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
2023
Antibiotic 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 timeAdults
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
Sex Differences in Use of a Clinical Complexity Measure to Predict Primary Care Utilization
Haskell SG, Han L, Abel EA, Bastian L, Driscoll M, Dziura J, Burg MM, Skanderson M, Brandt CA. Sex Differences in Use of a Clinical Complexity Measure to Predict Primary Care Utilization. Journal Of Women's Health 2021, 31: 71-78. PMID: 34388023, DOI: 10.1089/jwh.2021.0103.Peer-Reviewed Original ResearchConceptsPrimary care utilizationCare utilizationWomen veteransCare Assessment Need (CAN) scoreComplex high-risk patientsHigh-risk patientsRisk stratification toolPotential confounding factorsCorporate Data WarehouseSex differencesVA careVisit utilizationCare coordinationHigher oddsReproductive healthConfounding factorsVeterans AffairsPsychosocial variablesStrong associationQuintileWomenNeed scoresMenVeteransGood predictive accuracy
2020
Impact of Anticholinergic Burden on Cognitive Performance: A Cohort Study of Community-Dwelling Older Adults
Nishtala PS, Allore H, Han L, Jamieson HA, Hilmer SN, Chyou TY. Impact of Anticholinergic Burden on Cognitive Performance: A Cohort Study of Community-Dwelling Older Adults. Journal Of The American Medical Directors Association 2020, 21: 1357-1358.e3. PMID: 32402780, PMCID: PMC7971451, DOI: 10.1016/j.jamda.2020.03.027.Peer-Reviewed Original Research
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 outcomesImpairmentAntimicrobial therapy for asymptomatic bacteriuria or candiduria in advanced cancer patients transitioning to comfort measures
Datta R, Wang T, Zhu M, Dembry LM, Han L, Allore H, Quagliarello V, Juthani-Mehta M. Antimicrobial therapy for asymptomatic bacteriuria or candiduria in advanced cancer patients transitioning to comfort measures. Infection Control And Hospital Epidemiology 2019, 40: 470-472. PMID: 30821230, PMCID: PMC6482377, DOI: 10.1017/ice.2019.22.Peer-Reviewed Original ResearchConceptsUrinary tract infectionIncidence rate ratiosAdvanced cancer patientsAsymptomatic bacteriuriaCancer patientsAntimicrobial therapySymptomatic urinary tract infectionPotential urinary tract infectionTract infectionsInappropriate therapyAntimicrobial daysComfort measuresBacteriuriaCandiduriaCFU/mLPatientsTherapyRate ratioMLInfection
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 ResearchMeSH KeywordsAgedAged, 80 and overAgingCohort StudiesDeathFemaleHumansIndependent LivingMaleRetrospective StudiesTerminal CareConceptsCommunity-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 daysDeathDecedentsDaysMonthsAgeSexDisability 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 ResearchConceptsCommunity-living older adultsBack painSubsequent disabilityIADL disabilityOlder adultsDaily livingProspective cohort studyCohort studyHazard ratioInstrumental activitiesPainCox modelSubsequent burdenTime-varying covariatesMonthly interviewsStrong associationDisabilityAdultsEADLAssociationIADLLivingActivityMonths
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 needsAdmission
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 HavenPersonsParticipantsAnti-Hypertensive Medications and Cardiovascular Events in Older Adults with Multiple Chronic Conditions
Tinetti ME, Han L, McAvay GJ, Lee DS, Peduzzi P, Dodson JA, Gross CP, Zhou B, Lin H. Anti-Hypertensive Medications and Cardiovascular Events in Older Adults with Multiple Chronic Conditions. PLOS ONE 2014, 9: e90733. PMID: 24614535, PMCID: PMC3948696, DOI: 10.1371/journal.pone.0090733.Peer-Reviewed Original ResearchConceptsMultiple chronic conditionsAnti-hypertensive treatmentCardiovascular eventsAnti-hypertensive medicationsHigh-intensity groupChronic conditionsOlder adultsHazard ratioPropensity scoreIntensity groupStandardized daily doseCommunity-living participantsPropensity score adjustmentCV eventsMedication intensityLess comorbidityDaily doseRandomized trialsMAIN OUTCOMERepresentative cohortScore adjustmentSurvey cohortRCT resultsCohortMortalityEffect of &bgr;-Blockers on Cardiac and Pulmonary Events and Death in Older Adults With Cardiovascular Disease and Chronic Obstructive Pulmonary Disease
Lee DS, Markwardt S, McAvay GJ, Gross CP, Goeres LM, Han L, Peduzzi P, Lin H, Dodson JA, Tinetti ME. Effect of &bgr;-Blockers on Cardiac and Pulmonary Events and Death in Older Adults With Cardiovascular Disease and Chronic Obstructive Pulmonary Disease. Medical Care 2014, 52: s45-s51. PMID: 24561758, PMCID: PMC4050644, DOI: 10.1097/mlr.0000000000000035.Peer-Reviewed Original ResearchConceptsChronic obstructive pulmonary diseaseΒ-blocker useMajor cardiac eventsObstructive pulmonary diseasePulmonary eventsCardiovascular diseaseCardiac eventsOlder adultsPulmonary diseaseΒ-blockersCOPD/asthmaMajor pulmonary eventsCox proportional hazardsPulmonary outcomesCause mortalityHazard ratioStudy criteriaMedicare beneficiariesProportional hazardsSurvey cohortDiseaseAdultsMedicationsOutcomesDeath
2013
Cardiovascular Disease and Hip Fracture among Older Inpatients in Beijing, China
Xu B, Han L, Liu H, Wang J, Bao XY, Xi HX, Zhao L, Yu GP. Cardiovascular Disease and Hip Fracture among Older Inpatients in Beijing, China. BioMed Research International 2013, 2013: 493696. PMID: 23936809, PMCID: PMC3713359, DOI: 10.1155/2013/493696.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overCardiovascular DiseasesChinaCohort StudiesFemaleHip FracturesHumansMaleMiddle AgedRisk FactorsConceptsHip fractureICD-10 codesCardiovascular diseaseHypertensive diseaseOlder inpatientsCerebrovascular diseaseHospitalization summary reportsOverall cardiovascular diseaseHip fracture patientsDiagnosis of CVDOccurrence rateChinese inpatientsFracture patientsCohort studyTertiary hospitalInpatientsDiseaseAssociationFracturesEuropean populationsComorbiditiesPatientsHospitalYearsDiagnosis
2011
Antidepressant Use and Cognitive Functioning in Older Medical Patients With Major or Minor Depression
Han L, McCusker J, Cole M, apek R, Abrahamowicz M. Antidepressant Use and Cognitive Functioning in Older Medical Patients With Major or Minor Depression. Journal Of Clinical Psychopharmacology 2011, 31: 429-435. PMID: 21694621, PMCID: PMC3558972, DOI: 10.1097/jcp.0b013e318221b2f8.Peer-Reviewed Original ResearchConceptsOlder medical patientsAntidepressant useMinor depressionMedical patientsAntidepressant medicationMini-Mental State Examination scoreHamilton Depression Rating ScaleMini-Mental State ExaminationProvincial prescription databasePsychotropic drug useDepression Rating ScaleAcute care hospitalsState Examination scoreComplex medical conditionsLong-term cognitive effectsSignificant cognitive impairmentSmall cognitive improvementsAntidepressant prescriptionsCare hospitalConcomitant benzodiazepinesMedical inpatientsPrescription databaseAntidepressant agentsDepression diagnosisMajor depression
2009
Factors Associated With Recovery of Prehospital Function Among Older Persons Admitted to a Nursing Home With Disability After an Acute Hospitalization
Gill TM, Gahbauer EA, Han L, Allore HG. Factors Associated With Recovery of Prehospital Function Among Older Persons Admitted to a Nursing Home With Disability After an Acute Hospitalization. The Journals Of Gerontology Series A 2009, 64A: 1296-1303. PMID: 19661289, PMCID: PMC2773809, DOI: 10.1093/gerona/glp115.Peer-Reviewed Original ResearchMeSH KeywordsAcute DiseaseAge FactorsAgedAged, 80 and overCohort StudiesContinuity of Patient CareDisability EvaluationDisabled PersonsFemaleFollow-Up StudiesGeriatric AssessmentHomes for the AgedHospitalizationHumansKaplan-Meier EstimateLongitudinal StudiesMaleMultivariate AnalysisNursing HomesPatient DischargeProbabilityProportional Hazards ModelsRecovery of FunctionRisk FactorsTime FactorsUnited StatesConceptsNursing home admissionPrehospital functionHome admissionAcute hospitalizationSignificant weight lossNursing homesGross motor coordinationMotor coordinationOlder personsManual dexterityWeight lossMonthly telephone interviewsOngoing cohort studyCohort studyFunctional recoveryPrehospital levelMore admissionsDaily livingHospitalizationAdmissionCognitive impairmentMultivariate analysisTelephone interviewsPotential predictorsAnalytic sample
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 Haven12-Month Cognitive Outcomes of Major and Minor Depression in Older Medical Patients
Han L, McCusker J, Cole M, Abrahamowicz M, Čapek R. 12-Month Cognitive Outcomes of Major and Minor Depression in Older Medical Patients. American Journal Of Geriatric Psychiatry 2008, 16: 742-751. PMID: 18757768, DOI: 10.1097/jgp.0b013e31817c6ad7.Peer-Reviewed Original ResearchConceptsMini-Mental State ExaminationOlder medical patientsMinor depressionPoor cognitive functionMedical patientsDepression diagnosisCognitive functionStudy entryIndependent risk factorProspective cohort studyApparent cognitive impairmentFourth Edition criteriaAcute care hospitalsDiagnostic Interview ScheduleMixed effects regression modelsAntidepressant treatmentCohort studyCare hospitalHospital admissionMedical inpatientsRegression modelsPhysical functionRisk factorsCardiovascular diseaseEdition criteria