Dean's Professor in Global Health
Director, Global Health & Aging Research
Director for Research, Hartford Institute for Geriatric Nursing
Affiliated Professor, Ashman Department of Periodontology & Implant Dentistry
1 212 992 5951
433 First Avenue
New York, NY 10010
Bei Wu, PhD, is an inaugural co-director of the Aging Incubator at New York University. She holds the position of dean’s professor in hlobal health and director of global health and aging research at NYU Rory Meyers College of Nursing. She is also the director of research at the Hartford Institute for Geriatric Nursing at NYU. As a principal investigator, she has led a significant number of projects supported by federal agencies, such as the National Institutes of Health and Centers for Disease Control and Prevention. She is leading an ongoing NIH-funded clinical trial to improve oral health for persons with cognitive impairment.
Wu is an internationally known leader in gerontology. Her career in gerontology has been distinguished by interdisciplinary collaborations with researchers in various disciplines, including nursing and dentistry, at many academic institutions and organizations in the United States and abroad. Her research areas cover a wide range of topics related to aging and global health, including oral health, long-term care, dementia, and caregiving. She has published over 400 peer-reviewed papers, books, and conference abstracts and has delivered presentations at hundreds of conferences as an invited speaker. She has mentored hundreds of faculty members, visiting scholars, and students from various disciplines, including nursing, gerontology, dentistry, medicine, social work, demography, public health, sociology, public policy, geography, and economics.
Wu is a fellow of the Gerontological Society of America, Association for Gerontology in Higher Education, and the New York Academy of Medicine. She is an Honorary Member of the Honor Society of Nursing, Sigma Theta Tau International. Wu is the former president of the Geriatric Oral Research Group of the International Association for Dental Research. She has served on a number of NIH review panels and is a frequent reviewer for multiple international funding agencies. She was honored as the 2017 IADR Distinguished Scientist in Geriatric Oral Research.
Wu earned her PhD and MS in Gerontology from the University of Massachusetts, Boston, and BS from Shanghai University.
PhD - Gerontology Center, University of Massachusetts, BostonMS - Gerontology Center, University of Massachusetts, BostonBS - Shanghai University
Honorary Member, Sigma Theta Tau International - Honor Society of Nursing
Honors and awards
Faculty Honors AwardsDistinguished Scientist Award for Geriatric Oral Research, International Association for Dental Research (2017)Pauline Gratz Professorship, Duke University School of Nursing (2014)J. Morita Junior Investigator Award in Geriatric Oral Health, International Association for Dental Research (2007)Fellow, Association for Gerontology in Higher EducationFellow, Gerontological Society of AmericaFellow, New York Academy of Medicine
Advance Care Planning Engagement and End-of-life Preference Among Older Chinese Americans: Do Family Relationships and Immigrant Status Matter?AbstractObjectives: To examine how immigrant status and family relationships are associated with advance care planning (ACP) engagement and end-of-life (EOL) preference in burial planning among older Chinese Americans, the largest subgroup of Asian Americans. Design: Cross-sectional survey. Setting: Communities in Honolulu, Hawai'i. Participants: Participants were 430 older Chinese Americans aged 55 years and older. Measures: Measures included ACP contemplation, ACP discussion, and EOL preference in burial planning, immigrant status, family cohesion, family conflict, demographic information, and health status. Results: Results show that in comparison to foreign-born Chinese Americans, US-born Chinese Americans were more likely to have ACP contemplation [odds ratio (OR) 2.80, 95% confidence interval (CI) 1.39-5.63], ACP discussion (OR 3.02, 95% CI 1.50-6.08), and preferences for burial plans at the end of life (OR 4.56, 95% CI 2.04-10.18). Family conflict increased the possibility of having ACP contemplation (OR 1.21, 95% CI 1.07-1.38), ACP discussion (OR 1.22, 95% CI 1.07-1.39), and EOL preference in burial planning (OR 1.22, 95% CI 1.04-1.42), whereas family cohesion was not associated with these study outcomes. Conclusions and Implications: This study suggests that ACP should be adapted to be more culturally appropriate, especially in a time of coronavirus and xenophobia, such as framing ACP as a tool to help families reduce stress while fulfilling filial obligations, in order to ensure equitable access to ACP.
Anxiety about aging, resilience and health Status among Chinese older adults: Findings from Honolulu and WuhanAbstractA growing body of literature found that anxiety about aging is related to health and well-being of older adults. However, very few studies have been conducted on Chinese older adults residing in different countries and examined the role of resilience. Using the Pearlin's Stress Process Model, this study aims to fill in this gap by examining the relationship between anxiety about aging as the stressor and health status among Chinese older adults living in Honolulu, the United States (N = 292) and Wuhan, China (N = 532). The survey data were collected through June 2017 to September 2018, using snowball and convenience sampling strategy. The moderating role of resilience on the focal relationship is also explored. Results showed that for both samples, the negative relationship between anxiety about aging and self-rated health was significantly moderated by resilience (18 % and 13 %, respectively), implying the stress-buffering role of resilience. Although both mean levels of resilience and anxiety about aging were lower for the Honolulu sample, the moderating effect appeared to be stronger, implying that older adults in the Honolulu sample might rely more on psychological resources such as resilience in coping with stressors, compared with their counterparts in Wuhan. However, the moderating effect of resilience did not work for the association between anxiety about aging and number of chronic conditions for both samples. Our findings suggest that future research needs to take into account both social and psychological resources when examining anxiety about aging and health status among Chinese older adults residing in different cultural contexts.
Association between childhood conditions and arthritis among middle-aged and older adults in China: The China Health and Retirement Longitudinal StudyAbstractThis study examined the association between childhood conditions and arthritis among middle-aged and older adults in China. The data were derived from the 2015 wave and the life-history module of the China Health and Retirement Longitudinal Study. Face-to-face interviews were conducted with respondents age 45 and over across China. Multiple imputation was used to handle the missing data, generating a final analytic sample of 19,800. Doctor-diagnosed arthritis was the main outcome variable. Random-effects logistic regression models were used to test the proposed models. Approximately 8 per cent of the respondents had better family financial status in childhood than their neighbours. Close to 8 per cent had been hospitalised or encountered similar conditions (e.g. confined to bed or home) for at least one month in childhood. Around one-third reported better subjective health in childhood than their peers. The majority of the respondents (80%) reported that they had stable health resources, and that their mothers were illiterate during their childhood. Childhood family financial status, subjective health, mother's education, access to health care and medical catastrophic events were found to be significant factors associated with arthritis in later life, after controlling for adulthood and older-age conditions (family financial status: odds ratio (OR) = 0.885, 95 per cent confidence interval (95% CI) = 0.848-0.924; subjective health: OR = 0.924, 95% CI = 0.889-0.960; mother's education: OR = 0.863, 95% CI = 0.750-0.992; access to health care: OR = 0.729, 95% CI = 0.552-0.964; medical catastrophic events: OR = 1.266, 95% CI = 1.108-1.446). The study results highlight an important role that childhood conditions play in affecting the onset of arthritis in late life in China. Health-care providers may consider childhood conditions as a valuable screening criterion to identify risk populations, which could be used to guide health promotion and prevention programmes, and promote healthy ageing.
Association Between Early Cognitive Impairment and Midterm Functional Outcomes Among Chinese Acute Ischemic Stroke Patients: A Longitudinal StudyAbstractBackground: Cognitive decline is common after stroke. The influence of early cognitive impairment on midterm functional outcomes among Chinese acute ischemic stroke (AIS) patients has not been fully studied. The aim of the study was to assess the association between early cognitive impairment and midterm functional outcomes among Chinese AIS patients. Methods: A longitudinal survey focusing on Chinese AIS patients was conducted in three stroke centers in Shanghai, China (July to December 2016). A total of 185 eligible patients were interviewed at acute stage and at 1, 3, and 6 months after onset. Patients' functional outcomes were measured by modified Rankin Scale (mRS) and Barthel Index (BI) at each time point. Cognitive function was assessed using Montreal Cognitive Assessment, Changsha version (MoCA-CS), within 7 days after stroke onset. Covariates included patient's demographic characteristics, socioeconomic status, clinical characteristics of stroke, vascular risk factors, receiving rehabilitation after discharge from acute hospital, and recurrence. Generalized linear mixed models and general linear mixed models were applied. Results: The prevalence of cognitive impairment at acute stage of stroke among these patients was 88.1%. The risk of disability (mRS 2–5) of all patients after stroke decreased over time (OR = 0.491, 95% CI = 0.401–0.603). The risk of disability among those with cognitive impairment increased compared with those with normal cognition (OR = 7.384, 95% CI = 1.041–52.407). The BI score of all patients increased over time after controlling for covariates (β = 1.51, p < 0.01). The BI score of those with cognitive impairment was lower than that with normal cognition over the follow-up period after controlling for other covariates (β = −8.11, p < 0.05). Conclusions: This study showed that early cognitive impairment was associated with higher risk of disability and poor activity of daily living (ADL) among Chinese AIS patients. Further studies are needed to examine the linkage between multi-domain cognitive impairment and long-term disability and ADL among stroke survivors by using neuropsychological test batteries.
Characterizing Sugar-Sweetened Beverage Consumption for US Children and Adolescents by Race/EthnicityAbstractOBJECTIVES: To examine racial/ethnic differences in type of SSB most frequently consumed and in correlates of youth sugar-sweetened beverage (SSB) intake.METHODS: Data were obtained from the National Health and Nutrition Examination Survey (NHANES), 2011-2016, for children and adolescents aged 5-17 years (n = 6507). The main outcome was SSB consumption (i.e., sodas, sweetened fruit drinks, nectars, sports and energy drinks, sweetened coffees and teas, enhanced waters). Mean and proportions of SSB intake were estimated accounting for complex sampling strategy and weighting. Multivariable regression models were developed for each race/ethnicity and age group.RESULTS: Two-thirds of children and adolescents reported consuming SSB on a given day. Among consumers, mean SSB consumption was greatest for Black children and White adolescents and lowest for Asian American children and adolescents. The most popular type of SSB consumed was sweetened fruit drinks among children and soda among adolescents, except among White and Mexican American children for whom soda and Black adolescents for whom sweetened fruit drinks were most popular. Female sex and water intake were negatively associated with SSB consumption across most races/ethnicities. Screen time, dentist visits, nativity, and guardian education were associated with SSB intake among a subset of races/ethnicities.CONCLUSIONS: Associations between covariates and SSB intake as well as types of beverages preferred vary by race/ethnicity, as such chronic disease policies should not be 'one size fits all'. Targeted interventions for specific groups of vulnerable youths hold promise for further reducing SSB consumption, including directing efforts towards reducing sweetened fruit drinks for Black children.
Dataset of cognitive behavioral intervention for persons living with HIV in China: A randomized pilot trialAbstractGlobally, persons living with HIV (PLWH) are vulnerable to depressive and anxious symptoms . Cognitive behavioural therapy (CBT) is one of the first-line mental health treatment strategies for PLWH [2–3]. However, structured and systematic cognitive behavioural intervention (CBI) is rare for PLWH in China. This data article presents the raw data of a parallel two-arm randomized controlled trial investigating the preliminary effects of CBI on depression, anxiety, medication adherence, quality of life, and CD4 lymphocyte counts for PLWH in China. Twenty PLWH who aged ≥18, were undergoing antiretroviral therapy (ART), and scored the Patient Health Questionnaire-4 (PHQ-4) ≥2 were recruited face-to-face and randomly assigned to groups based on computerized random number generation. Intervention participants received a tailored group-based 10-week-long CBI. Control participants only took laboratory tests and received free ART medication. The data includes demographic variables, exposure variables and outcomes. The outcomes were repeated-measured at baseline (T0), after the intervention (T1), and after 6 months of follow-up (T2). We assessed depression and anxiety via the Hospital Anxiety and Depression Scale (HADS), quality of life via the WHOQOL-HIV BREF, medication adherence via self-report adherence, the visual analog scale (VAS) and the medication possession ratio (MPR). CD4 lymphocyte counts were available on participants’ medical records. The main manuscript of this dataset is “cognitive behavioral intervention for persons living with HIV in China: a randomized pilot trial” (Han et al., submitted for publication) .
Education, adult children's education, and depressive symptoms among older adults in rural ChinaAbstractThis study examines whether children's education amplifies the effect of older adults' own education on their later life depressions in rural China. Data derives from six waves of panel data (2001, 2003 2006, 2009, 2012 and 2015) from the Longitudinal Study of Older Adults in Anhui Province, China. Random effect models showed that both older adults' own education and adult children's education had direct effects on depressive symptoms of older adults. Older adults' education influenced children's education, and in turn influenced intergenerational support from children, which consequently influenced depressive symptoms of older adults. Taken together, children's education amplifies the effect of older adults' own education on their depressive symptoms in rural China. This process increases health inequalities among older adults as a result of associated educational achievements in two generations. Educational policy should promote the equality of educational attainment of individuals in the future.
Effects of Care Arrangement on the Age of Institutionalization among Community-dwelling Chinese Older AdultsAbstractEarly and unnecessary institutionalization of older adults can be a heavy burden on the country and taxpayers. It is crucial to understand factors impacting the age of institutionalization of older adults in China. This study examined care arrangements of older adults in China and the relationship between these arrangements and the age of relocation to long-term care facilities (institutionalization). Results show that care arrangements affect the age of institutionalization among community-dwelling Chinese older adults. Those who were primarily cared for by sons and daughter-in-laws tended to be institutionalized at a significantly later age compared to those who were cared for by their spouses. Those who were primarily cared for by other relatives and friends, by domestic helpers, and those with no caregivers tended to have significantly earlier institutionalization compared to those who were cared for by their spouses. However, the number of older adults living in empty nest families is increasing rapidly. Traditional family support for older adults has been shrinking due to fewer children, out-migration of adult children from rural to urban areas, and increased employment of women in China. There is an acute shortage of competent and qualified elder care workers. Most Chinese domestic helpers started their work with limited or even no training, risking the safety of themselves and their employers. In addition to increasing and optimizing the investment in the elder care industry, legal protection and policy support for the elderly and domestic helpers are urgently needed to address these key issues.
Effects and mediating mechanisms of a structured limbs-exercise program on general cognitive function in older adults with mild cognitive impairment: A randomized controlled trialAbstractBackground: Exercise is known to prevent cognitive decline. Sleep quality and depression symptoms, which are associated with processing speed, are considered as common mediators in the exercise-cognition putative model. However, these mediating mechanisms have not been empirically tested in an intervention study. Objective: The aim of this study was to evaluate the effects of a structured limbs-exercise program on general cognitive function, and to test the mediating effects and mediating pathways of depressive symptoms, sleep quality and processing speed in the relationship of exercise-induced cognitive benefits. Design: A two-arm and assessor-blinded randomized controlled trial. Settings and participants: Community-dwelling older adults with mild cognitive impairment living in an urban area in Chifeng, China. Methods: Participants (N=116) were randomly allocated to one of the two arms: (1) a 24-week structured limbs-exercise program (3 supervised limb exercise sessions /week, 60 min /session for the first 12 weeks and 3 unsupervised practice sessions /week, 60 min /session for the following 12 weeks) or (2) health promotion classes alone. Measures of depressive symptoms, sleep quality, processing speed, and general cognitive function were collected at baseline, 12-week, and 24-week. Multivariate analysis of variance and structural equation modeling was used to test the effectiveness and mechanisms of structured limbs-exercise-induced cognitive improvement respectively. Results: The structured limbs-exercise program was beneficial for maintaining general cognitive function at 12 weeks (mean difference = 1.20, 95% CI [0.354, 2.054], p = 0.006) and at 24 weeks (mean difference = 1.59, 95% CI [0.722, 2.458], p = 0.001) in the intervention group. The results from the goodness-of-fit indices of structural equation modeling show as following: (1) The effect of structured limbs-exercise program on cognitive function was partially mediated by depressive symptoms, sleep quality, and processing speed, with 69.22% of joint mediation proportion; (2) Relative to the combined Z values of depressive symptoms and processing speed, sleep quality was more strongly related to cognitive function in the structured limbs-exercise program (Z= 9.294, p<0.01); (3) Processing speed was affected by depressive symptoms, sleep quality, and in turn, yielding a significant effect on cognitive function; and (4) Five potential mediating pathways for improvement in general cognitive function in the structured limbs-exercise intervention were identified. Conclusion: This study shows that this exercise program can maintain general cognitive function for older adults with mild cognitive impairment. Mediating variables include depressive symptoms, sleep quality and processing speed. Future research should continue to incorporate path-oriented intervention strategies in the exercise intervention to maximize improvements in cognitive function. Registration number: ChiCTR1800016299
Gender differences in quality of life among community-dwelling older adults in low- and middle-income countries: results from the Study on global AGEing and adult health (SAGE)AbstractQuality of life (QoL) is an important component of individuals’ general well-being, particularly in older adults. However, factors influencing QoL among older adults in low- and middle-income countries (LMICs) have not been fully examined. Furthermore, the role of gender differences in relation to QoL in multiple LMICs has also not been examined in detail.