Faculty ProfilesKenneth Covinsky
Professor in Residence
4150 Clement Street
Ken completed medical school at UCSF, residency in Internal Medicine at Johns Hopkins, and fellowship in General Internal Medicine and Health Outcomes Research at Beth Israel Hospital. He was recruited back to UCSF in 1998 to lead and develop the vision for the research programs in the Geriatrics Division. Working with Division Chief, Seth Landefeld, the Geriatrics Division has developed a nationally recognized research program that improves health and quality of life in older persons. Ken and Seth's primary strategy for building our research program focused on identifying research scientists passionate about older persons early in their careers and supporting them with the best possible mentorship. Some of the first Geriatrician-Scientists we supported, including Louise Walter and Mike Steinman, have become national leaders in Geriatric Medicine, and now co-lead our research programs with Ken. We work to create a people-focused environment that provides exceptional mentorship and support for our faculity and trainees. We seek to create a scholary culture that is driven by our devotion to older patients, in which we are challenged to question existing paradigms.
Ken's research interests focus on understanding the determinants of health outcomes in older persons. He is particularly interested in the importance of functional status. His work has shown that the ability to basic tasks of daily living is a more determinant of health in older persons than their disease diagnoses. His work has also described the factors that lead to loss of functioning in older persons, including the role of acute illness. His work is funded by R01 grants from the National Institute on Aging and the National Institute on Nursing Research, and a K24 mentoring grant from the NIA. He has won several awards that recognize his accomplishments mentoring including the Society of General Internal Medicine Midcareer Mentoring Award. He sees patients in the Geriatrics clinic at the San Francisco VA Medical Center, where he also attends on the inpatient Medical Service.
Ken's research focuses on understanding health outcomes in older persons. His work shows how to combine information about medical, psychological, social, and economic factors to predict health outcomes. He uses these factors in prognostic models that can be used to improve health care in older persons.
Ken has special expertise in disability-the ability of older persons to function independently. He has shown that the functional status of older people, such as the degree of difficulty doing basic activities of daily living, is a more important predictor of health outcomes than illness diagnoses. This work has been used to teach health professionals the importance of asking their patients about functional difficulties. His research has identified factors that predict disability such as depression. His work has also shown that disability in older persons is often precipitated by hospitalization
Ken's clinical activities are based at the San Francisco VA Medical Center. He has an outpatient practice focused on the care of older patients. He also attends and teaches on the inpatient medical service
Recent Articles (139)
Aragon K, Covinsky K, Miao Y, Boscardin WJ, Flint L, Smith AK. Use of the Medicare posthospitalization skilled nursing benefit in the last 6 months of life. Arch Intern Med. 2012 Nov 12; 172(20):1573-9.
Byers AL, Vittinghoff E, Lui LY, Hoang T, Blazer DG, Covinsky KE, Ensrud KE, Cauley JA, Hillier TA, Fredman L, Yaffe K. Twenty-year depressive trajectories among older women. Arch Gen Psychiatry. 2012 Oct; 69(10):1073-9.
Naylor MD, Karlawish JH, Arnold SE, Khachaturian AS, Khachaturian ZS, Lee VM, Baumgart M, Banerjee S, Beck C, Blennow K, Brookmeyer R, Brunden KR, Buckwalter KC, Comer M, Covinsky K, Feinberg LF, Frisoni G, Green C, Guimaraes RM, Gwyther LP, Hefti FF, Hutton M, Kawas C, Kent DM, Kuller L, Langa KM, Mahley RW, Maslow K, Masters CL, Meier DE, Neumann PJ, Paul SM, Petersen RC, Sager MA, Sano M, Schenk D, Soares H, Sperling RA, Stahl SM, van Deerlin V, Stern Y, Weir D, Wolk DA, Trojanowski JQ. Advancing Alzheimer's disease diagnosis, treatment, and care: recommendations from the Ware Invitational Summit. Alzheimers Dement. 2012 Sep; 8(5):445-52.
Depalma G, Xu H, Covinsky KE, Craig BA, Stallard E, Thomas J, Sands LP. Hospital Readmission Among Older Adults Who Return Home With Unmet Need for ADL Disability. Gerontologist. 2013 Jun; 53(3):454-61.
Smith AK, McCarthy E, Weber E, Cenzer IS, Boscardin J, Fisher J, Covinsky K. Half of older Americans seen in emergency department in last month of life; most admitted to hospital, and many die there. Health Aff (Millwood). 2012 Jun; 31(6):1277-85.
Odden MC, Covinsky KE, Neuhaus JM, Mayeda ER, Peralta CA, Haan MN. The association of blood pressure and mortality differs by self-reported walking speed in older Latinos. J Gerontol A Biol Sci Med Sci. 2012 Sep; 67(9):977-83.
Widera E, Covinsky KE. Fulfilling our obligation to the caregiver: it's time for action: comment on "Translation of a dementia caregiver support program in a health care system--REACH VA". Arch Intern Med. 2011 Feb 28; 171(4):359-60.
Smith AK, Ayanian JZ, Covinsky KE, Landon BE, McCarthy EP, Wee CC, Steinman MA. Conducting high-value secondary dataset analysis: an introductory guide and resources. J Gen Intern Med. 2011 Aug; 26(8):920-9.
Kelly A, Conell-Price J, Covinsky K, Cenzer IS, Chang A, Boscardin WJ, Smith AK. Length of stay for older adults residing in nursing homes at the end of life. J Am Geriatr Soc. 2010 Sep; 58(9):1701-6.
Yaffe K, Vittinghoff E, Lindquist K, Barnes D, Covinsky KE, Neylan T, Kluse M, Marmar C. Posttraumatic stress disorder and risk of dementia among US veterans. Arch Gen Psychiatry. 2010 Jun; 67(6):608-13.
Byers AL, Yaffe K, Covinsky KE, Friedman MB, Bruce ML. High occurrence of mood and anxiety disorders among older adults: The National Comorbidity Survey Replication. Arch Gen Psychiatry. 2010 May; 67(5):489-96.
Barnes DE, Covinsky KE, Whitmer RA, Kuller LH, Lopez OL, Yaffe K. Commentary on "Developing a national strategy to prevent dementia: Leon Thal Symposium 2009." Dementia risk indices: A framework for identifying individuals with a high dementia risk. Alzheimers Dement. 2010 Mar; 6(2):138-41.
Covinsky KE, Yaffe K, Lindquist K, Cherkasova E, Yelin E, Blazer DG. Depressive symptoms in middle age and the development of later-life functional limitations: the long-term effect of depressive symptoms. J Am Geriatr Soc. 2010 Mar; 58(3):551-6.
Kurella Tamura M, Covinsky KE, Chertow GM, Yaffe K, Landefeld CS, McCulloch CE. Functional status of elderly adults before and after initiation of dialysis. N Engl J Med. 2009 Oct 15; 361(16):1539-47.
Williams BA, Baillargeon JG, Lindquist K, Walter LC, Covinsky KE, Whitson HE, Steinman MA. Medication prescribing practices for older prisoners in the Texas prison system. Am J Public Health. 2010 Apr; 100(4):756-61.
Justice AC, McGinnis KA, Skanderson M, Chang CC, Gibert CL, Goetz MB, Rimland D, Rodriguez-Barradas MC, Oursler KK, Brown ST, Braithwaite RS, May M, Covinsky KE, Roberts MS, Fultz SL, Bryant KJ. Towards a combined prognostic index for survival in HIV infection: the role of 'non-HIV' biomarkers. HIV Med. 2010 Feb; 11(2):143-51.
Mehta KM, Stewart AL, Langa KM, Yaffe K, Moody-Ayers S, Williams BA, Covinsky KE. "Below average" self-assessed school performance and Alzheimer's disease in the Aging, Demographics, and Memory Study. Alzheimers Dement. 2009 Sep; 5(5):380-7.
O'Hare AM, Kaufman JS, Covinsky KE, Landefeld CS, McFarland LV, Larson EB. Current guidelines for using angiotensin-converting enzyme inhibitors and angiotensin II-receptor antagonists in chronic kidney disease: is the evidence base relevant to older adults? Ann Intern Med. 2009 May 19; 150(10):717-24.
Lee SJ, Sudore RL, Williams BA, Lindquist K, Chen HL, Covinsky KE. Functional limitations, socioeconomic status, and all-cause mortality in moderate alcohol drinkers. J Am Geriatr Soc. 2009 Jun; 57(6):955-62.
Boyd CM, Landefeld CS, Counsell SR, Palmer RM, Fortinsky RH, Kresevic D, Burant C, Covinsky KE. Recovery of activities of daily living in older adults after hospitalization for acute medical illness. J Am Geriatr Soc. 2008 Dec; 56(12):2171-9.
Sands LP, Xu H, Craig BA, Eng C, Covinsky KE. Predicting change in functional status over quarterly intervals for older adults enrolled in the PACE community-based long-term care program. Aging Clin Exp Res. 2008 Oct; 20(5):419-27.
Schane RE, Walter LC, Dinno A, Covinsky KE, Woodruff PG. Prevalence and risk factors for depressive symptoms in persons with chronic obstructive pulmonary disease. J Gen Intern Med. 2008 Nov; 23(11):1757-62.
Covinsky KE, Lin F, Bittner V, Hlatky MA, Knight SJ, Vittinghoff E. Health-related quality of life following coronary artery bypass graft surgery in post-menopausal women. J Gen Intern Med. 2008 Sep; 23(9):1429-34.
Doolan DM, Stotts NA, Benowitz NL, Covinsky KE, Froelicher ES. The Women's Initiative for Nonsmoking (WINS) XI: age-related differences in smoking cessation responses among women with cardiovascular disease. Am J Geriatr Cardiol. 2008 Jan-Feb; 17(1):37-47.
Lee SJ, Moody-Ayers SY, Landefeld CS, Walter LC, Lindquist K, Segal MR, Covinsky KE. The relationship between self-rated health and mortality in older black and white Americans. J Am Geriatr Soc. 2007 Oct; 55(10):1624-9.
Mehta KM, Yaffe K, Brenes GA, Newman AB, Shorr RI, Simonsick EM, Ayonayon HN, Rubin SM, Covinsky KE. Anxiety symptoms and decline in physical function over 5 years in the health, aging and body composition study. J Am Geriatr Soc. 2007 Feb; 55(2):265-70.
Holroyd-Leduc JM, Sen S, Bertenthal D, Sands LP, Palmer RM, Kresevic DM, Covinsky KE, Seth Landefeld C. The relationship of indwelling urinary catheters to death, length of hospital stay, functional decline, and nursing home admission in hospitalized older medical patients. J Am Geriatr Soc. 2007 Feb; 55(2):227-33.
O'Hare AM, Bertenthal D, Walter LC, Garg AX, Covinsky K, Kaufman JS, Rodriguez RA, Allon M. When to refer patients with chronic kidney disease for vascular access surgery: should age be a consideration? Kidney Int. 2007 Mar; 71(6):555-61.
O'Hare AM, Bertenthal D, Covinsky KE, Landefeld CS, Sen S, Mehta K, Steinman MA, Borzecki A, Walter LC. Mortality risk stratification in chronic kidney disease: one size for all ages? J Am Soc Nephrol. 2006 Mar; 17(3):846-53.
Sands LP, Wang Y, McCabe GP, Jennings K, Eng C, Covinsky KE. Rates of acute care admissions for frail older people living with met versus unmet activity of daily living needs. J Am Geriatr Soc. 2006 Feb; 54(2):339-44.
Moody-Ayers SY, Stewart AL, Covinsky KE, Inouye SK. Prevalence and correlates of perceived societal racism in older African-American adults with type 2 diabetes mellitus. J Am Geriatr Soc. 2005 Dec; 53(12):2202-8.
Sands LP, Landefeld CS, Ayers SM, Yaffe K, Palmer R, Fortinsky R, Counsell SR, Covinsky KE. Disparities between black and white patients in functional improvement after hospitalization for an acute illness. J Am Geriatr Soc. 2005 Oct; 53(10):1811-6.
Moody-Ayers SY, Mehta KM, Lindquist K, Sands L, Covinsky KE. Black-white disparities in functional decline in older persons: the role of cognitive function. J Gerontol A Biol Sci Med Sci. 2005 Jul; 60(7):933-9.
Li AK, Covinsky KE, Sands LP, Fortinsky RH, Counsell SR, Landefeld CS. Reports of financial disability predict functional decline and death in older patients discharged from the hospital. J Gen Intern Med. 2005 Feb; 20(2):168-74.
Carey EC, Walter LC, Lindquist K, Covinsky KE. Development and validation of a functional morbidity index to predict mortality in community-dwelling elders. J Gen Intern Med. 2004 Oct; 19(10):1027-33.
Burton EC, Phillips RS, Covinsky KE, Sands LP, Goldman L, Dawson NV, Connors AF, Landefeld CS. The relation of autopsy rate to physicians' beliefs and recommendations regarding autopsy. Am J Med. 2004 Aug 15; 117(4):255-61.
Walter LC, Davidowitz NP, Heineken PA, Covinsky KE. Pitfalls of converting practice guidelines into quality measures: lessons learned from a VA performance measure. JAMA. 2004 May 26; 291(20):2466-70.
Walter LC, Lindquist K, Covinsky KE. Relationship between health status and use of screening mammography and Papanicolaou smears among women older than 70 years of age. Ann Intern Med. 2004 May 4; 140(9):681-8.
Covinsky KE, Newcomer R, Fox P, Wood J, Sands L, Dane K, Yaffe K. Patient and caregiver characteristics associated with depression in caregivers of patients with dementia. J Gen Intern Med. 2003 Dec; 18(12):1006-14.
Chuang KH, Covinsky KE, Sands LP, Fortinsky RH, Palmer RM, Landefeld CS. Diagnosis-related group-adjusted hospital costs are higher in older medical patients with lower functional status. J Am Geriatr Soc. 2003 Dec; 51(12):1729-34.
Mehta KM, Yaffe K, Langa KM, Sands L, Whooley MA, Covinsky KE. Additive effects of cognitive function and depressive symptoms on mortality in elderly community-living adults. J Gerontol A Biol Sci Med Sci. 2003 May; 58(5):M461-7.
Lindenberger EC, Landefeld CS, Sands LP, Counsell SR, Fortinsky RH, Palmer RM, Kresevic DM, Covinsky KE. Unsteadiness reported by older hospitalized patients predicts functional decline. J Am Geriatr Soc. 2003 May; 51(5):621-6.
Covinsky KE, Palmer RM, Fortinsky RH, Counsell SR, Stewart AL, Kresevic D, Burant CJ, Landefeld CS. Loss of independence in activities of daily living in older adults hospitalized with medical illnesses: increased vulnerability with age. J Am Geriatr Soc. 2003 Apr; 51(4):451-8.
Tan EJ, Lui LY, Eng C, Jha AK, Covinsky KE. Differences in mortality of black and white patients enrolled in the program of all-inclusive care for the elderly. J Am Geriatr Soc. 2003 Feb; 51(2):246-51.
Sands LP, Yaffe K, Covinsky K, Chren MM, Counsell S, Palmer R, Fortinsky R, Landefeld CS. Cognitive screening predicts magnitude of functional recovery from admission to 3 months after discharge in hospitalized elders. J Gerontol A Biol Sci Med Sci. 2003 Jan; 58(1):37-45.
Sands LP, Yaffe K, Lui LY, Stewart A, Eng C, Covinsky K. The effects of acute illness on ADL decline over 1 year in frail older adults with and without cognitive impairment. J Gerontol A Biol Sci Med Sci. 2002 Jul; 57(7):M449-54.
Covinsky KE, Covinsky MH, Palmer RM, Sehgal AR. Serum albumin concentration and clinical assessments of nutritional status in hospitalized older people: different sides of different coins? J Am Geriatr Soc. 2002 Apr; 50(4):631-7.
Justice AC, Landefeld CS, Asch SM, Gifford AL, Whalen CC, Covinsky KE. Justification for a new cohort study of people aging with and without HIV infection. J Clin Epidemiol. 2001 Dec; 54 Suppl 1:S3-8.
Covinsky KE, Eng C, Lui LY, Sands LP, Sehgal AR, Walter LC, Wieland D, Eleazer GP, Yaffe K. Reduced employment in caregivers of frail elders: impact of ethnicity, patient clinical characteristics, and caregiver characteristics. J Gerontol A Biol Sci Med Sci. 2001 Nov; 56(11):M707-13.
Walter LC, Brand RJ, Counsell SR, Palmer RM, Landefeld CS, Fortinsky RH, Covinsky KE. Development and validation of a prognostic index for 1-year mortality in older adults after hospitalization. JAMA. 2001 Jun 20; 285(23):2987-94.
Covinsky KE, Kahana E, Kahana B, Kercher K, Schumacher JG, Justice AC. History and mobility exam index to identify community-dwelling elderly persons at risk of falling. J Gerontol A Biol Sci Med Sci. 2001 Apr; 56(4):M253-9.
Counsell SR, Holder CM, Liebenauer LL, Palmer RM, Fortinsky RH, Kresevic DM, Quinn LM, Allen KR, Covinsky KE, Landefeld CS. Effects of a multicomponent intervention on functional outcomes and process of care in hospitalized older patients: a randomized controlled trial of Acute Care for Elders (ACE) in a community hospital. J Am Geriatr Soc. 2000 Dec; 48(12):1572-81.
Hamel MB, Lynn J, Teno JM, Covinsky KE, Wu AW, Galanos A, Desbiens NA, Phillips RS. Age-related differences in care preferences, treatment decisions, and clinical outcomes of seriously ill hospitalized adults: lessons from SUPPORT. J Am Geriatr Soc. 2000 May; 48(5 Suppl):S176-82.
Covinsky KE, Fuller JD, Yaffe K, Johnston CB, Hamel MB, Lynn J, Teno JM, Phillips RS. Communication and decision-making in seriously ill patients: findings of the SUPPORT project. The Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments. J Am Geriatr Soc. 2000 May; 48(5 Suppl):S187-93.
Phillips RS, Hamel MB, Covinsky KE, Lynn J. Findings from SUPPORT and HELP: an introduction. Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatment. Hospitalized Elderly Longitudinal Project. J Am Geriatr Soc. 2000 May; 48(5 Suppl):S1-5.
Lynn J, De Vries KO, Arkes HR, Stevens M, Cohn F, Murphy P, Covinsky KE, Hamel MB, Dawson NV, Tsevat J. Ineffectiveness of the SUPPORT intervention: review of explanations. J Am Geriatr Soc. 2000 May; 48(5 Suppl):S206-13.
Covinsky KE, Chren MM, Harper DL, Way LE, Rosenthal GE. Differences in patient-reported processes and outcomes between men and women with myocardial infarction. J Gen Intern Med. 2000 Mar; 15(3):169-74.
Covinsky KE, Palmer RM, Counsell SR, Pine ZM, Walter LC, Chren MM. Functional status before hospitalization in acutely ill older adults: validity and clinical importance of retrospective reports. J Am Geriatr Soc. 2000 Feb; 48(2):164-9.
Sehgal AR, Silver MR, Covinsky KE, Coffin R, Cain JA. Use of standardized ratios to examine variability in hemodialysis vascular access across facilities. Medical Review Board of The Renal Network, Inc. Am J Kidney Dis. 2000 Feb; 35(2):275-81.
Fortinsky RH, Covinsky KE, Palmer RM, Landefeld CS. Effects of functional status changes before and during hospitalization on nursing home admission of older adults. J Gerontol A Biol Sci Med Sci. 1999 Oct; 54(10):M521-6.
Covinsky KE, Martin GE, Beyth RJ, Justice AC, Sehgal AR, Landefeld CS. The relationship between clinical assessments of nutritional status and adverse outcomes in older hospitalized medical patients. J Am Geriatr Soc. 1999 May; 47(5):532-8.
Covinsky KE, Wu AW, Landefeld CS, Connors AF, Phillips RS, Tsevat J, Dawson NV, Lynn J, Fortinsky RH. Health status versus quality of life in older patients: does the distinction matter? Am J Med. 1999 Apr; 106(4):435-40.
Covinsky KE, Rosenthal GE, Chren MM, Justice AC, Fortinsky RH, Palmer RM, Landefeld CS. The relation between health status changes and patient satisfaction in older hospitalized medical patients. J Gen Intern Med. 1998 Apr; 13(4):223-9.
Roach MJ, Connors AF, Dawson NV, Wenger NS, Wu AW, Tsevat J, Desbiens N, Covinsky KE, Schubert DS. Depressed mood and survival in seriously ill hospitalized adults. The SUPPORT Investigators. Arch Intern Med. 1998 Feb 23; 158(4):397-404.
Covinsky KE, Palmer RM, Kresevic DM, Kahana E, Counsell SR, Fortinsky RH, Landefeld CS. Improving functional outcomes in older patients: lessons from an acute care for elders unit. Jt Comm J Qual Improv. 1998 Feb; 24(2):63-76.
Covinsky KE, King JT, Quinn LM, Siddique R, Palmer R, Kresevic DM, Fortinsky RH, Kowal J, Landefeld CS. Do acute care for elders units increase hospital costs? A cost analysis using the hospital perspective. J Am Geriatr Soc. 1997 Jun; 45(6):729-34.
Covinsky KE, Fortinsky RH, Palmer RM, Kresevic DM, Landefeld CS. Relation between symptoms of depression and health status outcomes in acutely ill hospitalized older persons. Ann Intern Med. 1997 Mar 15; 126(6):417-25.
Chren MM, Lasek RJ, Quinn LM, Covinsky KE. Convergent and discriminant validity of a generic and a disease-specific instrument to measure quality of life in patients with skin disease. J Invest Dermatol. 1997 Jan; 108(1):103-7.
Antani MR, Beyth RJ, Covinsky KE, Anderson PA, Miller DG, Cebul RD, Quinn LM, Landefeld CS. Failure to prescribe warfarin to patients with nonrheumatic atrial fibrillation. J Gen Intern Med. 1996 Dec; 11(12):713-20.
Beyth RJ, Antani MR, Covinsky KE, Miller DG, Chren MM, Quinn LM, Landefeld CS. Why isn't warfarin prescribed to patients with nonrheumatic atrial fibrillation? J Gen Intern Med. 1996 Dec; 11(12):721-8.
Covinsky KE, Landefeld CS, Teno J, Connors AF, Dawson N, Youngner S, Desbiens N, Lynn J, Fulkerson W, Reding D, Oye R, Phillips RS. Is economic hardship on the families of the seriously ill associated with patient and surrogate care preferences? SUPPORT Investigators. Arch Intern Med. 1996 Aug 12-26; 156(15):1737-41.
Covinsky KE, Goldman L, Cook EF, Oye R, Desbiens N, Reding D, Fulkerson W, Connors AF, Lynn J, Phillips RS. The impact of serious illness on patients' families. SUPPORT Investigators. Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatment. JAMA. 1994 Dec 21; 272(23):1839-44.
Jonas A, Covinsky KE, Sweeny SA. Effects of amino group modification in discoidal apolipoprotein A-I-egg phosphatidylcholine-cholesterol complexes on their reactions with lecithin:cholesterol acyltransferase. Biochemistry. 1985 Jul 2; 24(14):3508-13.