Featured Publications
Are 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
Functional disability and receipt of informal care among Chinese adults living alone with cognitive impairment
Liu X, Li C, Jin S, Cao X, Hoogendijk E, Han L, Xu X, Allore H, Feng Q, Zhang Q, Liu Z. Functional disability and receipt of informal care among Chinese adults living alone with cognitive impairment. Experimental Gerontology 2024, 194: 112490. PMID: 38876449, DOI: 10.1016/j.exger.2024.112490.Peer-Reviewed Original ResearchActivities of daily livingBurden of functional disabilityInformal careFunctional disabilityActivities of daily living disabilityCognitive impairmentChinese adultsInstrumental Activities of Daily Living (IADLReceipt of informal careNormal cognitionLong-term care servicesIADL disabilityInstrumental activitiesMobility disabilityProvision of long-term care servicesChina HealthFunctional healthCare servicesDaily livingMatched comparatorsOdds ratioMonthly hoursVulnerable subpopulationsCareDisability
2023
A Joint Model for Disability, Self-Rated Health, and Mortality Among Medicare Beneficiaries—Differences by Chronic Disease and Race/Ethnicity
Quiñones A, McAvay G, Vander Wyk B, Han L, Nagel C, Allore H. A Joint Model for Disability, Self-Rated Health, and Mortality Among Medicare Beneficiaries—Differences by Chronic Disease and Race/Ethnicity. Journal Of Aging And Health 2023, 36: 642-653. PMID: 37879084, PMCID: PMC11446605, DOI: 10.1177/08982643231210027.Peer-Reviewed Original ResearchPoor self-rated healthSelf-rated healthHigher oddsADL disabilityHip fractureAging Trends Study dataOlder adultsConcurrent riskPatient-centered outcomesLongitudinal logistic regression modelsLogistic regression modelsRace/ethnicityKidney diseaseChronic diseasesNational HealthDaily livingMortalityHealth declineOddsDisabilityHispanic respondentsDementiaDiseaseRiskWide variabilityRelationship 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 effectsOutcomesPersonsMultimorbidityAdmission
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
Factors 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 participantsDisabilityParticipantsYearsDisability 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
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 HavenRestricting 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 ResearchConceptsCommunity-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
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 ResearchConceptsFunctional disabilityOlder study populationStudy populationLongitudinal studyOlder personsCommunity-living older personsHealthy survivor effectLongitudinal outcomesSurvivor effectFunctional abilityDeathOutcomesDisabilityLongitudinal modelingTreatmentInformative censoringNoninformative censoringRapid declineStrong relationshipCohortPopulationPersonsStudySurvivorsDecedentsTrajectories of Disability in the Last Year of Life
Gill TM, Gahbauer EA, Han L, Allore HG. Trajectories of Disability in the Last Year of Life. New England Journal Of Medicine 2010, 362: 1173-1180. PMID: 20357280, PMCID: PMC2877372, DOI: 10.1056/nejmoa0909087.Peer-Reviewed Original ResearchConceptsCourse of disabilityDisability trajectoriesOrgan failureAdvanced dementiaSudden deathOlder personsSevere disabilityCommunity-dwelling older personsTrajectories of disabilityLevel of disabilityCatastrophic disabilityEnd of lifeProgressive disabilityFunctional statusDeath certificatesCommon conditionBaseline assessmentPredominant trajectoriesMonthly interviewsDeathDisabilityLongitudinal studyDementiaFrailtyDecedents
2008
Functional Trajectories in Older Persons Admitted to a Nursing Home with Disability After an Acute Hospitalization
Gill TM, Gahbauer EA, Han L, Allore HG. Functional Trajectories in Older Persons Admitted to a Nursing Home with Disability After an Acute Hospitalization. Journal Of The American Geriatrics Society 2008, 57: 195-201. PMID: 19170778, PMCID: PMC2676348, DOI: 10.1111/j.1532-5415.2008.02107.x.Peer-Reviewed Original ResearchConceptsNursing home admissionAcute hospitalizationNursing homesOlder personsHome admissionFunctional trajectoriesFirst nursing home admissionProspective cohort studyCommunity-living personsMonthly telephone interviewsContinuous disabilityCohort studyMedian timePoor outcomeHospitalizationDaily livingPremorbid levelTelephone interviewsAdmissionDisabilityMonthsAdditional researchParticipantsAnalytical sampleNew Haven
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