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 livingCumulative Anticholinergic Exposure Is Associated with Poor Memory and Executive Function in Older Men
Han L, Agostini JV, Allore HG. Cumulative Anticholinergic Exposure Is Associated with Poor Memory and Executive Function in Older Men. Journal Of The American Geriatrics Society 2008, 56: 2203-2210. PMID: 19093918, PMCID: PMC3952110, DOI: 10.1111/j.1532-5415.2008.02009.x.Peer-Reviewed Original ResearchConceptsTotal anticholinergic burdenCumulative anticholinergic exposureOlder menAnticholinergic medicationsAnticholinergic burdenAnticholinergic exposureCumulative exposureVeterans Affairs primary care clinicsExecutive functionAnticholinergic medication useDeleterious adverse effectsProspective cohort studySeverity of hypertensionCommunity-dwelling menPrimary care clinicsDaily Living ScalePotential risk factorsPrescription of drugsAnticholinergic scoreCohort studyMultiple medicationsAnticholinergic effectsMedication useCare clinicsPhysical function
2024
Impact of complementary health approaches on opioid prescriptions among veterans with musculoskeletal disorders – A retrospective cohort study
Han L, Goulet J, Skanderson M, Redd D, Brandt C, Zeng-Treitler Q. Impact of complementary health approaches on opioid prescriptions among veterans with musculoskeletal disorders – A retrospective cohort study. Journal Of Pain 2024, 26: 104695. PMID: 39384145, DOI: 10.1016/j.jpain.2024.104695.Peer-Reviewed Original ResearchIntegrative health approachesHealth approachOpioid prescriptionsMusculoskeletal disordersAdministration electronic health recordComplementary health approachesPrimary care visitsElectronic health recordsPharmacy dispensing recordsCIH approachesCare visitsDispensed opioid prescriptionsHealth recordsRetrospective cohort studyDispensing recordsPatient's painAnalytic sampleIndex diagnosisExposure groupCohort studyVeteransOpioid initiationQuasi-experimental investigationCIHPrescriptionFactors Associated with Influenza Vaccination in a National Veteran Cohort
Chen A, Farmer M, Han L, Runels T, Bade B, Crothers K, Bastian L, Bazan I, Bean-Mayberry B, Brandt C, Akgün K. Factors Associated with Influenza Vaccination in a National Veteran Cohort. AJPM Focus 2024, 100290. DOI: 10.1016/j.focus.2024.100290.Peer-Reviewed Original ResearchOdds of vaccinationInfluenza vaccineFemale veteransAmerican Indian/Alaskan Native raceFactors associated with influenza vaccinationReceipt of influenza vaccinationDocumenting influenza vaccinationReduced oddsRetrospective cohort studyElectronic health record dataMale veteransHealth record dataAmbulatory care utilizationInfluenza seasonRuralMale sexWhite male veteransWhite veteransAssociated with raceCohort studyBlack veteransBlack raceEthnic groupsRacial disparitiesInfluenzaVariation in Specialist Palliative Care Reach and Associated Factors Among People With Advanced Heart Failure in the Department of Veterans Affairs
Feder S, Han L, Zhan Y, Abel E, Akgün K, Fried T, Ersek M, Redeker N. Variation in Specialist Palliative Care Reach and Associated Factors Among People With Advanced Heart Failure in the Department of Veterans Affairs. Journal Of Pain And Symptom Management 2024, 68: 22-31.e1. PMID: 38561132, PMCID: PMC11168897, DOI: 10.1016/j.jpainsymman.2024.03.022.Peer-Reviewed Original ResearchOutpatient specialist palliative careSpecialist palliative careVeterans Affairs Medical CenterPalliative careSpecialist palliative care consultationRandom intercept multilevel logistic regressionDepartment of Veterans AffairsMultilevel logistic regressionAffairs Medical CenterClinical practice guidelinesICD-9/10 codesAdvanced heart failureRetrospective cohort studyVeterans AffairsOutpatient palliativeOutpatient deliveryPractice guidelinesCohort studyLogistic regressionCardiology involvementDelivery characteristicsAssociated factorsMedical CenterIdentified factorsICD-9/10
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 timeAdultsRacial, Ethnic, and Rural Disparities in U.S. Veteran COVID-19 Vaccine Rates
Bernstein E, DeRycke E, Han L, Farmer M, Bastian L, Bean-Mayberry B, Bade B, Brandt C, Crothers K, Skanderson M, Ruser C, Spelman J, Bazan I, Justice A, Rentsch C, Akgün K. Racial, Ethnic, and Rural Disparities in U.S. Veteran COVID-19 Vaccine Rates. AJPM Focus 2023, 2: 100094. PMID: 37362395, PMCID: PMC10038675, DOI: 10.1016/j.focus.2023.100094.Peer-Reviewed Original ResearchRace/ethnicity groupsFirst vaccinationFirst COVID-19 vaccinationVeterans AffairsWhite veteransCharlson Comorbidity IndexRetrospective cohort studyPrimary care visitsEthnicity groupsCOVID-19 vaccinationLarge healthcare systemEquitable vaccine distributionAsian Americans/Pacific IslandersRace/ethnicityUnvaccinated patientsComorbidity indexInfluenza vaccinationSelf-reported categoriesBlack groupCare visitsCohort studyHazard ratioPrimary outcomeWhite patientsBlack patients
2022
Post-9/11 deployment history and the incidence of breast cancer among women veterans
Gaffey A, Han L, Ramsey C, Skanderson M, Dziura J, Driscoll M, Burg M, Brandt C, Bastian L, Haskell S. Post-9/11 deployment history and the incidence of breast cancer among women veterans. Annals Of Epidemiology 2022, 77: 98-102. PMID: 36470323, DOI: 10.1016/j.annepidem.2022.11.010.Peer-Reviewed Original ResearchConceptsOEF/OIF deploymentBreast cancerWomen veteransHealthcare utilizationHormone replacement therapy useRetrospective cohort studyVeterans Affairs (VA) careHealthy soldier effectOEF/OIFCohort studyTherapy useBC incidenceHormonal contraceptivesLifestyle factorsPrimary careBC diagnosisLower incidenceOperations Enduring Freedom/Iraqi FreedomWomenIncidenceGreater likelihoodIraqi FreedomVeteransCancerCareNational Cohort Study of Homebound Persons Living With Dementia: Antibiotic Prescribing Trends and Opportunities for Antibiotic Stewardship
Datta R, Fried T, O’Leary J, Zullo AR, Allore H, Han L, Juthani-Mehta M, Cohen A. National Cohort Study of Homebound Persons Living With Dementia: Antibiotic Prescribing Trends and Opportunities for Antibiotic Stewardship. Open Forum Infectious Diseases 2022, 9: ofac453. PMID: 36147594, PMCID: PMC9487603, DOI: 10.1093/ofid/ofac453.Peer-Reviewed Original ResearchHome-based primary careDays of therapyAntibiotic use ratesAntibiotic useHomebound personsOverall median lengthPhysician home visitsNational cohort studyAntibiotic prescribing trendsVeterans Health AdministrationUse ratesProvider visitsAntibiotic prescriptionsCohort studyPrescribing trendsTelephone visitsMedian agePrescription fillsMedian lengthAntibiotic stewardshipNational cohortPrimary careHome visitsHealth AdministrationPrescribed classMilitary 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 impactFunctional Trajectories and Resilience Among Adults With Advanced Lung Cancer
Presley CJ, Arrato NA, Shields PG, Carbone DP, Wong ML, Benedict J, Reisinger SA, Han L, Gill TM, Allore H, Andersen BL, Janse S. Functional Trajectories and Resilience Among Adults With Advanced Lung Cancer. JTO Clinical And Research Reports 2022, 3: 100334. PMID: 35719868, PMCID: PMC9198463, DOI: 10.1016/j.jtocrr.2022.100334.Peer-Reviewed Original ResearchAdvanced NSCLCFunctional disabilityLung cancerBaseline Eastern Cooperative Oncology Group performance statusEastern Cooperative Oncology Group performance statusSevere disabilityPatient Health Questionnaire-9Adenocarcinoma histological subtypeDistinct functional trajectoriesAdvanced lung cancerProspective cohort studyRisk stratification toolFunctional trajectoriesLatent class trajectory modelingLung cancer treatmentWorse dyspneaBrain metastasesBaseline demographicsCohort studyFormer smokersPerformance statusBone metastasesEuroQol-5DStratification toolHistological subtypes
2020
Guardianship and End‐of‐Life Care for Veterans with Dementia in Nursing Homes
Cohen AB, Han L, OʼLeary JR, Fried TR. Guardianship and End‐of‐Life Care for Veterans with Dementia in Nursing Homes. Journal Of The American Geriatrics Society 2020, 69: 342-348. PMID: 33170957, PMCID: PMC7902349, DOI: 10.1111/jgs.16900.Peer-Reviewed Original ResearchConceptsDays of lifeHospital deathHigh-intensity treatmentMechanical ventilationTube placementHome residentsCardiopulmonary resuscitationNursing homesIntensive care unit admissionMinimum Data Set assessmentsCare unit admissionRetrospective cohort studyNursing home residentsHigh-intensity endMore nursing homesUnit admissionICU admissionCohort studySecondary outcomesPrimary outcomeHospital transferLife hospitalizationsSevere dementiaLife careDementia severityRisk 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 livingImpact 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 ResearchDisability 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
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 ResearchConceptsDietary 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
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 daysDeathDecedentsDaysMonthsAgeSexChronic Disease Management
Xu B, Cao G, Han L, Li M, Tayie F, Yao S. Chronic Disease Management. Innovation In Aging 2018, 2: 495-495. PMCID: PMC6227612, DOI: 10.1093/geroni/igy023.1844.Peer-Reviewed Original ResearchTotal fat consumptionMild cognitive impairmentPopulation-based studyRisk of dementiaFat intakeFat consumptionCognitive impairmentAlzheimer's diseaseCognitive outcomesConfidence intervalsChronic disease managementRelative risk valuesRandom-effects modelingCohort studyProspective studyDecreased riskBody of evidenceSignificant associationCognitive functionDementiaIntakeDiseaseDisease managementImpairmentQuantitative synthesisAssociation between death and loss of stage N2 sleep features among critically Ill patients with delirium
Knauert MP, Gilmore EJ, Murphy TE, Yaggi HK, Van Ness PH, Han L, Hirsch LJ, Pisani MA. Association between death and loss of stage N2 sleep features among critically Ill patients with delirium. Journal Of Critical Care 2018, 48: 124-129. PMID: 30179762, PMCID: PMC6226351, DOI: 10.1016/j.jcrc.2018.08.028.Peer-Reviewed Original ResearchConceptsICU patientsIll patientsOdds ratioHigher oddsSleep spindlesIntensive care unit outcomesGrade of encephalopathySignificant sleep disruptionWorse ICU outcomeMedical ICU patientsAcute brain injuryObservational cohort studySedative-hypnotic useImportant prognostic valueLength of stayStage N2 sleepK-complexesCohort studyCritical illnessHospital dischargeRankin ScaleICU outcomesPrognostic valueSevere gradesMedical records
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 Haven