2024
Variation 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
2021
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 living
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 living
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
Chronic 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 synthesis
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
2014
Epidemiology of Restricting Fatigue in Older Adults: The Precipitating Events Project
de Rekeneire N, Leo‐Summers L, Han L, Gill TM. Epidemiology of Restricting Fatigue in Older Adults: The Precipitating Events Project. Journal Of The American Geriatrics Society 2014, 62: 476-481. PMID: 24512073, PMCID: PMC4103720, DOI: 10.1111/jgs.12685.Peer-Reviewed Original ResearchConceptsCommunity-living older adultsPhysical frailtyOlder adultsCommunity-living older menEpidemiologic Studies Depression ScaleProspective cohort studySlow gait speedOverall incidence ratePrecipitating Events ProjectCohort studyCumulative incidenceMedian durationGait speedIncidence rateDepression ScaleUsual activitiesOlder menFrailtyDepressionMonthsWomenConsecutive monthsAdultsHigh rateRespective counterparts
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 activity
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
2010
P3‐066: Antidepressant use and cognitive function in older primary care patients with major or minor depression: A prospective cohort study with database linkage
Han L, McCusker J, Cole M, Capek R, Abrahamowicz M. P3‐066: Antidepressant use and cognitive function in older primary care patients with major or minor depression: A prospective cohort study with database linkage. Alzheimer's & Dementia 2010, 6: s468-s468. DOI: 10.1016/j.jalz.2010.05.1560.Peer-Reviewed Original Research
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
Cumulative 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