Featured Publications
Cognitive 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 associationsSeverity
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 ResearchMeSH KeywordsAgedAged, 80 and overHospitalizationHospitalsHumansPatient DischargeQuality of LifeRisk FactorsConceptsHealth 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 differenceHospitalRisk Factors Associated with Healthcare Utilization for Spine Pain
Higgins DM, Han L, Kerns RD, Driscoll MA, Heapy AA, Skanderson M, Lisi AJ, Mattocks KM, Brandt C, Haskell SG. Risk Factors Associated with Healthcare Utilization for Spine Pain. Pain Medicine 2022, 23: 1423-1433. PMID: 34999899, DOI: 10.1093/pm/pnab351.Peer-Reviewed Original ResearchMeSH KeywordsBack PainFemaleHumansMusculoskeletal PainPatient Acceptance of Health CareRisk FactorsVeteransConceptsSpine pain careSpine painHealthcare utilizationPain careRisk factorsPain episodesObservation periodNew episodesMultivariable logistic regression modelPotential risk factorsOutpatient visit dataLogistic regression analysisMental health conditionsBaseline observation periodLogistic regression modelsBaseline characteristicsOutpatient visitsClinical correlatesContinued careLower oddsPainVisit dataContinued episodesHealth conditionsCare
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
Cognitive 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 activitiesHospitalizationFunctional 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 for Disability After Emergency Department Discharge in Older Adults
Nagurney JM, Han L, Leo‐Summers L, Allore HG, Gill TM. Risk Factors for Disability After Emergency Department Discharge in Older Adults. Academic Emergency Medicine 2020, 27: 1270-1278. PMID: 32673434, PMCID: PMC7749835, DOI: 10.1111/acem.14088.Peer-Reviewed Original ResearchConceptsLower extremity weaknessDisability burdenRisk factorsOlder adultsED visitsPhysical frailtyLongitudinal multivariable modelsEmergency department dischargeModifiable risk factorsCommunity-living personsCandidate risk factorsEmergency department experienceED dischargeNonmodifiable factorsMultivariable analysisRisk stratificationFunctional outcomeIndependent associationMultivariable modelOngoing longitudinal studyMonthly interviewsAnalytic sampleFunctional activityAdultsVisitsRisk 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 livingAssociations Between Somatic Multimorbidity Patterns and Depression in a Longitudinal Cohort of Middle-Aged and Older Chinese
Yao SS, Cao GY, Han L, Huang ZT, Chen ZS, Su HX, Hu Y, Xu B. Associations Between Somatic Multimorbidity Patterns and Depression in a Longitudinal Cohort of Middle-Aged and Older Chinese. Journal Of The American Medical Directors Association 2020, 21: 1282-1287.e2. PMID: 31928934, DOI: 10.1016/j.jamda.2019.11.028.Peer-Reviewed Original ResearchMeSH KeywordsAgedChinaChronic DiseaseDepressionFemaleHumansLongitudinal StudiesMaleMiddle AgedMultimorbidityRisk FactorsConceptsChronic somatic conditionsSomatic multimorbidityDepressive symptomsOlder Chinese adultsSomatic conditionsChinese adultsEpidemiological Studies Depression ScaleLongitudinal associationsRetirement Longitudinal Study 2011Multimorbidity patternsLongitudinal cohortDepression ScaleRespiratory conditionsHigh riskGreater oddsRespiratory patternMental disordersSymptomsChina HealthGreater riskOlder populationOlder adultsSkeletal patternClinical practitionersDepressionFactors 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
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 outcomesImpairment
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 participantsDisabilityParticipantsYearsPrognostic 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 study
2016
Dyspnea in Community‐Dwelling Older Persons: A Multifactorial Geriatric Health Condition
Miner B, Tinetti ME, Van Ness PH, Han L, Leo‐Summers L, Newman AB, Lee PJ, Fragoso C. Dyspnea in Community‐Dwelling Older Persons: A Multifactorial Geriatric Health Condition. Journal Of The American Geriatrics Society 2016, 64: 2042-2050. PMID: 27549914, PMCID: PMC5073004, DOI: 10.1111/jgs.14290.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overAnkle Brachial IndexBody Mass IndexCausalityComorbidityCross-Sectional StudiesDyspneaEchocardiographyElectric ImpedanceFemaleGeriatric AssessmentHumansIndependent LivingMaleMental CompetencyRespiratory Function TestsRisk FactorsSeverity of Illness IndexStatistics as TopicUnited StatesConceptsBody mass indexSevere dyspneaOlder personsChair standCommunity-dwelling older personsMultivariable logistic regression modelHealth conditionsWhole body muscle massMini-Mental State ExaminationAnkle-brachial indexEpidemiologic Studies Depression ScaleRespiratory muscle weaknessMaximal inspiratory pressureVentricular ejection fractionCardiovascular Health StudyCommunity-dwelling personsDiastolic cardiac dysfunctionLogistic regression modelsGrip weaknessSerum hemoglobinBlood pressureDyspnea severityEjection fractionMedication useCardiac dysfunction
2013
Risk Factors for Restricting Back Pain in Older Persons
Makris UE, Fraenkel L, Han L, Leo-Summers L, Gill TM. Risk Factors for Restricting Back Pain in Older Persons. Journal Of The American Medical Directors Association 2013, 15: 62-67. PMID: 24239445, PMCID: PMC3872215, DOI: 10.1016/j.jamda.2013.09.013.Peer-Reviewed Original ResearchConceptsPersistent/recurrentCandidate risk factorsRisk factorsBack painOlder personsFemale sexComprehensive home-based assessmentsMultivariable Cox modelProspective cohort studyMonthly telephone interviewsMore chronic conditionsWeak grip strengthHome-based assessmentHip weaknessCohort studyCumulative incidenceIncident episodesMultivariable analysisProspective studyGrip strengthChronic conditionsPainCox modelDepressive symptomsRestricted activityCardiovascular 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 ResearchConceptsHip fractureICD-10 codesCardiovascular diseaseHypertensive diseaseOlder inpatientsCerebrovascular diseaseHospitalization summary reportsOverall cardiovascular diseaseHip fracture patientsDiagnosis of CVDOccurrence rateChinese inpatientsFracture patientsCohort studyTertiary hospitalInpatientsDiseaseAssociationFracturesEuropean populationsComorbiditiesPatientsHospitalYearsDiagnosis
2012
Risk factors and precipitants of long-term disability in community mobility: a cohort study of older persons.
Gill TM, Gahbauer EA, Murphy TE, Han L, Allore HG. Risk factors and precipitants of long-term disability in community mobility: a cohort study of older persons. Annals Of Internal Medicine 2012, 156: 131-40. PMID: 22250144, PMCID: PMC3278794, DOI: 10.7326/0003-4819-156-2-201201170-00009.Peer-Reviewed Original ResearchConceptsLong-term disabilityRisk factorsOlder personsCohort studyCommunity mobilityShort Physical Performance BatteryMultivariate hazard ratiosProspective cohort studyPhysical Performance BatteryMultiple risk factorsCandidate risk factorsSpecific risk factorsNational InstituteLong-term mobility disabilityHazard ratioAbsolute riskPerformance BatteryPotential precipitantsMobility disabilityRestricted activityOlder ageObserved associationsInitial onsetStrong associationQuarter mile
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
12-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