Lien Quach

• PhD, MPH, MD
• University of Massachusetts Boston

Falls are the leading cause of injuries among older adults in the United States, with over 14 million older adults, or 1 in 4, reporting a fall each year. This longitudinal prospective cohort study investigated fall trajectories and associated risk factors in people with no prior history of falls. We analyzed 2006 to 2018 data from the Health and R...

Falls affect one in four older adults annually and are linked to biological and environmental risk factors. Women with HIV (WWH) may be particularly vulnerable due to lower social support and higher loneliness but their relationship with falls is not well understood. We analyzed data from 1,068 women aged 50 and older in the 2017 Women’s Interagenc...

Many older adults experience falls that lead to adverse health consequences. The primary objective of this study is to estimate the associations between risk factors of falls and actual falls. The second objective is to identify whether race modifies these relationships. Panel data from the Health and Retirement Study from 2006-2012 were analyzed....

Women generally have higher prevalence of disability than men in later life. Moreover, Blacks and Hispanics usually have higher prevalence of disability than Whites. Little is known about the impact of gender on the association between race and disability. We used 2015-2016 CHIS data, restricted to adults ≥ 65 years old (n=15,044). Disability was c...

Background: Alzheimer's disease and related dementias (ADRD) impact the diagnosis and infection control of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in nursing homes (NH) by influencing the behavior of residents and their caregivers. Health system data show an association between ADRD and SARS-CoV-2. Whether this association is...

Background Multimorbidity and polypharmacy are common among individuals hospitalized for heart failure (HF). Initiating high-risk medications such as antipsychotics may increase the risk of poor clinical outcomes, especially if these medications are continued unnecessarily into skilled nursing facilities (SNFs) after hospital discharge.Objective Ex...

Social engagement is considered crucial for older adults’ well-being, generating social capital, connecting them to information about healthy lifestyles, and providing coping strategies for addressing daily challenges. Little is known about race and ethnic disparities regarding social engagement. This study examines the relationship between race, H...

Social engagement is crucial for older adults. This study examines the relationship between race, ethnicity, and social engagement among community-dwelling older adults using data came from the Health and Retirement Study (2014) (n=6221). Race and ethnic status were categorized as: non-Hispanic white (NHW), non-Hispanic black (NHB), non-Hispanic “A...

Introduction: Housing insecure veterans are aging, but the prevalence of Alzheimer's disease and related dementias (AD/ADRD) in the population is unknown. Methods: We calculated the prevalence of AD/ADRD diagnoses in 2018 among veterans that experienced homelessness, were at-risk for homelessness, or were stably housed. We determined acute care...

In recent years, medical image analysis has played a vital role in detecting diseases in their early stages. Medical images are rapidly becoming available for various applications to solve human problems. Therefore, complex medical features are needed to develop a diagnostic system for physicians to provide better treatment. Traditional methods of...

Background Electronic frailty indices (eFIs) are increasingly used to identify patients at risk for morbidity and mortality. Whether eFIs capture the spectrum of frailty change, including decline, stability, and improvement is unknown. Methods In a nationwide retrospective birth-cohort of US Veterans, a validated eFI, including 31 health deficits,...

Frailty, a vulnerability to stressors, has been increasingly woven into the clinical understanding of older people who are unable to respond to the impact of diseases, disability, and age-related decline. While the literature has focused on physical frailty, social frailty has been conceptualized within the domains of social needs (social and emoti...

Background Premature discontinuation of dual antiplatelet therapy (DAPT) after percutaneous coronary intervention is related to higher short‐term risks of adverse outcomes. Whether these risks persist in the long‐term is uncertain. Methods and Results We assessed all patients having percutaneous coronary intervention with coronary second‐ or first...

We studied male centenarian Veterans using VA health care to understand the impact of social characteristics on their annual mortality rate, adjusting for prevalent health conditions. This longitudinal study used VA Electronic Health Record data from 1997 to 2012 ( n = 1,858). Covariates included age, race, marital status, and periods of military s...

Studying health and mortality among centenarian Veterans is critical to understanding the limit of the male human life span and Veterans’ extraordinary model of successful aging. The majority of VA users are male, but little is known about social characteristics and health among male centenarians in general. We investigated the annual mortality rat...

Objectives This study investigated the association between childhood and young adult adversities and later-life subjective well-being among older male veterans. We also explored whether early-life parent–child relationships and later-life social engagement served as moderators and mediators, respectively. Methods Data were from the 2008 to 2012 wa...

Objectives: to estimate the association of social disconnectedness and perceived social isolation with the risk of falls and also investigate whether depression mediated this association. Method: Biennial longitudinal survey data from 2006 to 2012 waves of the U.S. Health and Retirement Study of adults aged 65 and older (N = 22,153 observations) we...

Relatively little is known about the relationship between social isolation and the risk of falls among older adults. Yet, a considerable amount of research demonstrates that lack of sufficient social relationships, broadly defined, represents a modifiable risk factor for many indicators of well-being in later life. This study examines the associati...

This study examined how social engagement (SE) and mild cognitive impairment (MCI) influence changes in mobility over three years of follow-up. We performed a secondary analysis of longitudinal data among primary care patients aged >64 years (N=430). Mobility outcomes include performance-based function via the Short Physical Performance Battery (SP...

Objective: We investigated the associations between mild cognitive impairment (MCI), social engagement (SE), and mobility. Design: We evaluated data from a cohort study of older adult primary care patients (N = 430). Outcomes included self-reported function (Late-Life Function Instrument [LLFI]) and performance-based mobility (Short Physical Per...

Background Neuromuscular and clinical factors contribute to falls among older adults, yet the interrelated nature of these factors is not well understood. We investigated the relationships between these factors and how they contribute to falls, which may help optimize fall risk assessment and prevention. Methods 365 primary care patients (age=77±7...

Objectives: To examine associations between mild cognitive impairment (MCI) and falls among primary care patients, and to investigate whether social engagement (SE) modifies these associations. Design: Cross sectional analysis using baseline data from an observational cohort study. Setting: Primary care. Participants: Community-dwelling olde...

Relatively little is known about if or how veteran status is related to pain and falls among community-dwelling older men. We investigated the association between pain and falls, and examined whether veterans status and combat experience might modify this association. The study sample included 2718 men from the Health and Retirement Study, a nation...

Background Individuals with mild cognitive impairment (MCI), often a precursor to dementia, experience limitations in completing daily activities. These limitations are particularly important to understand, as they predict risk for dementia. Relations between functional changes and both cognitive decline and upper extremity motor impairments have b...

Background Frailty is a key determinant of clinical outcomes. We sought to describe frailty among U.S. Veterans and its association with mortality. Methods Nationwide retrospective cohort study of regular Veterans Affairs (VA) users, aged at least 65 years in 2002–2012, followed through 2014, using national VA administrative and Medicare/Medicaid...

It is commonly understood that cognition and mobility are in dynamic feedback, but the role of specific aspects of neuromuscular functioning in driving this association has gone unexplored. We used data from Boston RISE (n=422; age=76.5 ± 7.0; 68.3% female; 17.3% non-white; SPPB score=8.7 ± 2.3) to evaluate the contribution of four neuromuscular at...

Relatively little is known about if or how pain and Veteran status are related to frailty. Our objectives were to determine the association between pain and frailty among community-dwelling older men, and examine how combat experience among Veterans might modify this association. The study sample included 3,136 men from the 2012 Health and Retireme...

Objective: The main aim of this study was to examine the differences between triple therapy (T: SSZ and HCQ added to MTX) and etanercept (E) added to MTX with regard to the infectious and gastrointestinal (GI) adverse events (AEs) reported in The Rheumatoid Arthritis Comparison of Active Therapies Trial. Methods: The patients were 353 RA MTX inc...

Objectives: To assess the impact of stent type on the risk of death or myocardial infarction (MI) related to dual antiplatelet therapy (DAPT) more than 12 months (prolonged DAPT) versus 12 or less months after PCI for an acute coronary syndrome (ACS). Background: The recent DAPT study reported lower recurrent ischemic events from prolonged DAPT...

The aims of this study were to examine the association between different types of arthritis and falls and to investigate whether clinically significant depression symptoms (CSDS) moderate these relationships. The study used nationally representative data from the 2008 Health and Retirement Study (n = 7,715, M age = 75, 62% female, and 90% White). A...

We sought to determine the incidence and risks for severe thrombocytopenia (platelets < 50 000/μL) in United States Veteran patients treated with pegylated interferon (PEG-IFN) plus ribavirin for hepatitis C virus-positive (HCV) chronic liver disease (CLD). Using a retrospective, observational cohort study design to analyze databases from the New E...

Dairy foods are a complex source of essential nutrients. In this study, fluid dairy intake, specifically milk, and yogurt intakes were associated with hip but not spine bone mineral density (BMD), while cream may adversely influence BMD, suggesting that not all dairy products are equally beneficial for the skeleton. Purpose This study seeks to exam...

The mechanisms linking falls and depression are still unknown. The aim of the study is to examine the association between depression and antidepressants, with indoor and outdoor falls, and to investigate how antidepressants mediate this relationship. The study included 763 men and women aged 70 and older with baseline measures for depression and an...

Objective To evaluate associations of milk, yogurt, cheese, cream & total dairy intakes with 4y% change in BMD at femoral neck‐FN, trochanter‐TR & lumbar spine‐LS in the Framingham Cohort; also whether VitD intake modified associations. Methods 802 participants had valid FFQ & BMD (1988–89, g/cm ² ); while 597 had follow‐up BMD (1992–93). Multivar...

Objective Health effects of dairy foods may be due to more than a single nutrient. We evaluated association of milk, yogurt, cheese, cream & total dairy intakes with incident hip fracture over a 20‐y follow‐up in the Framingham Original Cohort. Methods 802 men & women completed an FFQ at the baseline (1988–89) and were followed for hip fracture un...

BACKGROUND Delirium is characterized by acute cognitive impairment. We examined the association of delirium with long-term cognitive trajectories in older adults with Alzheimer disease (AD). METHODS We evaluated prospectively collected data from a nested cohort of hospitalized patients with AD (n = 263) in the Massachusetts Alzheimer Disease Resear...

BACKGROUND: Delirium is common after cardiac surgery and may be associated with long-term changes in cognitive function. We examined postoperative delirium and the cognitive trajectory during the first year after cardiac surgery. METHODS: We enrolled 225 patients 60 years of age or older who were planning to undergo coronary-artery bypass grafting...

To examine the relationship between gait speed and falls risk. Longitudinal analysis of the association between gait speed and subsequent falls and analysis of gait speed decline as a predictor of future falls. Population-based cohort study. Seven hundred sixty-three community-dwelling older adults underwent baseline assessments and were followed f...

To investigate the relationships between uncontrolled and controlled hypertension, orthostatic hypotension (OH), and falls in participants of the Maintenance of Balance, Independent Living, Intellect, and Zest in the Elderly of Boston Study (N=722, mean age 78.1). Prospective population-based study. Community. Seven hundred twenty-two adults aged 7...

Background Poor nutritional status is often present among older adults who experience a fall. However, dietary intake and weight loss are often overlooked as potential factors. The objective of this study was to test the association between dietary protein intake and risk of subsequent falls in a population-based cohort of elderly men and women. Me...

HIV-infected patients are at increased risk for cardiovascular disease, which may be mediated in part by inflammation. Surrogate marker studies suggest an increased prevalence of vascular abnormalities in HIV infection. We examined the association of all-cause mortality in HIV-infected patients with carotid artery intima-media thickness (cIMT) and...

Our objective was to investigate the association between hypertension and concurrent impairments in mobility, cognition, and mood; the role of brain white matter hyperintensities in mediating this association; and the impact of these impairments on disability and mortality in elderly hypertensive individuals. -Blood pressure, gait speed, digit symb...

Poor nutritional status is often present among older adults who experience a fall. However, dietary intake and weight loss are often overlooked as potential factors. The objective of this study was to test the association between dietary protein intake and risk of subsequent falls in a population-based cohort of elderly men and women. Dietary intak...

To identify risk factors for indoor and outdoor falls. Prospective cohort study. The MOBILIZE Boston Study, a study of falls etiology in community-dwelling older individuals. Seven hundred sixty-five women and men, mainly aged 70 and older, from randomly sampled households in the Boston, Massachusetts, area. Baseline data were collected by question...

Poor medication adherence is associated with negative health outcomes. We investigated whether poor medication adherence increases the rate of falls as part of Maintenance of Balance, Independent Living, Intellect, and Zest in the Elderly of Boston (MOBILIZE Boston), a prospective, community-based cohort recruited for the purpose of studying novel...

Malnutrition is associated with morbidity and mortality in HIV-infected individuals. Little research has been conducted to identify the roles that clinical, illicit drug use and socioeconomic characteristics play in the nutritional status of HIV-infected patients. This cross-sectional analysis included 562 HIV-infected participants enrolled in the...

Health care providers in Vietnam have been facing an increase in the number of HIV patients. However, little is known about physicians' knowledge, attitudes, and practices about HIV/AIDS and their correlates. A cross-sectional survey was conducted in 2003 with 151 physicians who had some contact with HIV-infected people. Anonymous data was collecte...