900 Geniuses: Mary Tinetti

Christian Sager

Photos courtesy of the John D. & Catherine T. MacArthur Foundation.
(Every year the MacArthur Foundation names 20-30 fellows. Each is granted $500,000 for what has been unofficially called the "genius" award. To date, more than 900 individuals have been named fellows for a combination of their intellect, persistence and creativity. Occasionally, Stuff of Genius will focus on one of these MacArthur fellows in a series called "900 Geniuses.")

My grandmother fell yesterday. She was surrounded by family, but still stumbled over her own walker, lacerated her arm and injured both her knee and back. The worst part is that it feels like there's nothing we can do to help prevent her falling again. 30% of people over the age of 65 fall every year. What can we do to help the elderly against these odds?

Physicians are searching for solutions. In 2009 the MacArthur Foundation chose Mary Tinetti as a Fellow for her work in geriatrics, specifically helping older people reduce their risk factors for falling. Tinetti has performed numerous studies on falling and directs the Yale Program on Aging, a Connecticut based program dedicated to reducing the health care risks that can lead to falling and subsequent injuries.

Tinetti's research identifies three risk factors that can be reduced to prevent falling:

  1. Muscle Weakness: Our muscles will decline as we get older. But a combination of prevention exercises and physical therapy can help stabilize our bodies' range of motion.
  2. Impairment in Balance: Health professionals that visit the home can diagnose further environmental risk factors that could lead to a fall. They assess balance by watching patients perform routine movements like standing, walking to and from a chair or a bed, carrying objects and bending over. These experts can pinpoint less dependable motions for the elderly to avoid.
  3. Use of Medications: Tinetti has found that medications taken for one condition can sometimes worsen the symptoms of another. Drug treatments for unrelated ailments can potentially affect muscle weakness and balance, increasing the chances of a fall. For instance, Tinetti is currently investigating how blood pressure medication may contribute to falling.

The key to Tinetti's recommendations is to observe multiple factors contributing to a patient's falls. Rather than diagnosing individual problems as they occur, she takes a broad view of the overall well-being of the elderly. To this end, in directing Yale's' Program on Aging, Tinetti ensures these risks are studied across disciplines, including biology, sociology, clinical medical practice and health policy. Hopefully as her practices influence the medical community we'll all be able to make sure our loved ones are safer in old age.

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