About

Richard Jones is a Professor of Psychiatry and Human Behavior, as well as a Professor of Neurology at Brown University. He is an epidemiologist and methodologist who leads the Quantitative Science Program (QSP) at the Brown University Warren Alpert Medical School, within the Departments of Psychiatry and Human Behavior and Neurology. His primary research interests focus on the cognitive reserve hypothesis in relation to cognitive aging, dementia, Alzheimer’s disease, and delirium, alongside measurement and methodological approaches in clinical neurosciences. His work involves investigating neuroimaging markers of brain reserve, assessing cognitive performance, and understanding the neurophysiological underpinnings of delirium, often utilizing advanced statistical and measurement models such as item response theory, structural equation modeling, and longitudinal data analysis. Dr. Jones's contributions extend to developing instruments for delirium assessment, exploring the long-term cognitive trajectories following major surgery, and applying digital health tools to study behavioral and lifestyle factors affecting health outcomes. His research aims to improve understanding of neurodegenerative and neuropsychiatric conditions, ultimately contributing to better diagnosis, assessment, and intervention strategies in aging and neurological disorders.

Research topics

• Medicine
• Psychology
• Neuroscience
• Political Science
• Computer Science
• Sociology
• Biology
• Genetics
• Anthropology
• Internal medicine
• Demography
• Gerontology
• Emergency medicine
• Environmental health
• Psychiatry
• Surgery
• General surgery
• Intensive care medicine
• Geography

Selected publications

• Repeated presentation of a word list in a consistent order increases differences in total words recalled between those with and without Alzheimer’s disease.

  Neuropsychology · 2026-04-16

  articleOpen access

  OBJECTIVE: Individuals with Alzheimer's disease (AD) are known to have difficulty utilizing semantic strategy to remember items from a list, such as during word list recall tasks. However, it is unclear if presenting words in the same order as compared to shuffling across trials of a list-learning test confers an advantage in terms of word recall in individuals with AD. METHOD: To address this issue, we leveraged data from 10,504 participants over five studies across four AD Research Centers that administered the Consortium to Establish a Registry for AD Word List Memory Test in either a standard sequence (shuffled words for each learning trial) or nonstandard sequence (unshuffled words in a consistent order for each learning trial). RESULTS: After controlling for gender, age, years of education, apolipoprotein E gene, Clinical Dementia Rating Global Score, and composite test scores for executive functioning and language comprehension, we found that differences in word recall performance between participants with and without probable AD were larger when they were tested with the unshuffled versus standard shuffled version of the word list. CONCLUSIONS: When administered the unshuffled Consortium to Establish a Registry for AD Word List, participants without AD demonstrated a larger recall advantage compared to those with probable AD. This advantage was higher on Trial 3 (β = 0.09) compared to Trial 2 (β = 0.04), suggesting that this advantage increases with multiple immediate repetitions. Using an unshuffled word list may enhance the ability to distinguish between individuals along the AD continuum. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

  PublisherDOI

• Later Age of Autism Diagnosis in Children with Multiple Co-Occurring Psychiatric Disorders

  medRxiv · 2025-10-24 · 1 citations

  preprintOpen access

  PURPOSE: In children with autism spectrum disorder (ASD), early diagnosis permits early access to therapeutic interventions which may improve outcomes. Factors affecting the age of diagnosis in ASD are not fully understood. METHODS: Here, two large independent datasets were analyzed to investigate age of autism diagnosis and co-occurring psychiatric conditions, including bipolar disorder, depressive disorder, anxiety disorder, obsessive-compulsive disorder, attention deficit hyperactivity disorder, oppositional defiant disorder, and conduct disorder. Clinical characteristics examined included demographics, verbal status, intellectual disability, restricted/repetitive behaviors, adaptive behaviors, and psychiatric medication use. RESULTS: Over 50,000 participants with ASD were analyzed from the Rhode Island Consortium for Autism Research and Treatment study (RI-CART; n=823) and the Simons Foundation Powering Autism Research for Knowledge (SPARK) database (n=52,611). In RI-CART, age of diagnosis differed between those with no co-occurring conditions (mean age at diagnosis = 4.3 years), those with one or two co-occurring conditions (7.1 years), and those with three or more co-occurring conditions (8.5 years; p<.001). This pattern was observed in the SPARK database (age of diagnosis 4, 7.1, and 10 years, respectively; p<.001). Controlling for age, sex, and symptom severity, more co-occurring psychiatric conditions was associated with later age of ASD diagnoses in both samples. Depression and ADHD were associated with later ASD diagnoses; OCD and ID were associated with earlier ASD diagnoses. CONCLUSION: These findings indicate that those children with high co-occurring psychiatric conditions, who are ultimately diagnosed with ASD, experience later diagnosis. This group of children may represent a distinct subtype of autism.

  PublisherOA PDFDOI

• Trajectory of Functional Recovery After Postoperative Delirium in Elective Surgery

  Innovation in Aging · 2025-12-01

  articleOpen access

  Abstract Objective Describe functional recovery after elective surgery and to determine whether improvements differ among individuals who develop delirium. Background Limited studies of older adults have investigated whether delirium influences the trajectory of functional recovery after elective surgery. Methods Patients age ≥70 undergoing major elective surgery were assessed daily while in hospital for presence and severity of delirium using the Confusion Assessment Method, and their functional recovery was followed for 18 months thereafter (N = 566). The Activities of Daily Living and Instrumental Activities of Daily Living Scales and the Physical Component Summary of the Short Form-12 were obtained before surgery and at 1, 2, 6, 12, and 18 months. A composite index (standard deviation 10, minimally clinically significant difference 2) derived from these scales was then analyzed using mixed-effects regression. Results Mean age was 77 years; 58% of participants were women and 24% developed postoperative delirium. Participants with delirium demonstrated lesser functional recovery than their counterparts without delirium; at 1 month, the covariate-adjusted mean difference on the physical function composite was -1.5 (95% confidence interval [CI] -3.3, -0.2). From 2 to 18 months, the corresponding difference was -1.8 (95% CI -3.2, -0.3), an effect comparable with the minimally clinically significant difference. Conclusions Delirium was associated with persistent and clinically meaningful impairment of functional recovery, to 18 months. Use of multifactorial preventive interventions for patients at high risk for delirium and tailored transitional care planning may help to maximize the functional benefits of elective surgery.

  PublisherOA PDFDOI

• Suicide Risk Screening in Jails: Protocol for a Pilot Study Leveraging the Mental Health Research Network Algorithm and Health Care Data

  JMIR Research Protocols · 2025-05-28 · 1 citations

  articleOpen access

  BACKGROUND: Suicide in local jails occurs at a higher rate than in the general population, requiring improvements to risk screening methods. Current suicide risk screening practices in jails are insufficient: They are commonly not conducted using validated screening instruments, not collected by clinically trained professionals, and unlikely to capture honest responses due to the chaotic nature of booking areas. Therefore, new technologies could improve such practices. Several studies have indicated that machine learning (ML) models considerably improve accuracy and have positive predictive value in detecting suicide risk compared with practice as usual (PAU). This study will use administrative data and ML modeling to improve suicide risk detection at jail booking. OBJECTIVE: This study is primarily focused on gathering preliminary information about the feasibility and practicality of using administrative data and ML modeling for suicide risk detection but also incorporates elements of hypothesis testing pertaining to clinical outcomes. METHODS: The study uniquely contributes to our understanding of suicide risk by further validating an existing ML model developed and previously validated by the Mental Health Research Network using Medicaid outpatient health care claims data. This validation uses complete claims data on a sample of approximately 6000 individuals booked into 2 diverse jails in a midwestern state. This model validation uses 313 unique demographic and clinical characteristics from 5 years of historical health care data. It detects suicide risk in jails and postrelease by using merged jail, Medicaid, and vital records data. The study will use jail administrative data for September 1, 2021, through February 28, 2022; Medicaid records data for September 1, 2016, through March 31, 2023; and vital records data for March 1, 2022, through March 31, 2023. RESULTS: First, the algorithm will be validated on the data gathered for the jail sample using the C-statistic and area under the receiver operating characteristic curve. Second, the resulting model will be compared with the jails' suicide identification PAU to assess risk and detection of identified suicide attempts and deaths from intake through 120 days and 13 months after jail release. The funding timeline for this project is August 1, 2022, through July 31, 2025. The algorithm's predictions and actual event incidence will be linked and validated in the spring of 2025, with results ready for publication in the fall of 2025. CONCLUSIONS: The study will also investigate implementation factors, such as feasibility, acceptability, and appropriateness, to optimize jail uptake. Interview data on the implementation factors will be gathered in the summer of 2025, with expected dissemination in 2026. We hypothesize that a combination of intake screening PAU and the ML model will be the optimal approach, in that the combination will be more accurate and can have practical application in this context. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/68517.

  PublisherDOI

• Preoperative parietal TMS-EEG hyperexcitability in patients with subsequent postoperative delirium

  Brain stimulation · 2025-07-01

  articleOpen access

  intensity increased, the patient's level of consciousness declined, with ACC electrical activity synchronously disappeared.CCEP revealed strong reciprocal connectivity between CLA and ipsilateral ACC.Functional MRI showed positive intrinsic connectivity between CLA and consciousnessrelated networks, including the Dorsal and Ventral Attention Networks.Interpretation: Our study confirms the CLA's significant role in consciousness.Consciousness impaired during CLA stimulation were associated to the suppression of 3 Hz oscillations in the ACC, offering the first electrophysiological evidence of the CLA-ACC pathway's role in consciousness.Building on these findings, we propose that deep brain stimulation of the claustrum (CLA-DBS) could serve as a promising therapeutic approach for treating disorders of consciousness.

  PublisherOA PDFDOI

• Corrigendum to “Level of consciousness at discharge and associations with outcome after ischemic stroke” [Journal of the Neurological Sciences, Volume 390 (2018): 102–107]

  Journal of the Neurological Sciences · 2025-11-20

  articleOpen access
  PublisherOA PDFDOI

• Six month repeat cognitive testing to identify people with MCI at greatest AD dementia risk

  medRxiv · 2025-12-30

  articleOpen access

  INTRODUCTION: People with mild cognitive impairment (MCI) are candidates for early intervention, but not all progress to Alzheimer's disease (AD) dementia. Identifying a subgroup at highest risk may improve treatment targeting. METHODS: We analyzed data from participants with MCI enrolled in the Alzheimer's Disease Neuroimaging Initiative (ADNI). Cognitive domains included memory, executive functioning, language, and visuospatial abilities. We evaluated baseline performance and 6-month change scores, using proportional hazards models to estimate associations with time to conversion to AD dementia. RESULTS: The strength of association varied by domain, but in general both baseline performance and 6-month change were associated with conversion. The strongest effects observed for memory and language. Observed associations were largely independent of established risk biomarkers, including APOE genotype, structural MRI measures, and CSF biomarkers. DISCUSSION: 6-month change scores on cognitive tests may help identify a high-risk subgroup of persons with MCI likely to progress to AD dementia. RESEARCH IN CONTEXT: Systematic review. The authors reviewed the literature using traditional (e.g. PubMed) sources. There is a modest literature on change scores in the context of the AD clinical spectrum, but few investigations have evaluated whether short-term changes may be able to identify a high-risk subgroup of people with MCI. The authors have published a systematic review of this literature (Jutten et al. 2020) and appropriately refer to relevant citations here.Interpretation: Our findings suggest that short-term changes in cognition may be useful as part of a strategy to identify subsets of people with MCI who are at highest risk of conversion. Findings were clearest for memory and language. Domain-specific changes appeared to be independent from other biomarkers used to identify people at highest risk. Domain-specific changes did not appear to be better than changes in global cognition as measured by the MMSE or the CDR-sum of boxes.Future directions: Short-term changes in cognition may be useful to help identify a subgroup of people with MCI at highest risk of conversion to AD dementia. Future work could consider time frames shorter than the 6-month data we had available, better characterizing changes with more than 2 time points, or developing strategies that combine changes in cognition with other biomarkers to identify a subgroup of people with MCI to target for treatment.

  PublisherOA PDFDOI

• Better Assessment of Illness Study (BASIL) II for Delirium Severity: Study Design, Variables, and Methods

  Journal of Geriatric Psychiatry and Neurology · 2025-05-16 · 1 citations

  articleOpen accessCorresponding

  PurposeDelirium is a common yet preventable complication of hospitalization, surgery and illness that is associated with poor outcomes. Older adults with Alzheimer's Disease and Related Dementias (ADRD) are especially vulnerable to delirium and experience greater delirium severity, yet no existing assessment tool is specifically designed to evaluate this vulnerable population. This study will validate two new delirium severity instruments, the Delirium Severity (DEL-S) rating for all older adults and the Delirium Severity Rating in ADRD (DEL-S-AD) for patients with dementia.Design/Setting and ParticipantsThe Better ASsessment of ILlness II (BASIL II) study is an innovative prospective cohort study that measures cognitive function, delirium, delirium severity, demographics, clinical and functional variables and clinical outcomes. Participants include older adults from 3 unique yet complementary clinical sites: medical inpatients, elective surgery inpatients, or skilled nursing facility residents.MethodsPerformance of DEL-S and DEL-S-AD items in older adults with cognition ranging from no impairment to moderate impairment will be determined. Analyses will include psychometric characteristics of DEL-S and DEL-S-AD items, harmonization of the two scales and validation against reference standard diagnoses.Conclusions and ImplicationsResults from this study will help accurately measure delirium severity, a critically important, graded outcome. The DEL-S-AD instrument holds broad applications in persons with and without ADRD to monitor delirium severity in clinical settings, and as an outcome measure in future clinical treatment trials and pathophysiologic studies. Ultimately, the DEL-S and DEL-S-AD have the potential to improve health care for the vulnerable, growing population of older adults with cognitive impairment worldwide.

  PublisherOA PDFDOI

• Characterization of Delirium and Its Severity Across Three Distinct Clinical Settings

  Innovation in Aging · 2025-12-01

  articleOpen access

  Abstract Delirium and its severity (i.e., the intensity or degree of delirium symptoms) can be difficult to measure in people with dementia due to substantial overlap in symptoms and clinical features, complicating both diagnosis and research. In this descriptive study, we used data from the Better Assessment of Illness II (BASIL II) study of adults aged ≥70 years recruited from medical inpatient (Site 1), inpatient elective surgery (Site 2), or skilled nursing facility (Site 3) settings, to characterize delirium and its severity in settings with varying dementia prevalence. Trained staff conducted patient and proxy interviews, chart review, and delirium assessments at baseline and 1-2 days after acute illness or surgery using the Confusion Assessment Method (CAM; delirium present/absent) and CAM-Severity (CAM-S; scored 0-19, 19 = worst). Among 488 participants (mean [SD] age 79 [6] years; 58% female; 75% white), dementia prevalence was 23% (Site 1), 11% (Site 2), and 83% (Site 3). Following acute illness or surgery, the proportion meeting criteria for delirium and median (IQR) CAM-S scores among those with delirium were: Site 1, 50%, score 6 (4-6); Site 2, 1%, score 3 (3-3); Site 3, 24%, score 8 (6-10). Delirium rates and severity showed different patterns of variation across settings. Dementia prevalence may be associated with greater delirium severity; however, it is possible that chronic cognitive symptoms may also elevate delirium severity scores. These findings underscore the pressing need for studies validating measures of delirium severity in populations with dementia to advance research and patient care.

  PublisherOA PDFDOI

• Recommended best practices for construct-centered adaptation of the Harmonized Cognitive Assessment Protocol

  The Journals of Gerontology Series B · 2025-10-24 · 6 citations

  articleOpen access

  OBJECTIVES: The Harmonized Cognitive Assessment Protocol (HCAP) neuropsychological assessment approach aims to support the collection of harmonizable data on cognitive function for cross-national cognitive aging and dementia research. As the measurement of cognition is sensitive to differences in contextual, cultural, educational, linguistic, social, and other factors that may influence cognitive test performance, HCAP requires adaptation to be appropriate for the contexts in which it is administered. We aim to provide methodological recommendations for the adaptation and implementation of the HCAP and other cognitive data collection tools in novel settings. METHODS: We drew from existing guidelines on cross-cultural psychological test adaptation (e.g., the International Test Commission Guidelines for Translating and Adapting Tests); the Cross-Cultural Survey Guidelines; and our shared experiences in adapting, administering, and harmonizing the HCAP in older populations across 10 countries. RESULTS: Recommendations for HCAP adaptation include phases of preparation (assembling local expert teams; resource planning), implementation (construct-centered adaptation guided by local experts), pre-testing (iterative, mixed-methods approach), and field preparation (creating documentation; interviewer training; planning for ongoing quality assurance). DISCUSSION: The HCAP neuropsychological assessment approach has unique considerations for adaptation that balance the needs of local validity with cross-national harmonization. Shared best practices for HCAP adaptation will improve the quality of cross-national HCAP data collection, data harmonization, analyses, and inferences. The HCAP is a useful model for cross-nationally harmonized data collection and research to improve our understanding of cognitive aging and dementia globally.

  PublisherDOI

Recent grants

• NIH Grant R03AG025262

  NIH · $127k · 2008

• NIDUS II: Advanced-Stage Development and Utilization of the NIDUS Research Infrastructure to Advance Interdisciplinary Aging Research in Delirium

  NIH · $4.0M · 2021–2027

• NIH Grant R03AG017680

  NIH · $35k · 2001

• Delirium, Alzheimer's Disease Biomarkers, and Long-Term Cognitive Decline

  NIH · $34.8M · 2018–2025

• BASIL“ Better Assessment of Illness: Delirium Severity Measures for Persons with and without Dementia

  NIH · $7.3M · 2014–2026

Frequent coauthors

• Sharon K. Inouye

  Beth Israel Deaconess Medical Center

  1229 shared

• Edward R. Marcantonio

  Harvard University

  1160 shared

• Tamara G. Fong

  Harvard University

  792 shared

• Thomas G. Travison

  Hebrew SeniorLife

  487 shared

• Eva M. Schmitt

  Hebrew SeniorLife

  428 shared

• Tammy T. Hshieh

  Dana-Farber Brigham Cancer Center

  406 shared

• Long Ngo

  Beth Israel Deaconess Medical Center

  314 shared

• David C. Alsop

  295 shared

Labs

• Quantitative Sciences Program of the Departments of Psychiatry and Neurology at the Alpert Medical School of Brown University (QSP)PI

Education

• ScD, Mental Hygiene, NIMH Training Program in Psychiatric Epidemiology

  Johns Hopkins University

  1998

• BA, Psychology

  George Washington University

  1991