Carla Perissinotto, MD, MHS

Adjunct Professor

Division of Geriatrics

Overview:
From 2017-2021, Dr. Carla Perissinotto served as the first Associate Chief for Geriatrics Clinical Programs at UCSF. Given the growth of clinical programs, the associate chief oversees and manages both inpatient and outpatient clinical programs which include Care at Home, Geriatrics consultation in the outpatient setting, and the new Acute Care for the Elderly (ACE) unit at Moffitt-Long Hospital, Orthopedic CO-Management programs and programs which are in development.

Carla is a Professor in the Division of Geriatrics, Department of Medicine. Carla is Board Certified in Internal Medicine, Geriatrics and Palliative Medicine. Carla is dedicated to working in both community and academic settings. Her main clinical work has been in home-based care, and she worked in UCSF Care at Home for over 10 years--which provides medical care to home bound older adults, and in embedded Geriatrics consult practices. From 2008-2017, Carla served as a primary care and consulting Geriatrician at the Over60 Health Center in Berkeley.

Carla joined the faculty in August 2010 as a clinician-educator and has received multiple awards for her excellence in teaching. Carla is passionate about working with diverse communities and improving the training of internal medicine residents and all learners in the care of elderly patients. Carla also has a special interest in teaching primary care doctors how to more effectively recognize cognitive impairment in the outpatient primary care setting. Carla was also a recipient of the highly-competitive HRSA Geriatric Academic Career Award 2010-2015, with which she developed curricula to teach a wide range of learners on the care of elderly patients in diverse settings. Carla has also gained national and international recognition for her research on the effects of loneliness on the health of older adults. She is frequently invited to discuss her research and discuss the clinical and policy implications of the health effects of loneliness.

Clinical:
At UCSF, she attends on the inpatient Internal Medicine Service, providers Geriatrics consultation in Women's Health Primary Care, the Positive Health 360 practice, and provides primary care to homebound older adults through UCSF Care at Home in San Francisco. Carla is passionate about the care of vulnerable elders and truly believes in sharing this excitement with residents, and other learners via lectures, bedside teaching, small group teaching, home visits, and visits to community senior centers.

From 2008-2017, Carla spent a portion of her clinical time at the Over 60 Health Center, a Federally Qualified Health Center, serving adults over age 55 in Alameda County. At Over 60, Carla directed the educational programs for UCSF learners, and focused on practice change by establishing a team-based model for community-based Geriatrics seeing adults across a continuum of care.

Carla has also had the privilege to work in clinical settings internationally, most notably, El Salvador, Kenya and Mexico. Annually, she volunteers in Chiapas, Mexico at the Hospital San Carlos (http://www.hospitalsancarlos.org/index.html) which serves the indigenous people of Chiapas. Carla has written about these experiences on GeriPal. She continues to work on improving the care of older patients in low resource settings across the globe, and has created an opportunity for trainees to volunteer in Chiapas alongside of her.

Academic Focus:
Carla published a paper in the Archives of Internal Medicine on loneliness in Older Adults in 2012 which gained worldwide recognition and has sparked more conversation in the medical community about the health effects of loneliness. Because of the wide prevalence of loneliness in older adults, there has been significant interest from multiple organizations hoping to explore ways to better identify, and intervene on loneliness. Carla is currently exploring potential future research and policy endeavors focused on loneliness.

As a Clinician-educator, Carla is dedicated to improving the Geriatrics training of Internal Medicine residents. Carla is interested ways to improve and integrate Geriatrics curriculum into general medicine practices. She has focused on providing community Geriatrics electives to residents, creating a housecalls program for residents, and embedding Geriatrics into General Medicine and specialty clinics.

Education
2018 - Diversity, Equity, and Inclusion Champion Training, University of California
Fellowship, 2010 - Geriatrics, University of California, San Francisco
Residency, 2009 - Internal Medicine, University of California, San Francisco
M.D., 2006 - School of Medicine, Tufts University
MHS, 2003 - School of Public Health, Johns Hopkins University
BA, 2000 - Anthropology, Barnard College, Columbia University
Websites
Publications
  1. Kotwal AA, Allison TA, Halim M, Garrett SB, Perissinotto CM, Ritchie CS, Smith AK, Harrison KL. "Relationships, Very Quickly, Turn to Nothing": Loneliness, Social Isolation, and Adaptation to Changing Social Lives Among Persons Living With Dementia and Care Partners. The Gerontologist 2024. PMID: 38499400


  2. Hough K, Kotwal AA, Boyd C, Tha SH, Perissinotto C. What Are "Social Prescriptions" and How Should They Be Integrated Into Care Plans? AMA journal of ethics 2023. PMID: 38085581


  3. Newmark RL, Allison TA, Smith AK, Perissinotto CM, Tha SH, Kotwal AA. The Role of Digital Technologies in Facilitating Psychosocial Resilience to Sudden Social Isolation Among Older Adults: Lessons Learned from the COVID-19 Pandemic. Journal of applied gerontology : the official journal of the Southern Gerontological Society 2023. PMID: 37536316


  4. Holt-Lunstad J, Perissinotto C. Social Isolation and Loneliness as Medical Issues. The New England journal of medicine 2023. PMID: 36648080


  5. Kotwal AA, Cenzer IS, Yaffe K, Perissinotto C, Smith AK. End-of-life health care use among socially isolated and cognitively impaired older adults. Journal of the American Geriatrics Society 2022. PMID: 36420540


  6. Rudy ET, McNamara KC, Parker A, Kotwal AA, Perissinotto CM. Loneliness Among Older Adults. Health affairs (Project Hope) 2022. PMID: 36190881


  7. Fuller SM, Kotwal AA, Tha SH, Hill D, Perissinotto C, Myers JJ. Key Elements and Mechanisms of a Peer-Support Intervention to Reduce Loneliness and Isolation among Low-Income Older Adults: A Qualitative Implementation Science Study. Journal of applied gerontology : the official journal of the Southern Gerontological Society 2022. PMID: 36053132


  8. Kotwal AA, Batio S, Wolf MS, Covinsky KE, Yoshino Benavente J, Perissinotto CM, O'Conor RM. Persistent loneliness due to COVID-19 over 18?months of the pandemic: a prospective cohort study. Journal of the American Geriatrics Society 2022. PMID: 36054661


  9. Perissinotto CM. The True Cause of Death. JAMA 2022. PMID: 35788791


  10. Sadarangani T, Perissinotto C, Boafo J, Zhong J, Yu G. Multimorbidity patterns in adult day health center clients with dementia: a latent class analysis. BMC geriatrics 2022. PMID: 35733122


  11. Kotwal AA, Cenzer IS, Waite LJ, Smith AK, Perissinotto CM, Hawkley LC. A single question assessment of loneliness in older adults during the COVID-19 pandemic: A nationally-representative study. TO REMOVE 2022. PMID: 35141875


  12. Holt-Lunstad J, Perissinotto CM. Isolation in the Time of Covid: What is the True Cost, and How Will we Know? TO REMOVE 2022. PMID: 35042426


  13. Eaton England AL, Ritchie CS, Mickler A, Perissinotto CM, Garrigues SK, Leff B, Sheehan OC, Harrison KL. Attitudes of Homebound Older Adults and their Caregivers toward Research and Participation as Research Advisors. The Gerontologist 2020. PMID: 33216908


  14. O'Sullivan R, Burns A, Leavey G, Leroi I, Burholt V, Lubben J, Holt-Lunstad J, Victor C, Lawlor B, Vilar-Compte M, Perissinotto CM, Tully MA, Sullivan MP, Rosato M, Power JM, Tiilikainen E, Prohaska TR. Impact of the COVID-19 Pandemic on Loneliness and Social Isolation: A Multi-Country Study. TO REMOVE 2021. PMID: 34639283


  15. Kotwal AA, Cenzer IS, Waite LJ, Covinsky KE, Perissinotto CM, Boscardin WJ, Hawkley LC, Dale W, Smith AK. The epidemiology of social isolation and loneliness among older adults during the last years of life. Journal of the American Geriatrics Society 2021. PMID: 34247388


  16. Leff B, Sheehan OC, Harrison KL, Eaton England A, Mickler A, Basyal PS, Garrigues SK, Schuchman M, Perissinotto C, Garrett SB, Ritchie CS. A Home-Based Care Research Agenda by and for Homebound Older Adults and Caregivers. Journal of applied gerontology : the official journal of the Southern Gerontological Society 2021. PMID: 33792428


  17. Mickler AK, Leff B, Eaton England A, Garrigues SK, Schuchman M, Perissinotto C, Ritchie CS, Harrison KL, Sheehan OC. Understanding the Daily Experiences and Perceptions of Homebound Older Adults and Their Caregivers: A Qualitative Study. Journal of applied gerontology : the official journal of the Southern Gerontological Society 2021. PMID: 33522364


  18. Harrison KL, Leff B, Garrigues SK, Eaton England AL, Perissinotto CM, Sheehan OC, Mickler AK, Basyal PS, Ritchie CS. Virtual Research Stakeholder Groups with Isolated Homebound Elders and Caregivers: Lessons Learned Relevant to Research during Pandemics. Journal of palliative medicine 2021. PMID: 33395555


  19. Kotwal AA, Holt-Lunstad J, Newmark RL, Cenzer I, Smith AK, Covinsky KE, Escueta DP, Lee JM, Perissinotto CM. Social Isolation and Loneliness Among San Francisco Bay Area Older Adults During the COVID-19 Shelter-in-Place Orders. Journal of the American Geriatrics Society 2020. PMID: 32965024


  20. Prohaska T, Burholt V, Burns A, Golden J, Hawkley L, Lawlor B, Leavey G, Lubben J, O'Sullivan R, Perissinotto C, van Tilburg T, Tully M, Victor C, Fried L. Consensus statement: loneliness in older adults, the 21st century social determinant of health? BMJ open 2020. PMID: 32788184


  21. Steinman MA, Perry L, Perissinotto CM. Meeting the Care Needs of Older Adults Isolated at Home During the COVID-19 Pandemic. JAMA internal medicine 2020. PMID: 32297903


  22. Ternes K, Iyengar V, Lavretsky H, Dawson WD, Booi L, Ibanez A, Vahia I, Reynolds C, DeKosky S, Cummings J, Miller B, Perissinotto C, Kaye J, Eyre HA. Brain health INnovation Diplomacy: a model binding diverse disciplines to manage the promise and perils of technological innovation. International psychogeriatrics 2020. PMID: 32019621


  23. Fried L, Prohaska T, Burholt V, Burns A, Golden J, Hawkley L, Lawlor B, Leavey G, Lubben J, O'Sullivan R, Perissinotto C, van Tilburg T, Tully M, Victor C. A unified approach to loneliness. Lancet (London, England) 2020. PMID: 31929010


  24. Perissinotto C, Holt-Lunstad J, Periyakoil VS, Covinsky K. Reply to: Older People's Loneliness in Clinical Work. Journal of the American Geriatrics Society 2019. PMID: 31381836


  25. Kotwal, A., Waite, L., Dale, W., Perissinotto, C. M., Covinsky, K., & Smith, A. K.. Pain and Loneliness: Results of a Nationally-Representative Survey of Community-Dwelling Older Adults Journal of the American Geriatrics Society 2019. PMID:


  26. Perissinotto C, Holt-Lunstad J, Periyakoil VS, Covinsky K. A Practical Approach to Assessing and Mitigating Loneliness and Isolation in Older Adults. Journal of the American Geriatrics Society 2019. PMID: 30762228


  27. Ritchie CS, Leff B, Garrigues SK, Perissinotto C, Sheehan OC, Harrison KL. A Quality of Care Framework for Home-Based Medical Care. Journal of the American Medical Directors Association 2018. PMID: 30056010


  28. Greene M, Hessol NA, Perissinotto C, Zepf R, Hutton Parrott A, Foreman C, Whirry R, Gandhi M, John M. Loneliness in Older Adults Living with HIV. AIDS and behavior 2018. PMID: 29151199


  29. Perissinotto CM, Walter LC. Capsule Commentary on Wolff, et al., A Look at Person- and Family-Centered Care Among Older Adults: Results from a National Survey. Journal of general internal medicine 2015. PMID: 26001544


  30. Rogers SE, Klein L, Perissinotto CM. The importance of cognitive assessment before ventricular device placement: a teachable moment. JAMA internal medicine 2015. PMID: 25822770


  31. Perissinotto CM, Covinsky KE. Living alone, socially isolated or lonely--what are we measuring? Journal of general internal medicine 2014. PMID: 25092012


  32. Perissinotto C, Covinsky KE. Health status in elderly persons living alone--reply. JAMA internal medicine 2013. PMID: 23440237


  33. Perissinotto CM, Stijacic Cenzer I, Covinsky KE. Loneliness in older persons: a predictor of functional decline and death. Archives of internal medicine 2012. PMID: 22710744


  34. Perissinotto CM, Valcour V. Preventing dementia: is there hope for progress? American family physician 2011. PMID: 21534514


  35. Lerner D, Adler DA, Chang H, Lapitsky L, Hood MY, Perissinotto C, Reed J, McLaughlin TJ, Berndt ER, Rogers WH. Unemployment, job retention, and productivity loss among employees with depression. Psychiatric services (Washington, D.C.) 2004. PMID: 15572564


  36. Adler DA, Irish J, McLaughlin TJ, Perissinotto C, Chang H, Hood M, Lapitsky L, Rogers WH, Lerner D. The work impact of dysthymia in a primary care population. General hospital psychiatry 2004. PMID: 15234821