Research & Publications
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 clinical care and decision-making with 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
Accidental Falls; Decision Making; Geriatrics; Risk Factors