About

Dr. David B. Reuben holds the Archstone Foundation Endowed Chair in Geriatrics at UCLA School of Medicine. His research activities focus on geriatrics, with a particular emphasis on fall prevention, dementia care, and health outcomes in older adults. He has been involved in numerous clinical trials and studies aimed at improving care strategies for the elderly, including pragmatic trials on dementia care effectiveness and cost-effectiveness, fall injury prevention, and dementia care navigation. Throughout his career, Dr. Reuben has contributed significantly to the understanding of aging-related health issues, including the development of high-quality dementia care frameworks, assessment of end-of-life care processes, and evaluation of healthcare spending for Medicare beneficiaries with dementia. His work also explores the impact of practice redesign on health outcomes and costs, caregiver burden, and the integration of comprehensive dementia care. His extensive research portfolio and leadership in geriatrics have made him a prominent figure in advancing clinical practices and health policies for older populations.

Research topics

• Medicine
• Emergency medicine
• Gerontology
• Physical therapy
• Political Science
• Intensive care medicine
• Psychiatry
• Internal medicine
• Nursing
• Physical medicine and rehabilitation
• Surgery

Selected publications

• <scp>GUIDE</scp> and Beyond: Strategies for Comprehensive Dementia Care Integration

  Journal of the American Geriatrics Society · 2025-10-31 · 1 citations

  articleOpen access

  The Centers for Medicare & Medicaid Services' (CMS) Guiding an Improved Dementia Experience (GUIDE) Model represents a landmark opportunity to improve outcomes for persons with dementia and their caregivers and scale comprehensive dementia care through a structured service delivery and alternative payment approach. The National Dementia Care Collaborative (NDCC), a coalition of scientific and clinical leaders in evidence-based dementia care, works to promote comprehensive dementia care. Drawing from the experiences of six previously tested programs-Aging Brain Care, Alzheimer's and Dementia Care, BRI Care Consultation, Care Ecosystem, Integrated Memory Care, and MIND at Home-we describe a four-step approach to enable successful adoption and implementation: identifying key leaders and partners, preparing a tailored value proposition, initiating program start-up, and ensuring sustainable implementation. Our guidance also emphasizes leveraging existing community assets, aligning efforts with organizational priorities, and using both storytelling and data to make the case for change. We highlight practical tools and resources to address operational challenges, including electronic health record integration, reimbursement strategies, and staff training. By focusing on evidence-based models, health systems and other providers can accelerate implementation, reduce costly emergency and institutional care, and deliver high-quality, person-centered support. This approach can help to empower GUIDE participants and others to build effective, durable, scalable comprehensive dementia care systems, ultimately advancing the goal of establishing such care as a permanent Medicare benefit.

  PublisherOA PDFDOI

• Caregiver Strain and Perceived Impact of COVID‐19 on Dementia Caregiving

  Alzheimer s & Dementia · 2025-12-01

  articleOpen accessSenior author

  BACKGROUND: The COVID-19 pandemic disproportionately affected people with Alzheimer's disease and related dementias and their caregivers. Caregivers with high strain may have been particularly vulnerable to disruptions caused by COVID-19. We examined the relationship between caregiver strain and perceived impact of COVID-19 on dementia caregiving, and whether this relationship is moderated by county-level COVID-19 burden. METHOD: We included caregivers from a RCT of dementia care models (The D-CARE Study) who completed an 8-item COVID-19 questionnaire at their 3-month follow-up visit. The exposure was baseline caregiver strain, measured using the Modified Caregiver Strain Index, with scores ≥13 indicating high strain. The outcome was perceived impact of COVID-19 on dementia caregiving, measured using a composite score from the COVID-19 questionnaire ranging from 0 (no impact) to 10 (maximum impact). The potential moderator was county-level COVID-19 burden, measured as average daily deaths per 100,000 people over the 30 days preceding COVID-19 questionnaire completion. We used an adjusted Two-Part Model, including: 1) logistic regression to assess whether the caregiver perceived an impact of COVID-19 on caregiving (yes/no) and 2) linear regression to examine the severity of the perceived impact among participants who reported experiencing an impact (non-zero responses). RESULT: Of 1,073 caregivers, 33% reported high baseline strain. High-strain caregivers were more often younger, female, unmarried, non-White, and family members; they were also more likely to report worse health and to have been a caregiver for >5 years as compared to low-strain caregivers (all p <0.01). High-strain caregivers had a 60% increase in the odds of reporting a perceived impact of COVID-19 on dementia caregiving (OR = 1.6, 95% CI: 1.1-2.3, p =0.013). Among caregivers who reported being impacted by COVID-19 (non-zero response), on average, caregivers with high strain had a 1.2-point higher perceived impact of COVID-19 on dementia caregiving (95% CI: 0.9-1.5, p <0.001). The county-level COVID-19 burden did not significantly moderate these relationships. CONCLUSION: Caregivers with pre-existing high strain may be especially vulnerable to the adverse impacts of unexpected public health emergencies such as COVID-19 and could benefit most from targeted interventions to foster resilience.

  PublisherOA PDFDOI

• Health System, Community-Based, or Usual Dementia Care for Persons With Dementia and Caregivers

  JAMA · 2025-01-29 · 18 citations

  letterOpen access1st authorCorresponding

  Importance: The effectiveness of different approaches to dementia care is unknown. Objective: To determine the effectiveness of health system-based, community-based dementia care, and usual care for persons with dementia and for caregiver outcomes. Design, Setting, and Participants: Randomized clinical trial of community-dwelling persons living with dementia and their caregivers conducted at 4 sites in the US (enrollment June 2019-January 2023; final follow-up, August 2023). Interventions: Participants were randomized 7:7:1 to health system-based care provided by an advanced practice dementia care specialist (n = 1016); community-based care provided by a social worker, nurse, or licensed therapist care consultant (n = 1016); or usual care (n = 144). Main Outcomes and Measures: Primary outcomes were caregiver-reported Neuropsychiatric Inventory Questionnaire (NPI-Q) severity score for persons living with dementia (range, 0-36; higher scores, greater behavioral symptoms severity; minimal clinically important difference [MCID], 2.8-3.2) and Modified Caregiver Strain Index for caregivers (range, 0-26; higher scores, greater strain; MCID, 1.5-2.3). Three secondary outcomes included caregiver self-efficacy (range, 4-20; higher scores, more self-efficacy). Results: Among 2176 dyads (individuals with dementia, mean age, 80.6 years; 58.4%, female; and 20.6%, Black or Hispanic; caregivers, mean age, 65.2 years; 75.8%, female; and 20.8% Black or Hispanic), primary outcomes were assessed for more than 99% of participants, and 1343 participants (62% of those enrolled and 91% still alive and had not withdrawn) completed the study through 18 months. No significant differences existed between the 2 treatments or between treatments vs usual care for the primary outcomes. Overall, the least squares means (LSMs) for NPI-Q scores were 9.8 for health system, 9.5 for community-based, and 10.1 for usual care. The difference between health system vs community-based care was 0.30 (97.5% CI, -0.18 to 0.78); health system vs usual care, -0.33 (97.5% CI, -1.32 to 0.67); and community-based vs usual care, -0.62 (97.5% CI, -1.61 to 0.37). The LSMs for the Modified Caregiver Strain Index were 10.7 for health system, 10.5 for community-based, and 10.6 for usual care. The difference between health system vs community-based care was 0.25 (97.5% CI, -0.16 to 0.66); health system vs usual care, 0.14 (97.5% CI, -0.70 to 0.99); and community-based vs usual care, -0.10 (97.5% CI, -0.94 to 0.74). Only the secondary outcome of caregiver self-efficacy was significantly higher for both treatments vs usual care but not between treatments: LSMs were 15.1 for health system, 15.2 for community-based, and 14.4 for usual care. The difference between health system vs community-based care was -0.16 (95% CI, -0.37 to 0.06); health system vs usual care, 0.70 (95% CI, 0.26-1.14); and community-based vs usual care, 0.85 (95% CI, 0.42 to 1.29). Conclusions and Relevance: In this randomized trial of dementia care programs, no significant differences existed between health system-based and community-based care interventions nor between either active intervention or usual care regarding patient behavioral symptoms and caregiver strain. Trial Registration: ClinicalTrials.gov Identifier: NCT03786471.

  PublisherOA PDFDOI

• MP37-14 MULTI-DOMAIN IMPROVEMENT AMONG WOMEN SEEKING TREATMENT FROM PRIMARY CARE PROVIDERS IN SOUTHERN CALIFORNIA

  The Journal of Urology · 2025-04-08

  article
  PublisherDOI

• MP23-03 EHR ALERTS AND URINARY INCONTINENCE COUNSELING AMONG PRIMARY CARE PROVIDERS

  The Journal of Urology · 2025-04-08

  article
  PublisherDOI

• MP30-01 QUALITY-OF-CARE FOR URGE URINARY INCONTINENCE IN PRIMARY CARE: IS THERE A NEED TO INTERVENE?

  The Journal of Urology · 2025-04-08

  article
  PublisherDOI

• OUTPACE: Outcomes of urinary incontinence treatment in primary care – APP co-management and electronic consult

  Contemporary Clinical Trials · 2025-04-21 · 2 citations

  article
  PublisherDOI

• Self-efficacy change among diverse family caregivers in dementia care

  The Journals of Gerontology Series B · 2025-11-13

  articleSenior author

  OBJECTIVES: To determine whether changes in caregiver self-efficacy (beliefs about one's ability to manage dementia-related problems and access help) differed by caregiver race and ethnicity across all participants enrolled in a large pragmatic trial of comprehensive dementia care. METHODS: In the Dementia Care Study (D-CARE), community-dwelling older adults with dementia and their unpaid family caregivers were randomized to receive usual care, community-based, or health system-based comprehensive dementia care. Caregiver self-efficacy was assessed at baseline, 6 months, and 18 months using a 4-item scale (range 4-20, higher scores indicate greater self-efficacy). Among all caregivers, we compared least squares means for overall change in self-efficacy from baseline across racial and ethnic groups (Latino, non-Latino Black, and non-Latino White). RESULTS: Among 2,126 dementia caregivers, 205 self-identified as Latino, 247 as non-Latino Black, and 1,674 as non-Latino White. Mean baseline caregiver self-efficacy scores were between 13.1 and 13.6 for all racial and ethnic groups. The least squares mean for self-efficacy change was between +1.53 and +1.66 from the baseline for all racial and ethnic groups. Caregiver self-efficacy change did not differ significantly by caregiver race and ethnicity. DISCUSSION: Black, Latino, and White dementia caregivers reported similar improvements in caregiver self-efficacy after participating in a comprehensive dementia care trial. Personalized aspects of comprehensive dementia care appear to address the needs of diverse caregiver populations. CLINICAL TRIALS REGISTRATION: NCT03786471.

  PublisherDOI

• Exploring Antipsychotic Initiation Among Persons Living With Dementia in a Comprehensive Dementia Care Program

  Journal of the American Geriatrics Society · 2025-06-09

  articleOpen accessSenior author

  BACKGROUND: Antipsychotic medications (APMs) are frequently prescribed for persons living with dementia despite limited benefits and increased risks. This study examined patient characteristics of those prescribed APMs, indications for initiation, and survival outcomes. METHODS: This retrospective cohort study of community-dwelling patients enrolled in a comprehensive dementia care program (2012-2014) focused on 190 patients not on an APM at baseline, with survival analyses including 200 additional patients on an APM at program entry. Patients were followed for 2 years for APM initiation and until January 2024 for mortality. Baseline measures included patient and caregiver demographics, Mini-Mental State Exam (MMSE), Functional Activities Questionnaire (FAQ), Modified Caregiver Strain Index (MCSI), caregiver Patient Health Questionnaire-9 (PHQ-9), and Neuropsychiatric Inventory Questionnaire (NPI-Q). Indications for APM initiation were abstracted from electronic health records. Logistic regression models examined associations between baseline characteristics and APM initiation. Survival was assessed using Kaplan-Meier estimates and Cox proportional hazards models. RESULTS: Among 190 patients (mean [SD] age, 81.2 [8.4] years; 60% female, and 80% Alzheimer's or dementia not otherwise specified) who were not on APMs at program enrollment, 65 (34%) initiated and 125 (66%) did not initiate an APM. NPI-Q severity (AOR 1.10, 95% CI 1.04-1.16) and NPI-Q distress (AOR 1.06, 95% CI 1.02-1.10) were associated with APM initiation. Agitation and psychotic symptoms were the most common indications, with quetiapine being the most frequently prescribed APM. Median survival was 37.8 months (IQR 19.3-63.2) for patients on an APM at baseline, 63.1 months (IQR 28.4-86.8) for patients initiating an APM, and 68.9 months (IQR 50-97.9) for patients not initiating an APM (p < 0.001). CONCLUSIONS: APM initiation was common despite enrollment in a comprehensive dementia care program that prioritizes non-pharmacologic strategies. Survival differences underscore the need for risk-benefit discussions of APMs and goals of care discussions with caregivers.

  PublisherOA PDFDOI

• IP25-34 EFFECTS OF LANGUAGE BARRIERS ON PATIENT KNOWLEDGE OF PELVIC FLOOR DISORDERS

  The Journal of Urology · 2025-04-08

  article
  PublisherDOI

Recent grants

• Randomized Trial of a Multifactorial Fall Injury Prevention Strategy

  NIH · $34.8M · 2014–2022

• NIH Grant R01HL071119

  NIH · $292k · 2005

• NIH Grant R01AG036776

  NIH · $1.0M · 2014

• NIH Grant R01AG016677

  NIH · $412k · 2003

• NIH Grant K12AG001004

  NIH · $4.3M · 2012

Frequent coauthors

• Neil S. Wenger

  135 shared

• Carol P. Roth

  91 shared

• David A. Ganz

  69 shared

• Paul G Shekelle

  VA Greater Los Angeles Healthcare System

  56 shared

• Heather McCreath

  University of California, Los Angeles

  52 shared

• John Adams

  University of Rochester

  52 shared

• Lillian Min

  Geriatric Research Education and Clinical Center

  51 shared

• Susan H. Hirsch

  Kaiser Permanente San Jose Medical Center

  50 shared

Education

• M.D., Medicine

  University of California, Los Angeles

  1977

• B.S., Biology

  University of California, Los Angeles

  1973

Awards & honors

• Archstone Foundation Endowed Chair in Geriatrics