptsNeighborhood-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 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 indexMonthsAntibiotic therapy is associated with adverse drug events among older adults with advanced cancer: A cohort study
Datta R, Han L, Doyle M, Allore H, Sanft T, Quagliarello V, Juthani-Mehta M. Antibiotic therapy is associated with adverse drug events among older adults with advanced cancer: A cohort study. Palliative Medicine 2023, 37: 793-798. PMID: 36999898, DOI: 10.1177/02692163231162889.Peer-Reviewed Original ResearchConceptsAdverse drug eventsAntibiotic therapyDrug eventsAdvanced cancerOlder adultsIndex admissionPalliative chemotherapyCohort studyTertiary care centerHospitalized older adultsPalliative care providersMultidrug-resistant organismsMean ageCommon tumorsCare centerCare providersRatio of daysSolid tumorsMultivariable testingPatientsTherapyStandardized criteriaCancerMean timeAdultsComplementary and Integrative Health Approaches and Pain Care Quality in the Veterans Health Administration Primary Care Setting: A Quasi-Experimental Analysis
Han L, Luther S, Finch D, Dobscha S, Skanderson M, Bathulapalli H, Fodeh S, Hahm B, Bouayad L, Lee A, Goulet J, Brandt C, Kerns R. Complementary and Integrative Health Approaches and Pain Care Quality in the Veterans Health Administration Primary Care Setting: A Quasi-Experimental Analysis. Journal Of Alternative And Complementary Medicine 2023, 29: 420-429. PMID: 36971840, PMCID: PMC10280173, DOI: 10.1089/jicm.2022.0686.Peer-Reviewed Original ResearchConceptsPain care qualityPrimary care settingCIH exposureIntegrative health approachesCare settingsPropensity scorePain managementCIH approachesPCQ scoresPrimary care clinic visitsHealth approachCare qualityInternational clinical guidelinesChronic pain managementPrimary care capacityDeclaration of AstanaVHA initiativesClinic visitsMusculoskeletal painBenefits patientsMassage therapyClinical guidelinesExposure groupCare capacityMusculoskeletal disordersDissemination and implementation of age‐friendly care and geriatric emergency department accreditation at Veterans Affairs hospitals
Hwang U, Runels T, Han L, Gruber E, McQuown C, Ragsdale L, Jetter E, Rossomano N, Javier D. Dissemination and implementation of age‐friendly care and geriatric emergency department accreditation at Veterans Affairs hospitals. Academic Emergency Medicine 2023, 30: 270-277. PMID: 36653961, DOI: 10.1111/acem.14665.Peer-Reviewed Original ResearchConceptsVA emergency departmentEmergency departmentOlder veteransED visitsVA Corporate Data WarehouseAge-friendly careIndex ED visitVeterans Affairs hospitalYears of ageCorporate Data WarehouseScreening prevalencePoor outcomeStandardization of practiceMean ageVisit encountersPotential confoundingEmergency careGreater oddsExtended careDemographic dataOlder adultsLevel 1Observational evaluationCarePandemic year
2022
Post-9/11 deployment history and the incidence of breast cancer among women veterans
Gaffey A, Han L, Ramsey C, Skanderson M, Dziura J, Driscoll M, Burg M, Brandt C, Bastian L, Haskell S. Post-9/11 deployment history and the incidence of breast cancer among women veterans. Annals Of Epidemiology 2022, 77: 98-102. PMID: 36470323, DOI: 10.1016/j.annepidem.2022.11.010.Peer-Reviewed Original ResearchConceptsOEF/OIF deploymentBreast cancerWomen veteransHealthcare utilizationHormone replacement therapy useRetrospective cohort studyVeterans Affairs (VA) careHealthy soldier effectOEF/OIFCohort studyTherapy useBC incidenceHormonal contraceptivesLifestyle factorsPrimary careBC diagnosisLower incidenceOperations Enduring Freedom/Iraqi FreedomWomenIncidenceGreater likelihoodIraqi FreedomVeteransCancerCareCharacteristics Associated with Spirometry Guideline Adherence in VA Patients Hospitalized with Chronic Obstructive Pulmonary Disease
Rodwin BA, DeRycke EC, Han L, Bade BC, Brandt CA, Bastian LA, Akgün KM. Characteristics Associated with Spirometry Guideline Adherence in VA Patients Hospitalized with Chronic Obstructive Pulmonary Disease. Journal Of General Internal Medicine 2022, 38: 619-626. PMID: 36241942, PMCID: PMC9971396, DOI: 10.1007/s11606-022-07826-5.Peer-Reviewed Original ResearchConceptsChronic obstructive pulmonary diseaseHigh-risk COPD patientsObstructive pulmonary diseaseAnnual spirometryCOPD patientsClinic visitsPulmonary diseaseChronic obstructive lung diseaseVeterans Health Administration facilitiesPost-hospitalization careGuideline-concordant careObstructive lung diseaseYear of hospitalizationCorporate Data WarehouseProvider-level dataPulmonary clinicGuideline adherencePatient demographicsConcordant careCOPD hospitalizationsPrimary outcomeVA patientsLung diseaseProvider variablesProvider ageMental Health Diagnoses are Not Associated With Indicators of Lower Quality Pain Care in Electronic Health Records of a National Sample of Veterans Treated in Veterans Health Administration Primary Care Settings
Dobscha SK, Luther SL, Kerns RD, Finch DK, Goulet JL, Brandt CA, Skanderson M, Bathulapalli H, Fodeh SJ, Hahm B, Bouayad L, Lee A, Han L. Mental Health Diagnoses are Not Associated With Indicators of Lower Quality Pain Care in Electronic Health Records of a National Sample of Veterans Treated in Veterans Health Administration Primary Care Settings. Journal Of Pain 2022, 24: 273-281. PMID: 36167230, PMCID: PMC9898089, DOI: 10.1016/j.jpain.2022.08.009.Peer-Reviewed Original ResearchConceptsPain care qualityQuality pain careMental health conditionsPrimary care cliniciansVeterans Health AdministrationPain carePCQ scoresHealth conditionsCare cliniciansUse disordersCare qualitySevere musculoskeletal painRetrospective cohort studyPrimary care visitsGeneral medical carePrimary care settingElectronic health record dataFinal adjusted modelMental health diagnosesEquation Poisson modelsHealth record dataBipolar disorder diagnosisSubstance use disordersAlcohol use disorderPost-traumatic stress disorderMilitary 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