Mary Elizabeth Tinetti, MD

Gladys Phillips Crofoot Professor of Medicine (Geriatrics) and Professor in the Institution for Social and Policy Studies; Section Chief, Geriatrics

Research Interests

Accidental Falls; Decision Making; Geriatrics; Risk Factors

Research Organizations

Internal Medicine: Geriatrics

School of Public Health

Faculty Research

Office of Cooperative Research

Research Summary

I conducted a series of epidemiological, intervention, and dissemination studies in the area of falls and fall injury risk factors identification and prevention. My current research focus is on clinical decision-making for older adults in the face of multiple health conditions, measuring the net benefit and harms of commonly used medications, and the importance of cross-disease universal health outcomes. I am leading an effort to develop and test an approach to health care that realigns primary and specialty care to focus on the health priorities of older adults with multiple conditions.

Specialized Terms: Falls and injuries; Mobility; Clinical decision-making in the face of multiple health conditions; Harms and benefits of medications; patients’ health priorities

Extensive Research Description

Many of the most frequent health conditions that cause morbidity and compromised functioning and quality of life among older persons result from combinations of medical, psychological, social, environmental, and other factors. The focus of my work has been on the assessment, management, and prevention of multifactorial geriatric health conditions such as falls, immobility, and dizziness. Observational studies and randomized controlled trials are conducted in various settings including the home, hospital, nursing home and outpatient clinics. The research projects are interdisciplinary including nursing, rehabilitation, epidemiology, biostatistics, medicine, and other disciplines.


Other ongoing projects include determining the contribution of multiple conditions to death; mapping disease-specific health outcomes onto a set of universal health outcomes; determining the prevalence and effects of the co-occurrence of competing health conditions; and determining the disease-specific and universal health outcomes associated with treating one disease in the face of the co-occurrence of another disease that worsens with treatment of the first disease (therapeutic competition). I am leading a national effort to develop and test an approach to health care that realigns primary and specialty care to focus on the health priorities of older adults with multiple conditions.

  • Multimorbidity in older adults (Variable priorities in the face of competing outcomes: The tradeoff among cardiovascular events, medication symptoms, and fall injuries.)
  • Universal outcomes as a common metric across multiple diseases among elders.
  • Aligning clinical-decision-making and care with the health priorities of older adults with multiple chronic conditions

Selected Publications

  • Designing Health Care for the Most Common Chronic Condition: Multi-morbidity.

    Tinetti ME, Fried TR, Boyd, CM. Designing Health Care for the Most Common Chronic Condition: Multi-morbidity. JAMA 2012; 307(23):2493-2495.

  • Contribution of multiple chronic diseases to universal health outcomes in older adults.

    Tinetti ME, McAvay G, Chang SS, Newman AB, Fried TR, Fitzpatrick AL, Satterfield S, Peduzzi P. Contribution of multiple chronic diseases to universal health outcomes in older adults. J Am Geriatr Soc. 2011; 59: 1686-1691.

  • Variable priorities in the face of competing outcomes: The tradeoff among cardiovascular events, medication symptoms, and fall injuries.

    Tinetti ME, McAvay G, Fried TR, Allore HG, Salmon J, Foody JM, Bianco L, Ginter S, Fraenkel L. Variable priorities in the face of competing outcomes: The tradeoff among cardiovascular events, medication symptoms, and fall injuries. J Am Geriatr Soc 56:1409-1416, 2008.

  • Effect of translating evidence into practice on rate of serious fall injury. Tinetti ME, Baker DI, King M, Gottschalk M, Murphy T, Acampora D, Leo-Summers L, Allore H. Effect of translating evidence into practice on rate of serious fall injury. New Engl J Med 359:252-61, 2008.
  • Patient Priority Directed Decision-making and Care for Older Adults with Multiple Chronic Conditions Tinetti ME, Esterson J, Ferris R, Posner P, Blaum CS. Patient Priority Directed Decision-making and Care for Older Adults with Multiple Chronic Conditions. Clin Geriatr Med 2016; 32(2):261-75.
  • Association between guideline-recommended medications and death in older adults with multiple chronic conditions: Population-based Cohort Study. Tinetti ME, McAvay G, Trentalange M, Cohen AB, Allore AG. Association between guideline-recommended medications and death in older adults with multiple chronic conditions: Population-based Cohort Study. BMJ.2015;351:4984.
  • Anti-hypertensive medications and serious fall injuries in a nationally representative sample of older adults Tinetti ME, Han L, McAvay GJ, Lee DSH, Peduzzi P, Gross CP, Zhang T, Lin H. Anti-hypertensive medications and serious fall injuries in a nationally representative sample of older adults. JAMA Intern Med 174(4):588-95, 2014.

Full List of PubMed Publications

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