Featured Publications
Health 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 cognitionShared 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
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 ResearchMeSH KeywordsAgedCausalityCross-Sectional StudiesDizzinessFemaleGeriatric AssessmentHumansMaleMultivariate AnalysisRisk FactorsSyndromeConceptsReports 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
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
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 effectsGoal-setting in clinical medicine
Bradley E, Bogardus S, Tinetti M, Inouye S. Goal-setting in clinical medicine. Social Science & Medicine 1999, 49: 267-278. PMID: 10414834, DOI: 10.1016/s0277-9536(99)00107-0.Peer-Reviewed Original ResearchWho 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 homesMismatches 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 Haven
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 analysis
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 performanceADLThe 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 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
1993
A predictive index for functional decline in hospitalized elderly medical patients
Inouye S, Wagner D, Acampora D, Horwitz R, Cooney L, Hurst L, Tinetti M. A predictive index for functional decline in hospitalized elderly medical patients. Journal Of General Internal Medicine 1993, 8: 645-652. PMID: 8120679, DOI: 10.1007/bf02598279.Peer-Reviewed Original ResearchMeSH KeywordsActivities of Daily LivingAgedAged, 80 and overChi-Square DistributionCohort StudiesConnecticutFemaleGeriatric AssessmentHospital Bed Capacity, 500 and overHospitals, UniversityHumansLikelihood FunctionsMaleMultivariate AnalysisPrevalenceProportional Hazards ModelsProspective StudiesReproducibility of ResultsRisk FactorsSingle-Blind MethodConceptsFunctional declineRisk factorsMedical patientsValidation cohortDevelopment cohortHospitalized elderly medical patientsIndependent baseline risk factorsLow social activity levelNumber of RFsPredictive indexBaseline risk factorsGeneral medical wardsProspective cohort studyGeneral medical patientsHigh-risk groupUniversity Teaching HospitalElderly medical patientsRisk stratification systemNursing home placementRate of deathSocial activity levelsComparable patientsCohort studyElderly patientsMedical wardsFear of falling and low self-efficacy: a case of dependence in elderly persons.
Tinetti M, Powell L. Fear of falling and low self-efficacy: a case of dependence in elderly persons. Journal Of Gerontology 1993, 48 Spec No: 35-8. PMID: 8409238, DOI: 10.1093/geronj/48.special_issue.35.Peer-Reviewed Original ResearchDevelopment of the Common Data Base for the FICSIT Trials
Buchner D, Hornbrook M, Kutner N, Tinetti M, Dry M, Mulrow C, Schechtman K, Gerety M, Fiatarone M, Wolf S, Rossiter J, Arfken C, Kanten K, Lipsitz L, Sattin R, DeNino L, Group F. Development of the Common Data Base for the FICSIT Trials. Journal Of The American Geriatrics Society 1993, 41: 297-308. PMID: 8440854, DOI: 10.1111/j.1532-5415.1993.tb06708.x.Peer-Reviewed Original ResearchMeSH KeywordsAccidental FallsAgedDatabases, FactualFrail ElderlyGeriatric AssessmentHealth Care CostsHealth PromotionHumansRisk FactorsUnited States
1991
Falls and Injuries in Frail and Vigorous Community Elderly Persons
Speechley M, Tinetti M. Falls and Injuries in Frail and Vigorous Community Elderly Persons. Journal Of The American Geriatrics Society 1991, 39: 46-52. PMID: 1987256, DOI: 10.1111/j.1532-5415.1991.tb05905.x.Peer-Reviewed Original ResearchConceptsElderly personsFrail subjectsCircumstances of fallsFall-related injuriesFrail elderly personsSerious health problemFrail groupFall circumstancesInjury preventionHealth problemsObserved incidencePreventive effortsInjurySerious injuriesFrailFallersVigorous groupSubjectsRepresentative sampleGroupPsychological variablesPersonsFallIncidenceTransition group