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
2024
Association Between Restricting Symptoms and Disability After Critical Illness Among Older Adults.
Jain S, Han L, Gahbauer E, Leo-Summers L, Feder S, Ferrante L, Gill T. Association Between Restricting Symptoms and Disability After Critical Illness Among Older Adults. Critical Care Medicine 2024, 52: 1816-1827. PMID: 39298623, DOI: 10.1097/ccm.0000000000006427.Peer-Reviewed Original ResearchActivities of daily livingAssociated with increased disabilityDaily livingOlder adultsRestricting symptomsInstrumental activities of daily livingCommunity-living older adultsICU hospitalizationMultivariable Poisson regression modelsCommunity-living adultsOlder ICU survivorsAge of participantsPoisson regression modelsSurvive critical illnessCritical illnessQuality of lifeInstrumental activitiesICU survivorsProspective longitudinal studyLength of stayPost-ICUIncreased disabilityMonthly interviewsICU length of stayPre-ICUFunctional 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 variability
2020
Cognitive frailty in relation to adverse health outcomes independent of multimorbidity in Chinese older adults
Liu Z, Chen C, Park J, Wu C, Xue Q, Agogo G, Han L, Wu Z. Cognitive frailty in relation to adverse health outcomes independent of multimorbidity in Chinese older adults. Innovation In Aging 2020, 4: 908-909. PMCID: PMC7741254, DOI: 10.1093/geroni/igaa057.3342.Peer-Reviewed Original ResearchChinese older adultsAdverse health outcomesCognitive frailtyHealth outcomesInstrumental ADLOlder adultsPhysical frailtyCognitive impairmentInternational Consensus GroupRetirement Longitudinal StudyPhysical frailty assessmentFrailty assessmentIADL disabilitySecondary preventionDaily livingHigh riskMobility disabilityMultimorbidityConsensus groupFrailtyChina HealthNormal cognitionBaseline cognitionHealthy agingDeathCognitive 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 activitiesHospitalizationPredictors of Residential Care Admission in Community-Dwelling Older People With Dementia
Jamieson H, Abey-Nesbit R, Nishtala PS, Allore H, Han L, Deely JM, Pickering JW. Predictors of Residential Care Admission in Community-Dwelling Older People With Dementia. Journal Of The American Medical Directors Association 2020, 21: 1665-1670. PMID: 32646821, PMCID: PMC7641960, DOI: 10.1016/j.jamda.2020.04.021.Peer-Reviewed Original ResearchConceptsAged residential careSubdistribution hazard ratiosMultivariable competing-risk modelResidential care admissionAbsence of dementiaDay of assessmentOlder New ZealandersRisk prediction modelPoor cognitive performanceCompeting-risks modelInterRAI-HC assessmentInterRAI dataCare admissionHazard ratioObservational studyReduced riskDaily livingExclusion criteriaHigh riskAlcohol consumptionDementiaOlder peopleResidential careSocial isolationCognitive performanceRisk 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
Prognostic 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 disability
2017
Restricting 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
Trajectories of Disability Among Older Persons Before and After a Hospitalization Leading to a Skilled Nursing Facility Admission
Buurman BM, Han L, Murphy TE, Gahbauer EA, Leo-Summers L, Allore HG, Gill TM. Trajectories of Disability Among Older Persons Before and After a Hospitalization Leading to a Skilled Nursing Facility Admission. Journal Of The American Medical Directors Association 2015, 17: 225-231. PMID: 26620073, PMCID: PMC4769913, DOI: 10.1016/j.jamda.2015.10.010.Peer-Reviewed Original ResearchConceptsSkilled nursing facility admissionsNursing facility admissionsDisability trajectoriesMinimal disabilityOlder personsFacility admissionModerate disabilityCommunity-dwelling older personsMinimal improvementDistinct disability trajectoriesSevere disability scoresProspective cohort studyTrajectories of disabilityShort-term outcomesMild disabilityLikelihood of improvementDisability scoresFirst hospitalizationSecondary outcomesCohort studyMean ageMAIN OUTCOMEDaily livingAdmissionMost older personsThe 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
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
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 Haven