Featured Publications
Effect of Chronic Disease–Related Symptoms and Impairments on Universal Health Outcomes in Older Adults
Tinetti ME, McAvay G, Chang SS, Ning Y, Newman AB, Fitzpatrick A, Fried TR, Harris TB, Nevitt MC, Satterfield S, Yaffe K, Peduzzi P. Effect of Chronic Disease–Related Symptoms and Impairments on Universal Health Outcomes in Older Adults. Journal Of The American Geriatrics Society 2011, 59: 1618-1627. PMID: 21883120, PMCID: PMC3287052, DOI: 10.1111/j.1532-5415.2011.03576.x.Peer-Reviewed Original ResearchConceptsUniversal health outcomesChronic obstructive pulmonary diseaseCardiovascular Health StudyHeart failureDisease-related symptomsEjection fractionHF symptomsSelf-rated healthHealth outcomesChronic diseasesCognitive impairmentObstructive pulmonary diseaseBody Composition StudyTarget of therapyDyspnea scaleExpiratory volumeHazard ratioJoint painPulmonary diseaseInstrumental activitiesDaily livingHealth StudyDisease severitySignificant associationSymptomsHealth Outcome Priorities Among Competing Cardiovascular, Fall Injury, and Medication‐Related Symptom Outcomes
Tinetti ME, McAvay GJ, Fried TR, Allore HG, Salmon JC, Foody JM, Bianco L, Ginter S, Fraenkel L. Health Outcome Priorities Among Competing Cardiovascular, Fall Injury, and Medication‐Related Symptom Outcomes. Journal Of The American Geriatrics Society 2008, 56: 1409-1416. PMID: 18662210, PMCID: PMC3494099, DOI: 10.1111/j.1532-5415.2008.01815.x.Peer-Reviewed Original ResearchMeSH KeywordsAccidental FallsActivities of Daily LivingAgedAlzheimer DiseaseAntihypertensive AgentsAttitude to HealthCardiovascular DiseasesDecision MakingDepressive DisorderFemaleGeriatric AssessmentHealth PrioritiesHealth SurveysHumansIndividualityMaleMobility LimitationPulmonary Disease, Chronic ObstructiveWounds and InjuriesConceptsFall injuriesMedication symptomsAntihypertensive medicationsCardiovascular eventsCardiovascular outcomesChronic obstructive pulmonary diseaseBlood pressure reductionObstructive pulmonary diseaseSerious fall injuriesSymptom-related outcomesPulmonary diseaseSymptom outcomesHigh riskDepressive symptomsLower riskHealth outcomesInterindividual variabilityInjuryIntact personsMedicationsPressure reductionSymptomsRisk estimatesOlder adultsLower cognitionEvaluation of Restorative Care vs Usual Care for Older Adults Receiving an Acute Episode of Home Care
Tinetti ME, Baker D, Gallo WT, Nanda A, Charpentier P, O'Leary J. Evaluation of Restorative Care vs Usual Care for Older Adults Receiving an Acute Episode of Home Care. JAMA 2002, 287: 2098-2105. PMID: 11966384, DOI: 10.1001/jama.287.16.2098.Peer-Reviewed Original ResearchConceptsHome care episodeUsual care patientsCare patientsCare episodesRestorative careCare officesUsual careHome careFunctional statusFunctional declineUsual home careHealth care utilizationSelf-care functionSevere cognitive impairmentReceipt of MedicareHome care servicesAcute episodeBaseline characteristicsOlder patientsCare unitCare utilizationEmergency departmentTotal careHome care agenciesPatientsShared risk factors for falls, incontinence, and functional dependence. Unifying the approach to geriatric syndromes.
Tinetti ME, Inouye SK, Gill TM, Doucette JT. Shared risk factors for falls, incontinence, and functional dependence. Unifying the approach to geriatric syndromes. JAMA 1995, 273: 1348-53. PMID: 7715059, DOI: 10.1001/jama.273.17.1348.Peer-Reviewed Original ResearchMeSH KeywordsAccidental FallsActivities of Daily LivingAgedAged, 80 and overAnxietyCausalityCognitionCohort StudiesGeriatric AssessmentHearingHumansLogistic ModelsMultivariate AnalysisNeuropsychological TestsNutritional Physiological PhenomenaPhysical FitnessPsychomotor PerformanceRisk FactorsUrinary IncontinenceVision, OcularConceptsUrinary incontinenceGeriatric syndromesMore basic activitiesProportion of participantsRisk factorsIncontinenceDaily livingDepression scoresSyndromeGeneral communityCompensatory abilityArm strengthBasic activitiesSignificant increaseHigh anxietyImpairmentMultiple areasNew HavenYearsParticipantsFallFactorsPredisposesCohortBaselineA Multifactorial Intervention to Reduce the Risk of Falling among Elderly People Living in the Community
Tinetti M, Baker D, McAvay G, Claus E, Garrett P, Gottschalk M, Koch M, Trainor K, Horwitz R. A Multifactorial Intervention to Reduce the Risk of Falling among Elderly People Living in the Community. New England Journal Of Medicine 1994, 331: 821-827. PMID: 8078528, DOI: 10.1056/nejm199409293311301.Peer-Reviewed Original ResearchConceptsRisk factorsIntervention groupControl groupPrescription medicationsAdjusted incidence rate ratioTargeted risk factorsUsual health careElderly peopleRisk factor modificationIncidence rate ratiosUse of sedativesTime of reassessmentYears of ageParticular risk factorsRange of motionProportion of personsPostural hypotensionMultifactorial interventionSerious morbidityExercise programGait impairmentBalance impairmentLeg strengthElderly personsMedications
2001
The Design and Implementation of a Restorative Care Model for Home Care
Baker D, Gottschalk M, Eng C, Weber S, Tinetti M. The Design and Implementation of a Restorative Care Model for Home Care. The Gerontologist 2001, 41: 257-263. PMID: 11327492, DOI: 10.1093/geront/41.2.257.Peer-Reviewed Original ResearchMeSH KeywordsActivities of Daily LivingAgedCase ManagementConnecticutHome Care ServicesHumansModels, OrganizationalPatient Care PlanningPilot ProjectsRehabilitationConceptsFunctional outcomeOlder adultsAcute disease processHome careMultidisciplinary work groupHome health aidesHome-based careOlder patientsChronic disabilityPractice patternsHome care agenciesCare modelPatient progressRehabilitative interventionsDisease processMedical treatmentHealth aidesFunctional independenceCareCare agenciesPersonal careAdultsOutcomesPatientsWork groups
2000
Health, Functional, and Psychological Outcomes Among Older Persons with Chronic Dizziness
Tinetti M, Williams C, Gill T. Health, Functional, and Psychological Outcomes Among Older Persons with Chronic Dizziness. Journal Of The American Geriatrics Society 2000, 48: 417-421. PMID: 10798469, DOI: 10.1111/j.1532-5415.2000.tb04700.x.Peer-Reviewed Original ResearchConceptsSelf-rated healthChronic dizzinessDepressive symptomsInstrumental activitiesDaily livingOlder personsProspective cohort studyGoals of carePotential confounding factorsCohort studyAdverse outcomesDizzinessAge 72Clinical strategiesBaseline levelsConfounding factorsSocial disabilityDiscrete diseaseSymptomsHealth conditionsMarginal significanceHospitalizationSyncopeOutcomesPsychological outcomes
1999
Home-based multicomponent rehabilitation program for older persons after hip fracture: A randomized trial
Tinetti M, Baker D, Gottschalk M, Williams C, Pollack D, Garrett P, Gill T, Marottoli R, Acampora D. Home-based multicomponent rehabilitation program for older persons after hip fracture: A randomized trial. Archives Of Physical Medicine And Rehabilitation 1999, 80: 916-922. PMID: 10453768, DOI: 10.1016/s0003-9993(99)90083-7.Peer-Reviewed Original ResearchConceptsMulticomponent rehabilitation programUsual careHip fractureRehabilitation programExtremity strengthOlder personsBetter gait performanceSelf-care ADLDaily living (ADL) disabilityDuration of rehabilitationOptimal functional recoveryProportion of participantsRehabilitation strategiesLower extremity strengthUpper extremity strengthYears of ageHome-based rehabilitationSocial activity levelsHome care servicesPrefracture levelSurgical repairFunctional recoveryImproved outcomesGait performanceHome care agenciesThe Combined Effects of Baseline Vulnerability and Acute Hospital Events on the Development of Functional Dependence Among Community-Living Older Persons
Gill T, Williams C, Tinetti M. The Combined Effects of Baseline Vulnerability and Acute Hospital Events on the Development of Functional Dependence Among Community-Living Older Persons. The Journals Of Gerontology Series A 1999, 54: m377-m383. PMID: 10462171, DOI: 10.1093/gerona/54.7.m377.Peer-Reviewed Original ResearchMeSH KeywordsActivities of Daily LivingAgedAged, 80 and overCognitionCohort StudiesFemaleHealth Services for the AgedHospitalsHumansMaleProspective StudiesConceptsCommunity-living older personsValidation cohortDevelopment cohortOlder personsBaseline vulnerabilityHospital eventsPopulation-based cohort studyAcute care hospital admissionsCommunity-living personsHigh-risk groupSkilled nursing facilitiesYears of ageCohort studyHospital admissionPrimary outcomeComparable personsNew disabilityDaily livingNursing facilitiesCohortCognitive statusHigh-vulnerability groupPrecipitating eventsPhysical performanceAdmissionAlcohol Use and Functional Disability Among Cognitively Impaired Adults
Reid M, Concaio J, Towle V, Williams C, Tinetti M. Alcohol Use and Functional Disability Among Cognitively Impaired Adults. Journal Of The American Geriatrics Society 1999, 47: 854-859. PMID: 10404931, DOI: 10.1111/j.1532-5415.1999.tb03844.x.Peer-Reviewed Original ResearchConceptsFunctional disabilityIADL scoresHeavy drinkersFormer drinkersMini-Mental Status Examination scoreRetrospective medical record reviewImpaired adultsPotential dose-response effectAlcohol useLower IADL scoresMedical record reviewDose-response effectRecord reviewAlcohol intakeProspective studyConsecutive participantsFunctional statusAlcohol exposureInstrumental activitiesDaily livingIADL functionModerate drinkersCognitive impairmentBADLAlcohol effectsMismatches Between the Home Environment and Physical Capabilities Among Community‐Living Older Persons
Gill T, Robison J, Williams C, Tinetti M. Mismatches Between the Home Environment and Physical Capabilities Among Community‐Living Older Persons. Journal Of The American Geriatrics Society 1999, 47: 88-92. PMID: 9920235, DOI: 10.1111/j.1532-5415.1999.tb01906.x.Peer-Reviewed Original ResearchConceptsOlder personsHomes of participantsCommunity-living older personsTub/showerAdverse functional outcomesPopulation-based cohortCross-sectional studySame deficitSpecific deficitsPhysical performance assessmentPhysical capabilitiesFunctional outcomeEpidemiologic linkGeneral communityPrevalenceComprehensive interviewObstructed pathwaysDeficitsEveryday functionGrab barsObserved deficitsParticipantsGaitPersonsNew HavenWho Dies at Home? Determinants of Site of Death for Community‐Based Long‐Term Care Patients
Fried T, Pollack D, Drickamer M, Tinetti M. Who Dies at Home? Determinants of Site of Death for Community‐Based Long‐Term Care Patients. Journal Of The American Geriatrics Society 1999, 47: 25-29. PMID: 9920226, DOI: 10.1111/j.1532-5415.1999.tb01897.x.Peer-Reviewed Original ResearchConceptsSite of deathInpatient hospiceLong-term care patientsCommunity-based long-term care programsDependent functional statusPatients 65 yearsChronic lung diseaseCoronary artery diseaseYear of admissionCommunity-based long-term careLong-term care programsLong-term careCohort studyArtery diseaseCare patientsHome deathLung diseaseFunctional statusPatient preferencesHomecare patientsFemale genderTerminal careMAIN OUTCOMECare needsNursing homes
1998
A Taxonomy for Goal Setting in the Care of Persons with Dementia
T. B, Bradley E, Tinetti M. A Taxonomy for Goal Setting in the Care of Persons with Dementia. Journal Of General Internal Medicine 1998, 13: 675-680. PMID: 9798814, PMCID: PMC1500896, DOI: 10.1046/j.1525-1497.1998.00203.x.Peer-Reviewed Original ResearchConceptsPrimary family caregiversCare of personsFamily caregiversCase managersLarge academic medical centerPhysicians of patientsGoals of careAcademic medical centerGoal-setting processGeriatric assessmentConsecutive patientsMedical CenterNegotiation of goalsPatientsPatient careCareCaregiversDementiaConstant comparative methodPhysiciansKey informant interviewsReported goalsQualitative studyOpen-ended interviewsMain measurementsDevelopment of a Test Battery to Identify Older Drivers at Risk for Self‐Reported Adverse Driving Events
Marottoli R, Richardson E, Stowe M, Miller E, Brass L, Cooney L, Tinetti M. Development of a Test Battery to Identify Older Drivers at Risk for Self‐Reported Adverse Driving Events. Journal Of The American Geriatrics Society 1998, 46: 562-568. PMID: 9588368, DOI: 10.1111/j.1532-5415.1998.tb01071.x.Peer-Reviewed Original ResearchConceptsAdverse driving eventsFunctional abilityTest batteryLimited neck rotationSafety cohortAdverse eventsCohort studyVisual acuityNumber cancellation taskOutcome measuresNeck rotationMean periodParticipants' homesOlder personsClinician's officeParticipants' historySafety interviewsCohortBattery of testsPossible interventionsEtiology of impairmentsProbability sampleImpairmentOlder driversCharacteristic analysisFactors Associated With Six‐Month Mortality in Recipients of Community‐Based Long‐Term Care
Fried T, Pollack D, Tinetti M. Factors Associated With Six‐Month Mortality in Recipients of Community‐Based Long‐Term Care. Journal Of The American Geriatrics Society 1998, 46: 193-197. PMID: 9475448, DOI: 10.1111/j.1532-5415.1998.tb02538.x.Peer-Reviewed Original ResearchMeSH KeywordsActivities of Daily LivingAgedCohort StudiesFemaleFrail ElderlyHealth StatusHome Care ServicesHumansLong-Term CareMaleMortalityMultivariate AnalysisRisk FactorsConceptsSix-month mortalityShort-term mortalityPresence of cancerCommunity-based long-term careLong-term careHeart diseaseChronic obstructive pulmonary diseaseNutritional problemsObstructive pulmonary diseaseSevere cognitive impairmentCommunity-based waiverCohort studyPulmonary diseaseHomecare programMortality registryMale sexFunctional impairmentClinical dataAdmission assessmentRoutine assessmentCognitive impairmentHealth statusMultivariate analysisCognitive statusMortality
1997
Predictors of Recovery in Activities of Daily Living Among Disabled Older Persons Living in the Community
Gill T, Robison J, Tinetti M. Predictors of Recovery in Activities of Daily Living Among Disabled Older Persons Living in the Community. Journal Of General Internal Medicine 1997, 12: 757-762. PMID: 9436895, PMCID: PMC1497202, DOI: 10.1046/j.1525-1497.1997.07161.x.Peer-Reviewed Original ResearchMeSH KeywordsActivities of Daily LivingAgedAged, 80 and overDisabled PersonsFemaleGeriatric AssessmentHumansMaleMultivariate AnalysisSocioeconomic FactorsConceptsGood nutritional statusADL functionDisabled older personsNutritional statusADL recoveryDaily livingFolstein Mini-Mental State Examination (MMSE) scoresOlder personsMini-Mental State Examination scoreMarkers of resiliencyProspective cohort studyPredictors of recoveryState Examination scoreIntact cognitive functionCohort studyMultivariable analysisMore ADLsMMSE scoresSelf-efficacy scoresHome assessmentBivariate analysisCognitive functionGeneral communityPhysical performanceADLSystematic home-based physical and functional therapy for older persons after hip fracture
Tinetti M, Baker D, Gottschalk M, Garrett P, McGeary S, Pollack D, Charpentier P. Systematic home-based physical and functional therapy for older persons after hip fracture. Archives Of Physical Medicine And Rehabilitation 1997, 78: 1237-1247. PMID: 9365355, DOI: 10.1016/s0003-9993(97)90338-5.Peer-Reviewed Original ResearchMeSH KeywordsActivities of Daily LivingAgedAged, 80 and overFemaleHip FracturesHumansLength of StayMalePhysical Therapy ModalitiesTreatment OutcomeWeight-BearingConceptsOlder personsHip fractureBerg Balance Scale scoreStair climbingTherapy componentsPhysical therapy componentTotal ADL scoreBalance Scale scoreHome-based therapyMaximum elbow extensionYears of ageHome-based rehabilitation protocolPercentage of participantsPercent of participantsImpaired older personsDaily exercise sessionsAmeliorate impairmentsADL scoresFractured hipExercise programGait deviationsRehabilitation protocolExercise sessionsDaily livingRehabilitation programThe Role of Change in Physical Performance in Determining Risk for Dependence in Activities of Daily Living Among Nondisabled Community-Living Elderly Persons
Gill T, Williams C, de Leon C, Tinetti M. The Role of Change in Physical Performance in Determining Risk for Dependence in Activities of Daily Living Among Nondisabled Community-Living Elderly Persons. Journal Of Clinical Epidemiology 1997, 50: 765-772. PMID: 9253386, DOI: 10.1016/s0895-4356(97)00065-6.Peer-Reviewed Original ResearchMeSH KeywordsActivities of Daily LivingAgedGeriatric AssessmentHumansLogistic ModelsMovementOdds RatioPhysical FitnessPrognosisProspective StudiesRisk FactorsWalkingConceptsUseful prognostic informationADL dependencePhysical performanceElderly personsPrognostic informationDaily livingCommunity-living elderly personsSingle assessmentLarge representative cohortAssessment of changesFuture disabilityBaseline interviewRepresentative cohortPowerful predictorRole of changesRiskParticipantsShort intervalsYearsAssessmentBaseline performancePersonsCohortYear interviewsADLA Predictive Model for ADL Dependence in Community‐Living Older Adults Based on a Reduced Set of Cognitive Status Items
Gill T, Williams C, Richardson E, Berkman L, Tinetti M. A Predictive Model for ADL Dependence in Community‐Living Older Adults Based on a Reduced Set of Cognitive Status Items. Journal Of The American Geriatrics Society 1997, 45: 441-445. PMID: 9100712, DOI: 10.1111/j.1532-5415.1997.tb05168.x.Peer-Reviewed Original ResearchMeSH KeywordsActivities of Daily LivingAgedCognitionCohort StudiesFemaleHumansMaleMemory, Short-TermMental Status ScheduleModels, StatisticalProspective StudiesROC CurveConceptsADL dependenceDevelopment cohortValidation cohortPresence of impairmentsPopulation-based cohort studyMini-Mental State Examination (MMSE) itemCommunity-living older adultsCommunity-living personsSelf-reported ADLOlder person's riskYears of ageCohort studyResearch nursesMultivariable analysisRisk groupsBaseline interviewInitial cohortStratified subjectsSeparate cohortCohortPerson's riskGeneral communityOlder adultsCognitive AssessmentComparable subjects
1996
Impairments in Physical Performance and Cognitive Status as Predisposing Factors for Functional Dependence Among Nondisabled Older Persons
Gill T, Williams C, Richardson E, Tinetti M. Impairments in Physical Performance and Cognitive Status as Predisposing Factors for Functional Dependence Among Nondisabled Older Persons. The Journals Of Gerontology Series A 1996, 51A: m283-m288. PMID: 8914500, DOI: 10.1093/gerona/51a.6.m283.Peer-Reviewed Original ResearchConceptsCognitive statusPhysical performanceOlder personsCommunity-living older adultsSlow functional declineWorse physical performanceCommunity-living adultsComplete outcome dataChronic conditionsPredisposing factorsFunctional declineDaily livingOutcome dataCognitive testingOlder adultsImpairmentRiskProbability sampleSubjectsStatusAdultsYearsComprehensive assessmentSimilar resultsFollow