Featured Publications
Effect 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 ConnecticutA 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
2019
Challenges and strategies in patients’ health priorities-aligned decision-making for older adults with multiple chronic conditions
Tinetti M, Dindo L, Smith CD, Blaum C, Costello D, Ouellet G, Rosen J, Hernandez-Bigos K, Geda M, Naik A. Challenges and strategies in patients’ health priorities-aligned decision-making for older adults with multiple chronic conditions. PLOS ONE 2019, 14: e0218249. PMID: 31181117, PMCID: PMC6557523, DOI: 10.1371/journal.pone.0218249.Peer-Reviewed Original ResearchConceptsPatients' health prioritiesMultiple chronic conditionsHealth priorityChronic conditionsPatient prioritiesPatient Priorities CarePrimary care cliniciansCare of patientsCare cliniciansPrimary carePatient outcomesCardiology practicePatientsCare optionsCare PilotCliniciansOlder adultsSerial trialsCarePriority careImplementation teamQualitative studyMultiple conditionsAdditional settingsMultiplicity of problems
2018
Feasibility of Implementing Patient Priorities Care for Older Adults with Multiple Chronic Conditions
Blaum CS, Rosen J, Naik AD, Smith CD, Dindo L, Vo L, Hernandez‐Bigos K, Esterson J, Geda M, Ferris R, Costello D, Acampora D, Meehan T, Tinetti ME. Feasibility of Implementing Patient Priorities Care for Older Adults with Multiple Chronic Conditions. Journal Of The American Geriatrics Society 2018, 66: 2009-2016. PMID: 30281777, PMCID: PMC7015118, DOI: 10.1111/jgs.15465.Peer-Reviewed Original ResearchConceptsPatient Priorities CarePrimary care providersMultiple chronic conditionsOlder adultsChronic conditionsElectronic health record supportStudy-Act cyclesImplementation feasibility studyClinical championsHealth outcome goalsPrimary careClinicians' perceptionsTreatment decisionsPatient prioritiesClinic workflowClinician concernsCardiology practiceCare providersPDSA cyclesEHR documentationClinical settingHealthcare preferencesPriority discussionInterprofessional communicationClinicians
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
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
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 ResearchConceptsFunctional 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
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 instrumentsDizziness 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
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 agenciesWho 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 measurementsHealth 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 practitioners
1997
Driving Cessation and Increased Depressive Symptoms: Prospective Evidence from the New Haven EPESE
Marottoli R, de Leon C, Glass T, Williams C, Cooney L, Berkman L, Tinetti M. Driving Cessation and Increased Depressive Symptoms: Prospective Evidence from the New Haven EPESE. Journal Of The American Geriatrics Society 1997, 45: 202-206. PMID: 9033520, DOI: 10.1111/j.1532-5415.1997.tb04508.x.Peer-Reviewed Original ResearchConceptsHealth-related factorsDepressive symptomsEpidemiologic Studies Depression ScaleEffect of cessationCohort studyMultivariable analysisOlder driversProspective evidenceElderly cohortEpidemiologic studiesMedical conditionsPotential confoundingAlternative transportation strategiesSymptomsCessationStrongest predictorNew HavenUrban communitiesFactorsCohortEPESEActive drivers
1996
Does 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 wards
1988
Risk Factors for Falls among Elderly Persons Living in the Community
Tinetti M, Speechley M, Ginter S. Risk Factors for Falls among Elderly Persons Living in the Community. New England Journal Of Medicine 1988, 319: 1701-1707. PMID: 3205267, DOI: 10.1056/nejm198812293192604.Peer-Reviewed Original ResearchConceptsRisk factorsElderly personsAbnormalities of balanceBimonthly telephone callsSimple clinical assessmentMore risk factorsDetailed clinical evaluationYears of ageAcute illnessPercent confidence intervalsPalmomental reflexSedative useFoot problemsProspective InvestigationClinical evaluationMental statusOdds ratioClinical assessmentLower extremitiesCognitive impairmentOlder personsGreater riskTelephone callsConfidence intervalsSerious injuries