Kenneth Covinsky, MD, MPH, BS

Professor of Medicine

Dr. Covinsky is a clinician-researcher in the UCSF Division of Geriatrics. His work focuses on understanding the determinants and outcomes of disability in older persons. He holds the Edmund G. Brown, Sr Distinguished Professorship in Geriatrics and is Principal Investigator of the UCSF Older Americans Independence Center.

Dr. Covinsky completed his undergraduate degree at the University of Illinois and medical school at UCSF. He completed his internal medical training on the Osler Medical Service of the Johns Hopkins Hospital, a fellowship in General Internal Medicine at the Beth Israel Hospital, and an MPH degree at the Harvard School of Public Health.

Dr. Covinsky was recruited back to UCSF in 1988 to lead the research program of the UCSF Geriatrics Division. He has led a nationally recognized research program that has advanced our understanding of the determinants and outcomes of disability in older persons. He has conducted pioneering work that has defined the hospitalization disability syndrome by demonstrating how hospitalization frequently precipitates disability in older persons. He is also a national leader in the science of prognostication in older persons. His work has proven that functional status is a vital determinant of health outcomes and quality of life in older persons.

Dr. Covinsky is passionate about mentoring trainees who are committed to improving the health and well being of older persons. He has received local and national awards for research mentorship including the Bay Area Clinical Research Mentor of the Year Award and the SGIM Midcareer Research Mentoring Award. Several of his mentees, including Louise Walter, Mike Steinman, Sei Lee, and Alex Smith are now local and national leaders in aging research.

Dr. Covinsky is Principal Investigator of the UCSF Older Americans Independence Center (OAIC), a National Institute on Aging Funded Pepper Center. The UCSF OAIC supports UCSF researchers who are working to improve the health outcomes and quality of life of older persons.

Dr. Covinsky attends on the Medical Service and Acute Care For Elders Unit and cares for patients in the Geriatrics clinic at the San Francisco VA Medical Center. He is an Associate Editor at JAMA-Internal Medicine and has served as chair of the Clinical Aging Study section at the National Institute on Aging.
Education
M.D., 1988 - Medicine, University of California, San Francisco
Honors and Awards
  • Academic Senate Distinction In Mentoring Award for faculty at the rank of full Professor, University of California, San Francisco, 2018
  • American Society For Clinical Investigation, 2007
  • Mid Career Research Mentorship Award, Society of General Internal Mediine, 2007
  • Clinical Research Mentor of the Year, Bay Area Clinical Research Symposium, 2005
  • Paul Beeson Faculty Scholar in Aging Research, 1999
Publications
  1. Co-Occurrence of Lower Urinary Tract Symptoms and Frailty among Community-Dwelling Older Men.
  2. Comparative Outcomes for Pelvic Organ Prolapse Surgery Among Nursing Home Residents and Matched Community-Dwelling Older Adults.
  3. Assessing Telemedicine Unreadiness Among Older Adults in the United States During the COVID-19 Pandemic.
  4. I Would Not Be Surprised. What Next?
  5. Moving prevention of functional impairment upstream: is middle age an ideal time for intervention?
  6. Difficulty and help with activities of daily living among older adults living alone with cognitive impairment.
  7. Expectations and Concerns of Older Adults With Cognitive Impairment About Their Relationship With Medical Providers: A Call for Therapeutic Alliances.
  8. Insight into the post-hospital syndrome: a 3-month longitudinal follow up on geriatric syndromes and their association with functional decline, readmission and mortality.
  9. Frailty after lung transplantation is associated with impaired health-related quality of life and mortality.
  10. Advance Care Planning Prior to Death in Older Adults with Hip Fracture.
  11. Switching Between Medicare Advantage And Traditional Medicare Before And After The Onset Of Functional Disability.
  12. Association of Functional, Cognitive, and Psychological Measures With 1-Year Mortality in Patients Undergoing Major Surgery.
  13. Supplemental Nutrition Assistance Program-Do Not Take the Food Out of Patients' Mouths.
  14. Heterogeneous Exposure Associations in Observational Cohort Studies: The Example of Blood Pressure in Older Adults.
  15. Patient-reported measures of well-being in older multiple myeloma patients: use of secondary data source.
  16. Ethical Issues Raised by the Introduction of Artificial Companions to Older Adults with Cognitive Impairment: A Call for Interdisciplinary Collaborations.
  17. Who Becomes a High Utilizer? A Case-Control Study of Older Adults in the USA.
  18. Frailty and the Burden of Concurrent and Incident Disability in Patients With Cirrhosis: A Prospective Cohort Study.
  19. Including the Family in Perioperative Care of Older Adults-A Call for HELP.
  20. 10-Min Targeted Geriatric Assessment Predicts Disability and Hospitalization in Fast-Paced Acute Care Settings.
  21. Caring community and relationship centred care on an end-stage dementia special care unit.
  22. Prognostic value of a rapid sarcopenia measure in acutely ill older adults.
  23. Care Settings and Clinical Characteristics of Older Adults with Moderately Severe Dementia.
  24. Reply to: Older People's Loneliness in Clinical Work.
  25. A Multi Year Cross Sectional Study of US National Prescribing Patterns of First Generation Sedating Antihistamines in Older Adults with Skin Disease.
  26. Clinical Trial Evidence for the Real World.
  27. Walking the Tightrope Between Study Participant Autonomy and Researcher Integrity: The Case Study of a Research Participant With Alzheimer's Disease Pursuing Euthanasia in Switzerland.
  28. Frailty trajectories in adult lung transplantation: A cohort study.
  29. The Precarity of Older Adults Living Alone With Cognitive Impairment.
  30. A Practical Approach to Assessing and Mitigating Loneliness and Isolation in Older Adults.
  31. Home Modifications to Reduce Disability in Older Adults With Functional Disability.
  32. A 10-min Targeted Geriatric Assessment Predicts Mortality in Fast-Paced Acute Care Settings: A Prospective Cohort Study.
  33. Creating a Partnership Between Dermatologists and Geriatricians-Reply.
  34. Family Caregiver Factors Associated With Emergency Department Utilization Among Community-Living Older Adults With Disabilities.
  35. Functional Status and Survival After Breast Cancer Surgery in Nursing Home Residents.
  36. Assessing Risk for Adverse Outcomes in Older Adults: The Need to Include Both Physical Frailty and Cognition.
  37. Family Caregivers of Older Adults, 1999-2015: Trends in Characteristics, Circumstances, and Role-Related Appraisal.
  38. Screening, Recruitment, and Baseline Characteristics for the Strategies to Reduce Injuries and Develop Confidence in Elders (STRIDE) Study.
  39. Geriatrics Literature 2017 Year in Review.
  40. Burden of Depressive Symptoms Over 2 Decades and Risk of Nursing Home Placement in Older Women.
  41. Long-Term Nursing Home Entry: A Prognostic Model for Older Adults with a Family or Unpaid Caregiver.
  42. Increased Risk of Suicide Attempts and Unintended Death Among Those Transitioning From Prison to Community in Later Life.
  43. Natural history of lesions suspicious for basal cell carcinoma in older adults in Ikaria, Greece.
  44. Geriatric Dermatology-A Framework for Caring for Older Patients With Skin Disease.
  45. Frailty phenotypes and mortality after lung transplantation: A prospective cohort study.
  46. Reply.
  47. Physical frailty after liver transplantation.
  48. Corrigendum to: "Who Take Naps? Self-Reported and Objectively Measured Napping in Very Old Women".
  49. Who Take Naps? Self-Reported and Objectively Measured Napping in Very Old Women.
  50. Targeted Geriatric Assessment for Fast-Paced Healthcare Settings: Development, Validity, and Reliability.
  51. Frailty as an Outcome in Geriatrics Research: Not Ready for Prime Time?
  52. The Effects and Meanings of Receiving a Diagnosis of Mild Cognitive Impairment or Alzheimer's Disease When One Lives Alone.
  53. The Liver Frailty Index Improves Mortality Prediction of the Subjective Clinician Assessment in Patients With Cirrhosis.
  54. Perioperative Gabapentin Does Not Reduce Postoperative Delirium in Older Surgical Patients: A Randomized Clinical Trial.
  55. Geriatrics Literature 2016 Year in Review.
  56. Remote Traumatic Brain Injury Is Associated with Motor Dysfunction in Older Military Veterans.
  57. Prospective Identification of Patients at Risk for Unwarranted Variation in Treatment.
  58. Association Between Persistent Pain and Memory Decline and Dementia in a Longitudinal Cohort of Elders.
  59. Development of a novel frailty index to predict mortality in patients with end-stage liver disease.
  60. Functional Impairment: An Unmeasured Marker of Medicare Costs for Postacute Care of Older Adults.
  61. Difficulty Managing Medications and Finances in Older Adults: A 10-year Cohort Study.
  62. Disability in patients with end-stage liver disease: Results from the functional assessment in liver transplantation study.
  63. Frailty and reduced physical function go hand in hand in adults with rheumatoid arthritis: a US observational cohort study.
  64. Assessment of geriatric syndromes and physical function in people living with HIV.
  65. Frailty and Surgical Decision Making.
  66. A Comparison of Muscle Function, Mass, and Quality in Liver Transplant Candidates: Results From the Functional Assessment in Liver Transplantation Study.
  67. Anticoagulation in the Very Old.
  68. Skin Cancer in U.S. Elderly Adults: Does Life Expectancy Play a Role in Treatment Decisions?
  69. The Clinical Impact of Medical Journals.
  70. Response to clinical assessments of health status as a potential marker to identify patients who are too sick to undergo transplantation.
  71. An Intervention to Reduce Use of Low-Value Imaging Tests.
  72. Risks Associated With Catheters.
  73. Functional decline in patients with cirrhosis awaiting liver transplantation: Results from the functional assessment in liver transplantation (FrAILT) study.
  74. Functional impairment in older liver transplantation candidates: From the functional assessment in liver transplantation study.
  75. Physical Function and Hospital Readmissions-Reply.
  76. Chronic care management for Medicare patients--reply.
  77. Functional outcomes after lower extremity revascularization in nursing home residents: a national cohort study.
  78. Geriatric Syndromes in Older HIV-Infected Adults.
  79. Functional impairment and hospital readmission in Medicare seniors.
  80. The critical importance of functional status in critical illness.
  81. Unmet Need for ADL Assistance Is Associated With Mortality Among Older Adults With Mild Disability.
  82. Medicare and care coordination: expanding the clinician's toolbox.
  83. Clinician assessments of health status predict mortality in patients with end-stage liver disease awaiting liver transplantation.
  84. The relationship of physical performance with HIV disease and mortality.
  85. Living alone, socially isolated or lonely--what are we measuring?
  86. The octogenarian donor: can the liver be "younger than stated age"?
  87. Frailty predicts waitlist mortality in liver transplant candidates.
  88. Making general internal medicine research relevant to the older patient with multiple chronic comorbidities.
  89. Multimorbidity, guidelines, and clinical inertia.
  90. Interpreting treatment effects from clinical trials in the context of real-world risk information: end-stage renal disease prevention in older adults.
  91. Functional status--an important but overlooked variable in the readmissions equation.
  92. Palliative care?=?hope.
  93. Using the GO-FAR score.
  94. Disability during the last two years of life.
  95. The problem of overuse.
  96. Does social isolation predict hospitalization and mortality among HIV+ and uninfected older veterans?
  97. Hospitalization in older persons: not just a medical outcome, a social outcome as well: comment on "Elder abuse as a risk factor for hospitalization in older persons".
  98. Pain as a risk factor for disability or death.
  99. Health status in elderly persons living alone--reply.
  100. The differential diagnosis of living alone: comment on "Living alone and risk of mortality in older, community-dwelling adults".
  101. The incremental nature of clinical research: comment on "The association of aspirin use with age-related macular degeneration".
  102. Walking speed is a useful marker of frailty in older persons--reply.
  103. Debating effect sizes.
  104. Advancing Alzheimer's disease diagnosis, treatment, and care: recommendations from the Ware Invitational Summit.
  105. Rethinking the association of high blood pressure with mortality in elderly adults: the impact of frailty.
  106. Hospital readmission among older adults who return home with unmet need for ADL disability.
  107. Loneliness in older persons: a predictor of functional decline and death.
  108. Half of older Americans seen in emergency department in last month of life; most admitted to hospital, and many die there.
  109. Insufficient help for activity of daily living disabilities and risk of all-cause hospitalization.
  110. The association of blood pressure and mortality differs by self-reported walking speed in older Latinos.
  111. Subjective social status and functional decline in older adults.
  112. Hospitalization-associated disability: "She was probably able to ambulate, but I'm not sure".
  113. Beyond the prescription: medication monitoring and adverse drug events in older adults.
  114. 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".
  115. Conducting high-value secondary dataset analysis: an introductory guide and resources.
  116. Prediction modeling to assess the prognostic significance of a biomarker panel.
  117. The epidemiology of pain during the last 2 years of life.
  118. Length of stay for older adults residing in nursing homes at the end of life.
  119. Adult day health center participation and health-related quality of life.
  120. Spouse-rated vs self-rated health as predictors of mortality.
  121. Medication prescribing practices for older prisoners in the Texas prison system.
  122. Towards a combined prognostic index for survival in HIV infection: the role of 'non-HIV' biomarkers.
  123. Pain, functional limitations, and aging.
  124. 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?
  125. Predicting risk of dementia in older adults: The late-life dementia risk index.
  126. Recovery of activities of daily living in older adults after hospitalization for acute medical illness.
  127. Predicting change in functional status over quarterly intervals for older adults enrolled in the PACE community-based long-term care program.
  128. Prevalence and risk factors for depressive symptoms in persons with chronic obstructive pulmonary disease.
  129. Health-related quality of life following coronary artery bypass graft surgery in post-menopausal women.
  130. Effect of arthritis in middle age on older-age functioning.
  131. The Women's Initiative for Nonsmoking (WINS) XI: age-related differences in smoking cessation responses among women with cardiovascular disease.
  132. Prediction of mortality in community-living frail elderly people with long-term care needs.
  133. Late-life mortality in older Jews exposed to the Nazi regime.
  134. Octogenarians and nonagenarians starting dialysis in the United States.
  135. The relationship of indwelling urinary catheters to death, length of hospital stay, functional decline, and nursing home admission in hospitalized older medical patients.
  136. When to refer patients with chronic kidney disease for vascular access surgery: should age be a consideration?
  137. Envisioning better approaches for dementia care.
  138. Aging, arthritis, and disability.
  139. Age and rising rates of cyclooxygenase-2 inhibitor use. Results from a national survey.
  140. Development and validation of an index to predict activity of daily living dependence in community-dwelling elders.
  141. Mortality risk stratification in chronic kidney disease: one size for all ages?
  142. Rates of acute care admissions for frail older people living with met versus unmet activity of daily living needs.
  143. Reports of financial disability predict functional decline and death in older patients discharged from the hospital.
  144. Development and validation of a functional morbidity index to predict mortality in community-dwelling elders.
  145. The relation of autopsy rate to physicians' beliefs and recommendations regarding autopsy.
  146. Pitfalls of converting practice guidelines into quality measures: lessons learned from a VA performance measure.
  147. Relationship between health status and use of screening mammography and Papanicolaou smears among women older than 70 years of age.
  148. Urinary incontinence and its association with death, nursing home admission, and functional decline.
  149. Association of older age and female sex with inadequate reach of screening flexible sigmoidoscopy.
  150. Diagnosis-related group-adjusted hospital costs are higher in older medical patients with lower functional status.
  151. Unsteadiness reported by older hospitalized patients predicts functional decline.
  152. Diet monotony as a correlate of poor nutritional intake among hemodialysis patients.
  153. Loss of independence in activities of daily living in older adults hospitalized with medical illnesses: increased vulnerability with age.
  154. Differences in mortality of black and white patients enrolled in the program of all-inclusive care for the elderly.
  155. Donepezil for nursing home patients with dementia: a reinterpretation of the evidence.
  156. Risk of hip fracture in disabled community-living older adults.
  157. Malnutrition and bad outcomes.
  158. Serum albumin concentration and clinical assessments of nutritional status in hospitalized older people: different sides of different coins?
  159. Justification for a new cohort study of people aging with and without HIV infection.
  160. Self-restriction of medications due to cost in seniors without prescription coverage.
  161. Reduced employment in caregivers of frail elders: impact of ethnicity, patient clinical characteristics, and caregiver characteristics.
  162. Screening mammography for frail older women: what are the burdens?
  163. A prospective study of physical activity and cognitive decline in elderly women: women who walk.
  164. Development and validation of a prognostic index for 1-year mortality in older adults after hospitalization.
  165. Cancer screening in elderly patients: a framework for individualized decision making.
  166. History and mobility exam index to identify community-dwelling elderly persons at risk of falling.
  167. 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.
  168. Bringing a generalist approach to the problems of older patients.
  169. Age-related differences in care preferences, treatment decisions, and clinical outcomes of seriously ill hospitalized adults: lessons from SUPPORT.
  170. 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.
  171. Findings from SUPPORT and HELP: an introduction. Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatment. Hospitalized Elderly Longitudinal Project.
  172. Ineffectiveness of the SUPPORT intervention: review of explanations.
  173. Differences in patient-reported processes and outcomes between men and women with myocardial infarction.
  174. Delivery of preventive services to older black patients using neighborhood health centers.
  175. Functional status before hospitalization in acutely ill older adults: validity and clinical importance of retrospective reports.
  176. Use of standardized ratios to examine variability in hemodialysis vascular access across facilities. Medical Review Board of The Renal Network, Inc.
  177. Effects of functional status changes before and during hospitalization on nursing home admission of older adults.
  178. The relationship between clinical assessments of nutritional status and adverse outcomes in older hospitalized medical patients.
  179. Depressive symptoms and 3-year mortality in older hospitalized medical patients.
  180. Health status versus quality of life in older patients: does the distinction matter?
  181. Assessing the generalizability of prognostic information.
  182. A patient-centered model of acute care for elders.
  183. The relation between health status changes and patient satisfaction in older hospitalized medical patients.
  184. Depressed mood and survival in seriously ill hospitalized adults. The SUPPORT Investigators.
  185. Building a research career in general internal medicine: a perspective from young investigators.
  186. Improving functional outcomes in older patients: lessons from an acute care for elders unit.
  187. A regional evaluation of variation in low-severity hospital admissions.
  188. Do acute care for elders units increase hospital costs? A cost analysis using the hospital perspective.
  189. Measuring prognosis and case mix in hospitalized elders. The importance of functional status.
  190. Relation between symptoms of depression and health status outcomes in acutely ill hospitalized older persons.
  191. Convergent and discriminant validity of a generic and a disease-specific instrument to measure quality of life in patients with skin disease.
  192. Failure to prescribe warfarin to patients with nonrheumatic atrial fibrillation.
  193. Physicians' attitudes toward using patient reports to assess quality of care.
  194. Why isn't warfarin prescribed to patients with nonrheumatic atrial fibrillation?
  195. Is economic hardship on the families of the seriously ill associated with patient and surrogate care preferences? SUPPORT Investigators.
  196. Using the biopsychosocial model in practice. Improving the care of patients with late-life depression.
  197. The impact of serious illness on patients' families. SUPPORT Investigators. Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatment.
  198. Effects of amino group modification in discoidal apolipoprotein A-I-egg phosphatidylcholine-cholesterol complexes on their reactions with lecithin:cholesterol acyltransferase.