Featured Publications
Shared 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
2022
Benefits and harms of oral anticoagulants for atrial fibrillation in nursing home residents with advanced dementia
Ouellet GM, O'Leary JR, Leggett CG, Skinner J, Tinetti ME, Cohen AB. Benefits and harms of oral anticoagulants for atrial fibrillation in nursing home residents with advanced dementia. Journal Of The American Geriatrics Society 2022, 71: 561-568. PMID: 36310367, PMCID: PMC9957933, DOI: 10.1111/jgs.18108.Peer-Reviewed Original ResearchConceptsNursing home residentsAtrial fibrillationAdvanced dementiaHome residentsStroke riskLong-stay nursing home residentsMedicare Part D claimsDementia-related mortalityGuideline-recommended thresholdHarms of anticoagulationRetrospective cohort studyMultivariable survival analysisValvular heart diseaseRisk of deathPart D claimsMonths of lifeMinimum Data SetAnticoagulant discontinuationAnticoagulated individualsMean CHAVASc scoreCause mortalityMultivariable adjustmentOral anticoagulantsCohort study
2014
A Cluster-Randomized Controlled Trial of a Multicomponent Intervention Protocol for Pneumonia Prevention Among Nursing Home Elders
Juthani-Mehta M, Van Ness PH, McGloin J, Argraves S, Chen S, Charpentier P, Miller L, Williams K, Wall D, Baker D, Tinetti M, Peduzzi P, Quagliarello VJ. A Cluster-Randomized Controlled Trial of a Multicomponent Intervention Protocol for Pneumonia Prevention Among Nursing Home Elders. Clinical Infectious Diseases 2014, 60: 849-857. PMID: 25520333, PMCID: PMC4415071, DOI: 10.1093/cid/ciu935.Peer-Reviewed Original ResearchConceptsNursing home residentsUsual careHome residentsIntervention protocolFirst pneumoniaControl armClinical trialsNursing homesMultivariable Cox regression modelsElderly nursing home residentsCluster-randomized clinical trialImportant public health problemChlorhexidine oral rinseModifiable risk factorsRespiratory tract infectionsCox regression modelNursing home eldersPublic health problemHazard ratioPneumonia preventionSecondary outcomesTract infectionsControlled TrialsPrimary outcomeOral rinse
2009
Pilot Testing of Intervention Protocols to Prevent Pneumonia in Nursing Home Residents
Quagliarello V, Juthani‐Mehta M, Ginter S, Towle V, Allore H, Tinetti M. Pilot Testing of Intervention Protocols to Prevent Pneumonia in Nursing Home Residents. Journal Of The American Geriatrics Society 2009, 57: 1226-1231. PMID: 19558483, PMCID: PMC2779042, DOI: 10.1111/j.1532-5415.2009.02311.x.Peer-Reviewed Original ResearchConceptsNursing home residentsChlorhexidine oral rinseOral brushingHome residentsOral hygieneStaff adherenceOral rinseIntervention protocolImproved oral hygienePneumonia risk factorsRisk factor reductionPlaque score reductionPrevent PneumoniaChlorhexidine rinseProspective studyRisk factorsScore reductionNursing homesSwallowing techniquesAdherenceBrushingFactor reductionPneumoniaHygieneMonths
2008
Development of a Tool for Eliciting Patient Priority from Among Competing Cardiovascular Disease, Medication‐Symptoms, and Fall Injury Outcomes
Tinetti ME, McAvay GJ, Fried TR, Foody JM, Bianco L, Ginter S, Fraenkel L. Development of a Tool for Eliciting Patient Priority from Among Competing Cardiovascular Disease, Medication‐Symptoms, and Fall Injury Outcomes. Journal Of The American Geriatrics Society 2008, 56: 730-736. PMID: 18266842, PMCID: PMC3703614, DOI: 10.1111/j.1532-5415.2007.01627.x.Peer-Reviewed Original ResearchConceptsMedication symptomsFall injuriesIntraclass correlationCardiovascular disease outcomesMedication-related symptomsWilcoxon rank sum testRank sum testCVD outcomesCardiovascular diseaseDisease outcomePatient prioritiesSenior housing residentsSenior housing sitesInjury outcomesInjurySum testConvenience sampleRelative importance scores
2005
Nursing Home Practitioner Survey of Diagnostic Criteria for Urinary Tract Infections
Juthani‐Mehta M, Drickamer MA, Towle V, Zhang Y, Tinetti ME, Quagliarello VJ. Nursing Home Practitioner Survey of Diagnostic Criteria for Urinary Tract Infections. Journal Of The American Geriatrics Society 2005, 53: 1986-1990. PMID: 16274383, DOI: 10.1111/j.1532-5415.2005.00470.x.Peer-Reviewed Original ResearchConceptsUrinary tract infectionNursing home residentsTract infectionsLaboratory criteriaHome residentsDiagnostic criteriaClinical practiceConsensus criteriaInfection control practitionersFirst diagnostic stepMcGeer criteriaNoncatheterized patientsUrine cultureProspective dataMental statusNineteen physiciansSurveillance criteriaNursing homesPrevention strategiesSelf-administered surveyDipstick analysisDiagnostic stepsPhysician assistantsCharge nursesNurses
2001
Validation of Dizziness as a Possible Geriatric Syndrome
Kao A, Nanda A, Williams C, Tinetti M. Validation of Dizziness as a Possible Geriatric Syndrome. Journal Of The American Geriatrics Society 2001, 49: 72-75. PMID: 11207845, DOI: 10.1046/j.1532-5415.2001.49012.x.Peer-Reviewed Original ResearchConceptsReports of dizzinessRisk factorsGeriatric syndromesOlder personsClinic-based cohortCharacteristics of patientsSeverity of dizzinessCommunity-based cohortPopulation-based studyClinic-based populationCross-sectional studyPhysical examination dataEligible patientsPostural hypotensionMore medicationsMultifactorial interventionOlder patientsMedical historyMyocardial infarctionDizzinessMultifactorial etiologyDepressive symptomsAbnormal balancePatientsDiscrete disease
2000
Dizziness among older adults: a possible geriatric syndrome.
Tinetti M, Williams C, Gill T. Dizziness among older adults: a possible geriatric syndrome. Annals Of Internal Medicine 2000, 132: 337-44. PMID: 10691583, DOI: 10.7326/0003-4819-132-5-200003070-00002.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overAnxietyConnecticutCross-Sectional StudiesDepressionDizzinessDrug-Related Side Effects and Adverse ReactionsFemaleHearing DisordersHumansHypotension, OrthostaticMaleMyocardial InfarctionPostural BalancePrevalenceRisk FactorsSensation DisordersStatistics as TopicSyndromeConceptsAdjusted relative riskGeriatric syndromesRelative riskEpisodes of dizzinessCommunity-living personsPast myocardial infarctionCross-sectional studyYears of agePostural hypotensionMore medicationsMyocardial infarctionImpaired balanceDizzinessDepressive symptomsSyndromeImpaired hearingSpecific causesOlder adultsMultiple causesSymptomsProbability sampleRiskSensationCauseNew Haven
1999
Alcohol 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 effectsWho 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 homesDrugs and Falls in Older People: A Systematic Review and Meta‐analysis: I. Psychotropic Drugs
Leipzig R, Cumming R, Tinetti M. Drugs and Falls in Older People: A Systematic Review and Meta‐analysis: I. Psychotropic Drugs. Journal Of The American Geriatrics Society 1999, 47: 30-39. PMID: 9920227, DOI: 10.1111/j.1532-5415.1999.tb01898.x.Peer-Reviewed Original ResearchConceptsPsychotropic drugsNeuroleptic useOlder peopleLong acting benzodiazepinesDuration of therapyIncidence of fallsNumber of fallersAdverse outcome eventsPooled odds ratioEnglish-language articlesIncreased fallsAntidepressant useHypnotic useMore fallsActing benzodiazepineBenzodiazepine useMean agePsychotropic usePooled ORsOdds ratioOutcome eventsTCA useExclusion criteriaEligibility criteriaResponse rateDrugs and Falls in Older People: A Systematic Review and Meta‐analysis: II. Cardiac and Analgesic Drugs
Leipzig R, Cumming R, Tinetti M. Drugs and Falls in Older People: A Systematic Review and Meta‐analysis: II. Cardiac and Analgesic Drugs. Journal Of The American Geriatrics Society 1999, 47: 40-50. PMID: 9920228, DOI: 10.1111/j.1532-5415.1999.tb01899.x.Peer-Reviewed Original ResearchConceptsPooled odds ratioAnalgesic drugsOdds ratioDiuretic useRecurrent fallsOlder peopleOlder adultsAnalgesic drug useNonnarcotic analgesic useDuration of therapyIncidence of fallsNumber of fallersCalcium channel blockersMean subject ageEnglish-language articlesDigoxin useNSAID useAnalgesic useAspirin useLoop diureticsMedication useThiazide diureticsNarcotic useACE inhibitorsMore falls
1998
Development 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 ResearchConceptsSix-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
The 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 ResearchConceptsUseful prognostic informationADL dependencePhysical performanceElderly personsPrognostic informationDaily livingCommunity-living elderly personsSingle assessmentLarge representative cohortAssessment of changesFuture disabilityBaseline interviewRepresentative cohortPowerful predictorRole of changesRiskParticipantsShort intervalsYearsAssessmentBaseline performancePersonsCohortYear interviewsADL
1996
A Multifactorial Approach to Reducing Injurious Falls
King M, Tinetti M. A Multifactorial Approach to Reducing Injurious Falls. Clinics In Geriatric Medicine 1996, 12: 745-759. PMID: 8890114, DOI: 10.1016/s0749-0690(18)30199-x.Peer-Reviewed Original ResearchDoes Multiple Risk Factor Reduction Explain the Reduction in Fall Rate in the Yale FICSIT Trial?
Tinetti M, McAvay G, Claus E. Does Multiple Risk Factor Reduction Explain the Reduction in Fall Rate in the Yale FICSIT Trial? American Journal Of Epidemiology 1996, 144: 389-399. PMID: 8712196, DOI: 10.1093/oxfordjournals.aje.a008940.Peer-Reviewed Original ResearchConceptsRisk factor reductionPostural blood pressure changesBlood pressure changesFall rateFactor reductionMultiple risk factor reductionCommunity-living older personsStudied risk factorsLower fall ratesGreater risk reductionFICSIT TrialsBorderline significanceIntervention groupRisk factorsFall preventionSV groupControl groupOlder personsStep lengthTertileToilet transferPressure changesChange scoresTreatment effectsRisk reduction
1995
The Contribution of Predisposing and Situational Risk Factors to Serious Fall Injuries
Tinetti M, Doucette J, Claus E. The Contribution of Predisposing and Situational Risk Factors to Serious Fall Injuries. Journal Of The American Geriatrics Society 1995, 43: 1207-1213. PMID: 7594153, DOI: 10.1111/j.1532-5415.1995.tb07395.x.Peer-Reviewed Original ResearchConceptsSerious fall injuriesRisk factorsFall injuriesSerious injuriesSituational risk factorsLower body mass indexPercentage of fallersBody mass indexLoss of consciousnessMulticomponent intervention programPhysical performance measuresFirst fallRisk of injuryCohort studyInjury overallPrimary outcomeMass indexHead injuryJoint dislocationFemale genderHome assessmentCognitive impairmentPreventive programsMultivariate analysisInjuryRisk Factors for Serious Injury During Falls by Older Persons in the Community
Tinetti M, Doucette J, Claus E, Marottoli R. Risk Factors for Serious Injury During Falls by Older Persons in the Community. Journal Of The American Geriatrics Society 1995, 43: 1214-1221. PMID: 7594154, DOI: 10.1111/j.1532-5415.1995.tb07396.x.Peer-Reviewed Original ResearchConceptsSerious fall injuriesFall injury eventsFall injuriesOlder personsRisk factorsInjury eventsLower body mass indexCommunity-living personsBody mass indexSerious injuriesFall calendarsHospital recordsMass indexGait impairmentChronic conditionsEmergency roomFemale genderOlder fallersInjury dataCognitive impairmentInjuryTelephone interviewsPrevention effortsIdentifiable factorsOnly subjects