Yeates Conwell

Yeates Conwell
University of Rochester School of Medicine & Dentistry · Psychiatry

MD

About

435
Publications
62,710
Reads
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21,838
Citations
Additional affiliations
November 2012 - present
University of Rochester
Position
  • Director, Office for Aging Research and Health Services
July 1985 - April 2015
University of Rochester
Position
  • Professor and Vice Chair
July 1980 - June 1985
Yale-New Haven Hospital
Position
  • Resident & Fellow

Publications

Publications (435)
Article
Objective: Hispanic/Latino adults, particularly Spanish speakers, are underserved in mental healthcare, and little is known about the day-to-day variation in their suicide risk. Smartphones have the potential to overcome geographical and linguistic barriers to mental health assessment and intervention. The purpose of the current study was to exami...
Article
The National Partnership to Improve Dementia Care in Nursing Homes (i.e., the National Partnership) was launched in March 2012. Using national Medicare, Minimum Data Set, and Nursing Home Compare data in CY 2010–2014, we examined changes in hospital readmissions for older post-acute skilled nursing facility (SNF) residents with Alzheimer’s disease...
Article
Objectives: We sought to characterize the social networks of older adults who report feeling lonely or like a burden on others, psychological states that are associated with risk for suicide according to the Interpersonal Theory of Suicide. Methods: We used a latent class analysis to identify distinct groups of older adults based on social netwo...
Preprint
Background Effectiveness of integrated care management for common, comorbid physical and mental disorders has been insufficiently examined in low- and middle-income countries. We tested hypotheses that older adults treated in rural Chinese primary care clinics with integrated care management of comorbid depression and HTN would show greater improve...
Article
We examined whether baseline depression is associated with myocardial infarction (MI) within a 2-year period among middle-age and older adults in China and whether the association varies by sociodemographic characteristics. Two-year longitudinal data from a nationally representative sample of people aged 45+ years in China were analyzed (N = 15 226...
Preprint
Objectives Evidence-based strategies to reduce loneliness in later life are needed because loneliness impacts all domains of health, functioning, and quality of life. Volunteering is a promising strategy, as a large literature of observational studies documents associations between volunteering and better health and well-being. However, relatively...
Article
Objectives: Polypharmacy is common in home health care (HHC). This study examined the prevalence of medications associated with geriatric syndromes (MAGS), its predictors, and association with subsequent hospitalization in HHC. Design: Analysis of HHC electronic medical records, the Outcome and Assessment Information Set (OASIS), and Medicare HH...
Article
The purpose of this study was to compare adolescents' reports of self-injurious thoughts and behaviors (SITBs) between ecological momentary assessment (EMA) and a traditional, retrospective interview. Adolescents were recruited following recent discharge from acute psychiatric care for a suicidal crisis (as part of a larger study). Participants com...
Article
Full-text available
Adequate pain management is important to post-acute care functional recovery, yet persons with Alzheimer’s disease and related dementias (ADRD) are often under-treated for pain. The objectives of this study were to examine in Medicare post-acute home health (HH) recipients with daily interfering pain 1) if analgesic use at home is related to functi...
Article
Full-text available
The Network for Emotional Well-being and Brain Aging (NEW Brain Aging) was funded by NIA with the goal of forming a national, transdisciplinary collaborative that includes investigators with research expertise in emotional well-being (EWB), Alzheimer’s disease and related dementias (ADRD), human and animal neuroimaging, stress regulation, and compu...
Article
Suicidal thoughts and behaviors (STBs) are major public health concerns among adolescents, and research is needed to identify how risk is conferred over the short term (hours and days). Sleep problems may be associated with elevated risk for STBs, but less is known about this link in youth over short time periods. The current study utilized a multi...
Article
Background: Care transitions are frequent among patients with dementia. This study aimed to estimate the impact of continuity of care (COC) on successful community discharge after hospitalization. Methods: National Veterans Health Administration data linked to Medicare claims in fiscal years 2014-2015. Community-dwelling older veterans with deme...
Article
Objective To examine racial differences in the frequency of schizophrenia diagnosis codes used among nursing home (NH) residents with Alzheimer's Disease and Related Dementias (ADRD), pre and post the implementation of public reporting of antipsychotic use in NHs). Methods The 2011-2017 Minimum Data Set and Medicare Master Beneficiary Summary File...
Article
Background: Pain management is important to post-acute functional recovery, yet older persons with Alzheimer's disease and related dementias (ADRD) are often undertreated for pain. The main objectives were (1) to examine the relationship between ADRD and analgesic use among Medicare home health care (HHC) recipients with daily interfering pain, an...
Article
Objectives To examine how mental illness (MI) and Alzheimer's disease and related dementias (ADRD) were associated with whether skilled nursing facility (SNF) residents returned to and remained in the community and if receipt of home health services was associated with post-SNF home time . Design Retrospective cohort study based on secondary data...
Article
Objectives: Sensory loss may be a barrier to accessing healthcare services, and this study seeks to examine the association of sensory loss with whether older adults report having a usual source of health care. Methods: Our study included 7548 older adults who participated in the National Health and Aging Trends Study in 2015. Having a self-reporte...
Article
Introduction In 2018, 1.6 million fee-for-service (FFS) Medicare beneficiaries used skilled nursing facilities (SNFs) at least once. Older adult SNF patients with mental illness (MI) and Alzheimer's disease and related dementias (ADRD) comprise groups that are at risk of nursing home long-term care. We examined how the presence of MI and ADRD were...
Article
Background Targeting social connection to prevent suicide in later life shows promise but requires additional study to identify the most effective and acceptable interventions. This study examines acceptability, feasibility, and efficacy of Engage Psychotherapy to improve subjective disconnection (target mechanisms: low belonging and perceived burd...
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Full-text available
Objective: Case-control psychological autopsy studies are the research standard for the postmortem, quantitative study of ongoing or recent risk factors for suicide. We aimed to develop a reliable checklist of methodological quality of these studies. Method: We adapted items from a validated checklist to address general methodological elements a...
Article
Both social disconnection and suicide are significant public health concerns among older adults, and social disconnection is associated with greater risk for suicide-related thoughts and behaviors in late life. We present a synthesis of research discussed during a workshop hosted by the NIMH on social disconnection and late-life suicide. Social dis...
Article
Background/objectives: Care-partner support affects outcomes among assisted living (AL) residents. Yet, little is known about care-partner support and its effects on hospitalization during post-acute care transitions. This study examined the variation in care-partner support and its impact on hospitalizations among AL residents receiving Medicare...
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The HOPE Project is an ongoing RCT testing whether Senior Corps volunteering for lonely older adults (age 60+) leads to reduced loneliness and improved quality of life—outcomes associated with suicide in later life. We have randomly assigned 130 participants to 12-months of volunteering or active control. We will describe the trial as well as basel...
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High rates of substance use disorders (SUDs) in persons age 50 and older are concerning. Those reentering the community in later life after incarceration are especially at risk. We determined if later-life prison release increases risk of SUD-related hospitalizations and ED visits in a national sample of veterans (N=7,671) released from prison betw...
Article
Objective To assess associations between physical, mental, and social well‐being and suicide and self‐harm in a community‐based sample of older adults. Methods Using a cohort design, questionnaire data from 102,880 individuals aged 65 years or older living in New South Wales, Australia during 2006–2009 were linked to hospital and cause‐of‐death da...
Article
Background: Hospitalization is a difficult experience, especially for patients with dementia. Understanding whether better continuity of care (COC) reduces hospitalizations can indicate interventions that might help curb hospitalizations. Objective: To estimate the causal impact of COC on hospitalizations and different reasons for hospitalizatio...
Article
Objectives To estimate the causal impact of continuity of care (COC) on total, institutional, and noninstitutional cost among community‐dwelling older veterans with dementia. Data Sources Combined Veterans Health Administration (VHA) and Medicare data in Fiscal Years (FYs) 2014‐2015. Study Design FY 2014 COC was measured by the Bice‐Boxerman Cont...
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Full-text available
Background Pain is common yet under-studied among older Medicare home health (HH) patients with Alzheimer's disease and related dementias (ADRD). Aims Examine (1) the association between ADRD and severe pain in Medicare HH patients; and (2) the impact of severe pain and ADRD on unplanned facility admissions in this population. Design Analysis of...
Article
Objectives To determine whether peer companionship delivered by an aging services agency to socially-disconnected older adult primary care patients was associated with improvement in suicidal ideation depression, anxiety, and psychological connectedness. Design Pragmatic, non-blinded, parallel-group, randomized controlled trial comparing peer comp...
Article
Objectives Following the 2012 launch of the National Partnership to Improve Dementia Care in Nursing Homes (the National Partnership), the use of antipsychotics has declined. However, little is known about the impact of this effort on quality of care and outcomes for nursing home (NH) residents with Alzheimer's disease and related dementia (ADRD)....
Article
Full-text available
OBJECTIVES/GOALS: Geographic and linguistic isolation is associated with negative mental health outcomes, including increased risk for suicide, among ethnic/racial minorities. This study explores the feasibility of using smartphone technology with active and passive sensing to assess mental health symptoms and social behavior among at risk Spanish-...
Article
Older age and medical comorbidity are factors associated with more severe illness and risk of death due to COVID-19 infection. Social distancing is an important public health strategy for controlling the spread of the virus and minimizing its impact on the older adult population. It comes at a cost, however. Loneliness is associated with myriad adv...
Article
Objective: The study purpose was to examine the feasibility and acceptability of intensive ecological momentary assessment (EMA) among high-risk adolescents with suicidal thoughts and behaviors following discharge from acute psychiatric care. Method: Fifty-three adolescents, 12–18 years old, and their parents, were recruited following discharge fro...
Article
Objective: Depression symptom questionnaires are not for diagnostic classification. Patient Health Questionnaire-9 (PHQ-9) scores ≥ 10 are nonetheless often used to estimate depression prevalence. We compared PHQ-9 ≥ 10 prevalence to Structured Clinical Interview for DSM (SCID) major depression prevalence and assessed whether an alternative PHQ-9...
Article
Background: The population of older prisoners (age ≥50), a group with high suicide rates, is growing. We sought to explore the associations among functional disability, depression, and suicidal ideation (SI) among older prisoners, focusing on the mediating role of depression. Methods: Study participants were 220 sentenced male inmates age ≥50 wh...
Article
Researchers increasingly use meta-analysis to synthesize the results of several studies in order to estimate a common effect. When the outcome variable is continuous, standard meta-analytic approaches assume that the primary studies report the sample mean and standard deviation of the outcome. However, when the outcome is skewed, authors sometimes...
Article
Objective: To assess prevalence of suicidal ideation (SI) among new postacute and long-stay nursing home (NH) admissions and examine the associations with individual and NH-level factors. Setting/participants: A total of 1,864,102 postacute and 304,106 long-stay admissions to just over 15,000 NHs between 7/1/2014 and 6/30/2015. Measurement: Us...
Article
Objectives: To examine the added effect of having both cognitive deficit and physical frailty, compared to having either one only, on hospitalization and emergency department (ED) visits. Methods: Data from a population-based study of 3,157 community-dwelling older (≥60 years) Chinese adults in the U.S. were used. Cognitive deficit was measured by...
Article
Objectives: To evaluate the association between home health (HH) services, including skilled nursing (SN), physical therapy (PT), occupational therapy, social work (SW), and homemaking aide assistance with the hazard of unplanned facility admissions among Medicare patients with and without Alzheimer's disease and related dementias (ADRD). Design:...
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The U.S. prison population is aging; more persons are being incarcerated in the second half of life and are aging “in place.” In the first prospective study to evaluate older prisoners’ mental health (Aging INSIDE), we determined if disability in activities of daily living specific to prison, prison activities of daily living (PADLs), predicts depr...
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This study is a secondary analysis of the Outcome and Assessment Information Set (OASIS) and administrative billing records of 6,153 adults ≥ 65 years old who received home health (HH) from a not-for-profit HH agency in upstate New York in CY 2017. We evaluated the association between the use of home health services (HH) with the hazard of unplanne...
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Adults aged 70 and older have the highest suicide rates in most countries across the globe (World Health Organization, 2014). Prevalence may increase as the Baby Boomers transition into older adulthood (Phillips, 2014). Disease and disability increase risk for late-life suicide, thus identifying opportunities to intervene within the network of serv...
Article
Background Depression often coexists with other chronic conditions in older people. The COACH study is an ongoing random controlled trial (RCT) to test the effectiveness of a primary-care-based collaborative care approach to treat co-morbid hypertension and depression in Chinese rural elders. In the COACH model, a team—village doctor (VD), aging wo...
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Full-text available
Background: Screening for major depression with the Patient Health Questionnaire-9 (PHQ-9) can be done using a cutoff or the PHQ-9 diagnostic algorithm. Many primary studies publish results for only one approach, and previous meta-analyses of the algorithm approach included only a subset of primary studies that collected data and could have publish...
Article
Although often perceived to be a problem of the young, violence commonly affects older adults, a rapidly growing segment of the population. Violence can be directed toward older adults (elder abuse and intimate partner violence), self-directed (suicide), or perpetrated by older adults against others (intimate partner violence and violence in dement...
Article
This study was performed to compare the treatment status between older (≥65 years) and younger adults (18-64 years) with severe mental illness (SMI) and explore factors associated with treatment status in rural China. Persons with SMI were identified in one mental health survey in 2015 in 6 townships of Xinjin County, Chengdu, China. Logistic regre...
Article
Equivalency of the diagnostic accuracy of the PHQ-8 and PHQ-9: a systematic review and individual participant data meta-analysis – ERRATUM - Yin Wu, Brooke Levis, Kira E. Riehm, Nazanin Saadat, Alexander W. Levis, Marleine Azar, Danielle B. Rice, Jill Boruff, Pim Cuijpers, Simon Gilbody, John P.A. Ioannidis, Lorie A. Kloda, Dean McMillan, Scott B....
Article
Objectives: To identify comorbidity profiles of older patients last seen in primary care before a suicide attempt and assess attempt and clinical factors (eg, means and lethality of attempt) associated with these profiles. Design: Cohort study and latent class analysis using Department of Veterans Affairs (VA) national data (2012-2014). Setting...
Article
Background: Screening for major depression with the Patient Health Questionnaire-9 (PHQ-9) can be done using a cutoff or the PHQ-9 diagnostic algorithm. Many primary studies publish results for only one approach, and previous meta-analyses of the algorithm approach included only a subset of primary studies that collected data and could have publis...
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Full-text available
Background Item 9 of the Patient Health Questionnaire-9 (PHQ-9) queries about thoughts of death and self-harm, but not suicidality. Although it is sometimes used to assess suicide risk, most positive responses are not associated with suicidality. The PHQ-8, which omits Item 9, is thus increasingly used in research. We assessed equivalency of total...
Article
This study aims to investigate the association of patient-reported improvement and rehabilitation characteristics with mortality among older adults who received rehabilitation. To do so, a national sample of Medicare beneficiaries from the National Health and Aging Trends Study was examined. Among those who reported receiving rehabilitation service...
Article
Objectives: Our article's primary objective is to examine whether rehabilitation providers can predict which patients discharged from skilled nursing facility (SNF) rehabilitation will be successful in their transition to home, controlling for sociodemographic factors and physical, mental, and social health characteristics. Design: Longitudinal...
Article
Introduction Millions of Medicare beneficiaries receive rehabilitation services in skilled nursing facilities or inpatient rehabilitation facilities. This study was designed to study whether receipt of rehabilitation services in nursing homes or inpatient settings is associated with clinically significant depressive symptoms at follow-up among olde...
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Full-text available
Neuropsychiatric symptoms (NPS) are common in Alzheimer's disease (AD)-associated neurodegeneration. However, NPS lack a consistent relationship with AD pathology. It is unknown whether any common neural circuits can link these clinically disparate while mechanistically similar features with AD pathology. Here, we explored the neural circuits of NP...
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1 Background The objective of this study was to develop and validate a short form of the Patient Health Questionnaire‐9 (PHQ‐9), a self‐report questionnaire for assessing depressive symptomatology, using objective criteria. 2 Methods Responses on the PHQ‐9 were obtained from 7,850 English‐speaking participants enrolled in 20 primary diagnostic tes...
Article
Introduction: People with severe mental illness have greater risk of un-detected and inadequately treated medical disorders, adding up to the risk of premature death. This study investigated how chronic medical comorbidity evolved across the lifespan in schizophrenia and the associated impact on mortality. Method: A register-based retrospective...
Article
Objective: The aim of this study was to determine whether patients who received rehabilitation services had an increased risk of having late-life depressive or anxiety symptoms within the year following termination of services. Methods: The National Health and Aging Trends Study (NHATS) is a population-based, longitudinal cohort survey of a nati...
Article
Objectives Both depression and hypertension (HTN) are prevalent, costly and destructive, and frequently coexist among the aging population of China. This study aimed to examine the role that treatment adherence plays in blood pressure control in older adult Chinese with depression. Methods Data for these analyses were taken from a randomized contr...
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Full-text available
Objectives: We measured the prevalence and severity of aggressive behaviors (ABs) among nursing home (NH) residents and examined whether individuals with behavioral health disorders were more likely to exhibit aggressive behaviors than others. Setting and participants: The analytical sample included 3,270,713 first Minimum Data Set (MDS) assessm...
Article
It is well-established that racial/ethnic minority older adults, and other underserved groups, including older adults with severe mental illness, have unmet need for mental health care. Mental health services researchers use a variety of methodologies, such as surveys, interventions, qualitative interviews, and large-scale data analytic techniques,...
Article
The U.S. prison population is aging; increasing numbers of older adults (age ≥50) are being incarcerated and are aging “in place.” Older prisoners are likely to experience depression and suicidal ideation (SI), which are both strong predictors of suicide. However, “conventional” factors associated with increased suicide risk in mixed-age inmate sam...
Article
Integrated, interdisciplinary care models have shown promise for addressing behavioral health care needs of older adults. Behavioral health services have been integrated into Veterans Health Administration (VHA) primary and geriatric care settings, to optimize access to care for veterans with mental illness, behavioral and psychological symptoms of...
Article
The number of middle/older-age persons reentering the community following incarceration is growing exponentially, yet little is known about suicide-related outcomes (attempts and deaths) in this population. We conducted a retrospective cohort study (2012–2014) of Veterans age ≥50 who were Medicare enrollees to compare rates of death by suicide, dru...
Article
Older adults are disproportionately likely to die by suicide, with older men being at the highest risk of any demographic group. To address this major public health problem, there is an urgent need to identify risk factors relevant to suicide in later life and to translate this knowledge into treatments that will reduce the risk of suicide in this...
Article
There are more than one million fee-for-service Medicare beneficiaries admitted to skilled nursing facilities (SNFs) annually for post-acute care, and relatively little is known about the SNF-to-home transition and outcomes of older adults post-SNF discharge. Limited data suggest that older adults admitted to SNFs for post-acute care struggle with...
Article
Physician-assisted death (PAD) of persons in which psychiatric disorders are the basis for the procedure (psychiatric PAD) remains infrequent but rising in number in Belgium and the Netherlands where it is legal, comprising about 1% to 2% of PAD. There were 83 cases in the Netherlands in 2017¹ (per capita US equivalent would be about 1580 cases). C...
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Patient beliefs about depression and its treatment in primary care clinics in China influence the delivery of care. Our objective was to investigate primary care patients' beliefs about depression and its treatment as well as help-seeking preferences regarding depression in China to aid in the development and promotion of interventions that are acc...
Article
Background Loneliness is a significant public health concern among older adults (OA) given its association with a wide range of adverse health outcomes. Primary care is an opportune setting to manage loneliness. However, the epidemiology of loneliness in Chinese OA treated in primary care remains unclear. The present study investigated the prevalen...
Article
Objective: The number of individuals transitioning from correctional facilities to community in later life (age ≥50 ) is increasing. We sought to determine if later-life prison release is a risk factor for suicidal behavior and death by accidental injury, including drug overdose. Design: Retrospective cohort study. Setting: U.S. Department of...
Article
Objectives: Our study examines factors associated with patient-reported outcomes in functioning among Medicare beneficiaries who reported receiving rehabilitation services in a nursing home or inpatient (ie, hospital or rehabilitation facility) setting in the prior year. Design: Data are from the 2015 and 2016 rounds of the National Health and A...
Article
This study aimed to examine racial and ethnic differences in significant depressive symptoms among long-term nursing home residents. We analyzed the 2014 national Minimum Data Set linked to a nursing home file, and estimated multivariable logistic regressions to determine the associations of race and ethnicities with significant depressive symptoms...
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Full-text available
Objective: The objective of the study is to examine the association of auditory, vision, and dual sensory impairment with late-life depressive and anxiety symptoms. Method: Our study included 7,507 older adults from the National Health & Aging Trends Study, a nationally representative sample of U.S. Medicare beneficiaries. Auditory and vision im...
Article
Background: Chinese patients with depression have limited access to mental health specialty care because of myriad barriers at different levels. Recently, there has been increased interest in targeting primary care settings for managing depression, beca