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The development of TV applications nowadays excludes users with certain impairments from interacting with and accessing the same type of contents as other users do. Developers are also not interested in developing new or different versions of applications targeting different user characteristics. In this paper we describe a novel adaptive accessibility approach on how to develop accessible TV applications, without requiring too much additional effort from the developers. Integrating multimodal interaction, adaptation techniques and the use of simulators in the design process, we show how to adapt User Interfaces to the individual needs and limitations of elderly users. For this, we rely on the identification of the most relevant impairment configurations among users in practical user-trials, and we draw a relation with user specific characteristics. We provide guidelines for more accessible and centered TV application development.