Featured Publications
Antihypertensive Medications and Serious Fall Injuries in a Nationally Representative Sample of Older Adults
Tinetti ME, Han L, Lee DS, McAvay GJ, Peduzzi P, Gross CP, Zhou B, Lin H. Antihypertensive Medications and Serious Fall Injuries in a Nationally Representative Sample of Older Adults. JAMA Internal Medicine 2014, 174: 588-595. PMID: 24567036, PMCID: PMC4136657, DOI: 10.1001/jamainternmed.2013.14764.Peer-Reviewed Original ResearchConceptsSerious fall injuriesAdjusted hazard ratioAntihypertensive medicationsMultiple chronic conditionsFall injuriesAntihypertensive groupHazard ratioOlder adultsChronic conditionsAntihypertensive medication classesStandardized daily doseAntihypertensive medication useCommunity-living adultsPropensity score adjustmentTraumatic brain injuryHealthy older adultsMedication intensityCardiovascular eventsMedication classesDaily doseHip fractureMedication useNationally Representative SampleHead injuryBrain injuryHealth 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 cognitionEffect of Dissemination of Evidence in Reducing Injuries from Falls
Tinetti ME, Baker DI, King M, Gottschalk M, Murphy TE, Acampora D, Carlin BP, Leo-Summers L, Allore HG. Effect of Dissemination of Evidence in Reducing Injuries from Falls. New England Journal Of Medicine 2008, 359: 252-261. PMID: 18635430, PMCID: PMC3472807, DOI: 10.1056/nejmoa0801748.Peer-Reviewed Original ResearchConceptsFall-related injuriesSerious fall-related injuriesAdjusted ratesIntervention regionClinical practiceElderly personsPercentage of cliniciansPrimary care cliniciansPrevention of fallsMedical servicesRate of injuryYears of ageEvaluation periodDissemination of evidenceCare cliniciansIntervention visitsOutpatient rehabilitationPreintervention periodFall preventionMorbid conditionsNonrandomized designInjuryReducing InjuryCliniciansRegions of ConnecticutShared 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
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
2001
Where Is the Vision for Fall Prevention?
Tinetti M. Where Is the Vision for Fall Prevention? Journal Of The American Geriatrics Society 2001, 49: 676-677. PMID: 11380766, DOI: 10.1046/j.1532-5415.2001.49132.x.Peer-Reviewed Original Research
2000
Environmental Hazards and the Risk of Nonsyncopal Falls in the Homes of Community-Living Older Persons
Gill T, Williams C, Tinetti M. Environmental Hazards and the Risk of Nonsyncopal Falls in the Homes of Community-Living Older Persons. Medical Care 2000, 38: 1174-1183. PMID: 11186296, DOI: 10.1097/00005650-200012000-00004.Peer-Reviewed Original ResearchConceptsNonsyncopal fallsOlder personsCommunity-living older personsProspective cohort studyBalance/gaitYears of ageFall calendarsCohort studyResearch nursesRoom assessmentFall preventionRelative riskSlip hazardsConsistent associationNumber of participantsRiskFace validityPhone callsHigh face validityProbability sampleAgeAssociationFallYearsStandard instrumentsHealth, 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
Mismatches 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 HavenDrugs 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
Health Care Utilization and Costs in a Medicare Population by Fall Status
Rizzo J, Friedkin R, Williams C, Nabors J, Acampora D, Tinetti M. Health Care Utilization and Costs in a Medicare Population by Fall Status. Medical Care 1998, 36: 1174-1188. PMID: 9708590, DOI: 10.1097/00005650-199808000-00006.Peer-Reviewed Original ResearchMeSH KeywordsAccidental FallsAgedCenters for Medicare and Medicaid Services, U.S.ConnecticutFemaleFollow-Up StudiesHealth Care CostsHealth Care SurveysHealth ServicesHealth StatusHumansInjury Severity ScoreLogistic ModelsLong-Term CareMaleMedicareMultivariate AnalysisRegistriesSocioeconomic FactorsUnited StatesConceptsHealth care costsCare costsOlder personsTotal health care costsEmergency room costsHealth care utilizationSeverity of fallsAnnual hospital costsHealth Care Financing AdministrationPublic health practitionersNoninjurious fallsNursing home costsInjurious fallsCare registriesCare utilizationHospital costsFall statusMedicare populationHome healthNursing homesFall frequencyRoom costsFall severitySame time periodHealth practitionersThe Effect of Falls and Fall Injuries on Functioning in Community-Dwelling Older Persons
Tinetti M, Williams C. The Effect of Falls and Fall Injuries on Functioning in Community-Dwelling Older Persons. The Journals Of Gerontology Series A 1998, 53A: m112-m119. PMID: 9520917, DOI: 10.1093/gerona/53a.2.m112.Peer-Reviewed Original ResearchConceptsNoninjurious fallsOlder personsInjurious fallsIndependent determinantsPhysical activityFall statusSerious injuriesCommunity-dwelling older personsAdverse functional outcomesCommunity-dwelling personsAge 71 yearsHospital surveillanceMore fallsFunctional outcomeRisk factorsFall injuriesHigh burdenPreventive strategiesFunctional declineInstrumental activitiesOutcome measuresCohort membersDaily livingHierarchical linear regression modelsInjury
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 subjectsFalls in Community‐Dwelling Older Persons
King M, Tinetti M. Falls in Community‐Dwelling Older Persons. Journal Of The American Geriatrics Society 1995, 43: 1146-1154. PMID: 7560708, DOI: 10.1111/j.1532-5415.1995.tb07017.x.Peer-Reviewed Original Research
1993
Fear 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 Research