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 differenceHospital
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 livingDisability 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
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 weaknessEmergency 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
2014
Restricting 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
2011
Epidemiology of Restricting Back Pain in Community‐Living Older Persons
Makris UE, Fraenkel L, Han L, Leo‐Summers L, Gill TM. Epidemiology of Restricting Back Pain in Community‐Living Older Persons. Journal Of The American Geriatrics Society 2011, 59: 610-614. PMID: 21410444, PMCID: PMC3098613, DOI: 10.1111/j.1532-5415.2011.03329.x.Peer-Reviewed Original ResearchConceptsCommunity-living older personsCumulative incidenceBack painIncidence rateOlder personsFirst episodeBaseline age groupProspective cohort studyKaplan-Meier methodCommunity-living menPoisson regression modelsCohort studyMedian durationMedian timeDescriptive epidemiologyTotal episodesOlder womenPainOlder menAge groupsRestricted activityIncidenceWomenMenConsecutive months
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 ResearchConceptsFunctional disabilityOlder study populationStudy populationLongitudinal studyOlder personsCommunity-living older personsHealthy survivor effectLongitudinal outcomesSurvivor effectFunctional abilityDeathOutcomesDisabilityLongitudinal modelingTreatmentInformative censoringNoninformative censoringRapid declineStrong relationshipCohortPopulationPersonsStudySurvivorsDecedents
2007
Predisposing Factors and Precipitants for Bathing Disability in Older Persons
Gill TM, Han L, Allore HG. Predisposing Factors and Precipitants for Bathing Disability in Older Persons. Journal Of The American Geriatrics Society 2007, 55: 534-540. PMID: 17397431, DOI: 10.1111/j.1532-5415.2007.01099.x.Peer-Reviewed Original ResearchConceptsBathing disabilityPersistent disabilityPredisposing factorsPotential precipitantsComprehensive home-based assessmentsOlder personsCommunity-living older personsCommunity-living residentsMultivariable hazard ratiosProspective cohort studyLow physical activityMonthly telephone interviewsPotential predisposing factorsHome-based assessmentCohort studyHazard ratioPhysical activityRestricted activityTelephone interviewsStrong associationDisabilityHospitalizationInjuryIllnessSuitable target
2006
Bathing Disability and the Risk of Long-Term Admission to a Nursing Home
Gill TM, Allore HG, Han L. Bathing Disability and the Risk of Long-Term Admission to a Nursing Home. The Journals Of Gerontology Series A 2006, 61: 821-825. PMID: 16912099, DOI: 10.1093/gerona/61.8.821.Peer-Reviewed Original ResearchConceptsLong-term nursing home admissionNursing home admissionHome admissionPersistent disabilityLong-term admissionBathing disabilityPotential confoundersDaily livingCommunity-living older personsCommunity-living personsMonthly telephone interviewsPrevalence of disabilityProportional hazards modelShort-term admissionsLong-term care servicesAdmission increasesProspective studyHazards modelNursing homesAdmissionCare servicesOlder personsTelephone interviewsDisabilityConfounders