Bei Wu

Dr. Wu is Dean’s Professor in Global Health and Vice Dean for Research at the NYU Rory Meyers College of Nursing. She is an inaugural Co-Director of the NYU Aging Incubator. Prior to joining NYU, she was the Pauline Gratz Professor of Nursing at Duke University School of Nursing. Prof. Wu is an internationally-known leader in gerontology.

As a principal investigator, Prof. Wu has led numerous projects supported by federal agencies and private foundations, including the NIH and CDC. She is currently leading several NIH-funded projects including a clinical trial to improve oral health for persons

with cognitive impairment, and a large secondary data analysis to examine how the co-occurrence of diabetes and poor oral health may lead to the development of dementia and cognitive decline. She co-leads the newly funded Rutgers-NYU Center for Asian Health Promotion and Equity. Through this center, she also leads a 5-year intervention study that focuses on supporting Chinese and Korean dementia caregivers who are at increased risk for high blood pressure and diabetes due to the physical and emotional demands of caregiving. She is a director of the Research and Education Core for the NIA-funded Asian Resource Center for Minority Aging Research (RCMAR).

As a scholar, Prof. Wu is an internationally known leader in gerontology. Her scholarship has been distinguished by interdisciplinary collaborations with researchers in various disciplines, including nursing and dentistry, in the US 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 is one of the first in the nation to study the linkages between oral health and cognitive decline in older adults. Her research has also addressed knowledge gaps in the linkages between oral health and diabetes.

Prof. Wu has devoted much of her time to training the next generation of aging and nursing scientists from dozens of academic institutions in the U.S. and abroad. 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. She is successful in mentoring several dozens of early-stage faculty members in receiving competitive funding from NIH, Robert Wood Johnson Scholars, the Alzheimer’s Society (UK), National Science Foundation of China, China Medical Board, National Medical Research Council (Singapore), and many others.

Prof. Wu is a productive researcher. She has published more than 600 peer-reviewed papers, books, reports, and conference abstracts. Her extensive publications cover a wide range of topics related to aging and global health. She has delivered presentations at hundreds of conferences as an invited speaker. Her work has been widely recognized in the field. Research findings from her team have been featured by the National Institute on Aging, and in numerous media outlets, including the New York Times, CNN, BBC, U.S. News and World Report, MarketWatch, CBS News, Reuters, AARP Bulletin, China Daily, Daily Mail, South China Morning Post, and Financial Review.

Her achievement has been recognized by many international and national organizations and she is a fellow of the Gerontological Society of America, the 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, and 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. She is the recipient of the 2022 Wei Hu Inspiration Award from the China Health Policy and Management Society.

PhD - Gerontology Center, University of Massachusetts, Boston

MS - Gerontology Center, University of Massachusetts, Boston

BS - Shanghai University

Gerontology

Global

Honorary Member, Sigma Theta Tau International - Honor Society of Nursing

Distinguished 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, Gerontological Society of America

Fellow, New York Academy of Medicine

Fellow, Association for Gerontology in Higher Education

Association Between Oral Hygiene Behaviours and Cognitive Decline in Adults: A Systematic Review and Meta-Analysis

Zhu, Z., Yang, Z., Qi, X., Mao, W., Pei, Y., & Wu, B. (2024). Journal of Advanced Nursing. 10.1111/jan.16525

Abstract

Abstract

Aim: To evaluate the association between oral hygiene behaviour and cognitive decline in adults. The outcomes include changes in global cognitive function, visual attention, task switching and the risk of dementia. Design: We conducted a systematic review following the preferred reporting items for systematic reviews and meta-analyses guidelines. Data Sources: A systematic search of 11 databases and grey literature sources was conducted from inception to January 2024. We included interventional trials or cohort studies that investigated the effect of oral hygiene behaviours (e.g., toothbrushing, mouth washing, flossing, using toothpicks and cleaning dentures) on cognitive decline in adults. Methods: Data extraction and risk of bias assessment were performed by two independent reviewers with expertise in conducting systematic reviews. Meta-analyses were conducted using random-effects models, and heterogeneity was assessed with the I2 statistic and χ2 test. Results: A total of eight studies (six intervention studies and two cohort studies) met inclusion criteria, including 261,772 participants. Follow-up periods ranged from 30 days to 48 months for interventions and 9 to 18 years for cohorts. Toothbrushing was associated with a significantly slower decline in global cognitive overtime. Toothbrushing in older adults with moderate/severe dementia could achieve significant changes in cognitive decline. There was no significant difference between the effectiveness of toothbrushing performed by professionals and caregivers. Other oral hygiene behaviours, including dental flossing, using mouthwash, using toothpicks and cleaning dentures, were not associated with the risk of dementia. Conclusions: Toothbrushing is linked to a decreased risk of dementia and improved global cognitive function. Promoting toothbrushing at least twice daily may significantly reduce the risk of cognitive decline and dementia. Impact: These findings highlight the urgent need for programmes that encourage daily toothbrushing, particularly in nursing home settings and among older adults with moderate-to-severe dementia.

The Association Between Trajectories of Perceived Unmet Needs for Home and Community-Based Services and Life Satisfaction Among Chinese Older Adults: The Moderating Effect of Psychological Resilience

Wang, H., Liu, H., Wu, B., & Hai, L. (2024). Research on Aging, 46(2), 139-152. 10.1177/01640275231203608

Abstract

Abstract

This study examined whether trajectories of perceived unmet needs for Home and Community-Based Services (HCBS) were associated with life satisfaction among Chinese older adults and whether the association was moderated by psychological resilience. Data came from five waves (2005-2018) of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Latent class growth analysis revealed three distinct trajectories of perceived unmet HCBS needs: “increasing” (n = 977, 36.24%), “persistent” (n = 570, 21.14%), and “decreasing” (n = 1149, 42.62%). Multiple regression estimates showed that the increasing group was associated with lower life satisfaction, and the association was moderated by psychological resilience, especially for older adults who were male, living in rural, and oldest-old. Results indicate that inequalities in cumulative exposure to perceived unmet HCBS needs may further lead to increasing inequalities in life satisfaction. Interventions focused on minimizing the provision-need gap of HCBS and enhancing personal resilience should be considered to improve the life satisfaction of older adults.

Association of Gum Treatment with Cognitive Decline and Dementia Risk among Older Adults with Periodontal Symptoms: A 12-Year Prospective Cohort Study

Qi, X., Zhu, Z., Wang, K., Zheng, Y., Li, A., & Wu, B. (2024). Neuroepidemiology, 1-10. 10.1159/000540086

Abstract

Abstract

INTRODUCTION: This study examines the associations of gum treatment with cognitive decline and dementia risk among older adults with periodontal symptoms in the USA.METHODS: A cohort of 866 adults aged ≥50 with periodontal symptoms was recruited for the 2008 Health and Retirement Study "Dental Health Experimental Module" and followed until 2020. Cognitive function was assessed with the Telephone Interview for Cognitive Status (TICS). Dementia status was ascertained with the Langa-Weir algorithm based on TICS scores and proxy assessments. Linear mixed-effects model and multivariable Cox regression models were utilized to analyze the associations of gum treatment with cognitive decline and the risk of dementia, respectively.RESULTS: Of 866 participants (mean age 67.7, 61.4% women), 105 (12.1%) developed dementia with a median follow-up of 9 (IQR, 6-10) years. The dementia incidence rates were lower in the group with gum treatment (7.4 vs. 12.9 per 1,000 person-years). Compared with participants who did not have gum treatment, those with gum treatment experienced a decline in TICS score that was on average 0.025 (95% CI, 0.005-0.044) points less per year and a 38% lower incidence of dementia (hazard ratio, 0.62; 95% CI, 0.41-0.93). These associations were consistent across participants with a different severity of periodontal symptoms and sociodemographic characteristics (age, sex, race, ethnicity, and education) except for income levels.CONCLUSION: Prompt gum treatment for older adults with periodontal symptoms may be beneficial for their cognitive health.

Can formal home and community-based care substitute informal care? Evidence from Chinese Longitudinal Healthy Longevity Survey

Wang, Y., Wu, B., & Yang, W. (2024). BMC Geriatrics, 24(1). 10.1186/s12877-024-05312-7

Abstract

Abstract

Background: Formal home and community-based care are often considered as the preferable option to institutional care, offering older individuals the convenience of receiving care in their homes. Although research has found that these services may alleviate the burden on informal caregivers, there is a lack of research on which specific types of formal home and community-based care influence informal care provision. Methods: Employing fixed-effects and quantile regression models, this study seeks to explore the effects that various formal home and community-based care services have on reducing the burden of informal care. This study draws data from the Chinese Longitudinal Healthy Longevity Survey 2005, 2008, 2011, 2014, and 2018. Results: Our findings indicate that two types of formal care substantially influence the provision of informal care. The availability of daily living assistance services correlates with reduced informal caregiving hours, especially for those with extensive care needs. The availability of community-based health care services is linked to a reduction in the direct expenses incurred from informal caregiving, especially for those incurring greater direct caregiving costs. These effects are more prominent among urban residents. Other services, such as mental health support and legal advice services, do not demonstrate significant effects on reducing informal care hours and costs. Conclusions: Daily living assistance and community-based health care services play a crucial role in benefiting informal caregivers. It is important to prioritize the expansion of these services, especially among those with greater care needs.

Care partners experience of an oral health intervention for individuals with mild cognitive impairment and mild dementia using behavior change technique: A qualitative study

Bryant, A. L., Hirschey, R., Caiola, C. E., Chan, Y. N., Cho, Y., Plassman, B. L., Wu, B., Anderson, R. A., & Bailey, D. E. (2024). Geriatric Nursing, 56, 40-45. 10.1016/j.gerinurse.2023.12.021

Abstract

Abstract

Oral health declines in older adults with cognitive impairment. We aimed to improve oral hygiene outcomes for individuals with mild cognitive impairment (MCI) or mild dementia (MD) by fostering behavior changes among carepartners assisting them. We used qualitative data of verbatim transcripts of coaching sessions with carepartners (n = 17 dyads:10 dyads for MCI, 7 dyads for MD). Directed and emergent coding were used to understand behavior change techniques (BCTs). BCTs were compared with carepartners of participants with MCI and MD. Most frequently used BCTs in both groups: prompts and cues, instruction on how to perform the behavior, review behavioral goal, and problem solving. Different BCTs emerged in study: social support-unspecified of the MCI group and credible source for MD group. Findings clarified active intervention components, common BCTs used by carepartners, and different BCT approaches for both participants. Findings help to elucidate the mechanisms of changes in individuals’ behaviors in these interventions.

Caregiving in Asia: Priority areas for research, policy, and practice to support family caregivers

Jiang, N., Wu, B., & Li, Y. (2024). Health Care Science, 3(6), 374-382. 10.1002/hcs2.124

Abstract

Abstract

Population aging presents a growing societal challenge and imposes a heavy burden on the healthcare system in many Asian countries. Given the limited availability of formal long-term care (LTC) facilities and personnel, family caregivers play a vital role in providing care for the increasing population of older adults. While awareness of the challenges faced by caregivers is rising, discussions often remain within academic circles, resulting in the lived experiences, well-being, and needs of family caregivers being frequently overlooked. In this review, we identify four key priority areas to advance research, practice, and policy related to family caregivers in Asia: (1) Emphasizing family caregivers as sociocultural navigators in the healthcare system; (2) addressing the mental and physical health needs of family caregivers; (3) recognizing the diverse caregiving experiences across different cultural backgrounds, socioeconomic status, and countries of residence; and (4) strengthening policy support for family caregivers. Our review also identifies deficiencies in institutional LTC and underscores the importance of providing training and empowerment to caregivers. Policymakers, practitioners, and researchers interested in supporting family caregivers should prioritize these key areas to tackle the challenge of population aging in Asian countries. Cross-country knowledge exchange and capacity development are crucial for better serving both the aging population and their caregivers.

Caregiving-Related Characteristics and Dental Care Utilization in Informal Caregivers of Persons With Dementia: Is There a Gender Difference?

Mao, W., Wu, B., Zhang, F., & Yang, W. (2024). Gerontologist, 64(11). 10.1093/geront/gnae133

Abstract

Abstract

Background and Objectives: Dental care utilization is an important, yet understudied aspect of healthcare in informal caregivers of persons with dementia. This study examined how caregiving-related characteristics are associated with dental care utilization among U.S. informal caregivers of persons with dementia and further examined gender differences. Research Design and Methods: Pooled data came from the Behavioral Risk Factor Surveillance System in 2016, 2018, 2020, and 2022. A nationally representative sample of informal caregivers (n = 3,909) was included. Dental care utilization was "yes"versus "no"within the past year. Caregiving-related characteristics included caregiver role, intensity of care, duration of care, and type of care. Logistic regressions and subgroup analyses were conducted. Results: In total sample, compared to adult child caregivers, spousal caregivers were 28% less likely to visit a dentist (odds ratio [OR] = 0.72; 95% confidence interval [CI] = 0.56, 0.94). Caregivers who provided care for more than 20 hr per week were 18% less likely to visit a dentist (OR = 0.82; 95% CI = 0.69, 0.98). In subgroup analyses, intensity of care was a barrier to dental care utilization for female caregivers (OR = 0.78; 95% CI = 0.62, 0.98), whereas caregiver role such as spousal caregiver (OR = 0.59; 95% CI = 0.39, 0.89) or other relative caregiver (OR = 0.70; 95% CI = 0.50, 0.99) was a barrier to dental care utilization for male caregivers. Discussion and Implications: The findings highlight the importance of caregiving-related characteristics in dental care utilization and suggest gender-tailored interventions.

Characterizing Mental Health Status and Service Utilization in Chinese Americans With Type 2 Diabetes in New York City: Cross-Sectional Study

Shi, Y., Wu, B., Islam, N., Sevick, M. A., Shallcross, A. J., Levy, N., Tamura, K., Bao, H., Lieu, R., Xu, X., Jiang, Y., & Hu, L. (2024). JMIR Formative Research, 8. 10.2196/59121

Abstract

Abstract

Background: Emerging evidence indicates that individuals with type 2 diabetes (T2D) are more prone to mental health issues than the general population; however, there is a significant lack of data concerning the mental health burden in Chinese Americans with T2D. Objective: The aim of this study was to explore the comorbid mental health status, health-seeking behaviors, and mental service utilization among Chinese Americans with T2D. Methods: A cross-sectional telephone survey was performed among 74 Chinese Americans with T2D in New York City. We used standardized questionnaires to assess mental health status and to gather data on mental health–seeking behaviors and service utilization. Descriptive statistics were applied for data analysis. Results: A total of 74 Chinese Americans with T2D completed the survey. Most participants (mean age 56, SD 10 years) identified as female (42/74, 57%), were born outside the United States (73/74, 99%), and had limited English proficiency (71/74, 96%). Despite nearly half of the participants (34/74, 46%) reporting at least one mental health concern (elevated stress, depressive symptoms, and/or anxiety), only 3% (2/74) were currently using mental health services. Common reasons for not seeking care included no perceived need, lack of information about Chinese-speaking providers, cost, and time constraints. The cultural and language competence of the provider was ranked as the top factor related to seeking mental health care. Conclusions: Chinese Americans with T2D experience relatively high comorbid mental health concerns yet have low service utilization. Clinicians may consider team-based care to incorporate mental health screening and identify strategies to provide culturally and linguistically concordant mental health services to engage Chinese Americans with T2D.

Cognitive Trajectories and Associated Social and Behavioral Determinants Among Racial/Ethnic Minority Older Adults in the United States

Wang, K., Chen, X. S., Zeng, X., Wu, B., Liu, J., Daquin, J., Li, C., & Gaugler, J. E. (2024). Gerontologist, 64(12). 10.1093/geront/gnae147

Abstract

Abstract

Background and Objectives. Despite higher risks of developing Alzheimer’s disease and Alzheimer’s disease–related dementias among racial/ethnic minority populations, some maintain good cognition until old age. The aims of this study were to investigate heterogeneous cognitive trajectories among non-Hispanic Black and Hispanic older adults, examine cognitive impairment prevalence across trajectory classes, and identify associated social and behavioral determinants. Research Design and Methods. Using 11 waves of data from the Health and Retirement Study (1996–2016), 1,322 non-Hispanic Black and 747 Hispanic adults aged 50+ years in 1996 with normal cognition were included. Latent class growth modeling and multinomial logistic regressions were performed to examine cognitive trajectories and associated determinants. Results. For both racial/ethnic groups, 3 trajectory classes were identified: high, medium, and low cognition. In the low-cognition class, 87% and 100% of non-Hispanic Black and Hispanic participants, respectively, developed cognitive impairment. For both racial/ethnic groups, older age and living in rural areas during schooltime increased the likelihood of being in the low-cognition class, whereas more education was associated with a lower likelihood. Unique risk and protective determinants for non-Hispanic Black and Hispanic participants were also identified. Discussion and Implications. This study reveals the heterogeneity of cognitive trajectories among racial/ethnic minority older adults and various associated social and behavioral determinants. More prevention interventions and accessible, affordable diagnosis and treatment should be provided to older racial/ethnic minorities with these characteristics to reduce disparities. More research is needed to further explore associations between unique determinants and cognition in racial/ethnic minority populations to better inform interventions.

Community Social Capital and Self-Reported Oral Health among Chinese Older Adults: The Moderating Role of Income and the Mediating Role of Depressive Symptoms

Lu, N., Wu, B., & Mao, S. (2024). Health and Social Care in the Community, 2024. 10.1155/2024/8991939

Abstract

Abstract

This study examined the associations between community social capital and self-reported oral health among older adults in urban China, as well as the moderating effect of household income and the mediating role of depressive symptoms in these associations. Data were obtained from a community survey conducted in 2020 in Tianjin and Shijiazhuang City, China; the final analytical sample comprised 776 adults aged 60 years and above. To test the proposed moderation and mediation models, the data were analysed using binary logistic regression models and a path analysis, respectively. The findings showed that cognitive social capital and social participation (i.e., an indicator of structural social capital) were significantly associated with self-reported oral health. Additionally, the results revealed that while income significantly moderated the association between cognitive social capital and self-reported oral health, depressive symptoms significantly mediated it. The findings not only highlight the crucial role of community social capital in promoting oral health in later life among low-income older adults but also provide important evidence for a psychosocial pathway between social capital and oral health. Given the impacts of income and depressive symptoms on the relationship between community social capital and oral health among older adults, future social policies and interventions to support oral health should target financially vulnerable older adults with poor psychological well-being.