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

Factors Associated with Death Anxiety Among Rural Chinese Older Adults: The Terror Management Perspective

Pei, Y., Cong, Z., Silverstein, M., Li, S., & Wu, B. (2022). Research on Aging, 44(1), 65-72. 10.1177/0164027520981726

Abstract

Abstract

Objectives: The aim of this study was to examine how the factors suggested by the Terror Management Theory are associated with death anxiety among rural Chinese older adults. Method: Data were derived from a longitudinal survey of older adults aged 60 and above, had at least one living child, and were living in rural areas of Anhui Province. The working sample included 1,362 older adults. Two-level random effects models were used. Results: Children’s financial support was negatively related to death anxiety, whereas emotional closeness with children was positively related to death anxiety. Older women reported more death anxiety than older men. Functional limitations were positively associated with death anxiety, and the widowed reported less death anxiety than the married. We did not find a significant association between religious belief and death anxiety. Discussion: The study highlights the importance of culture in shaping death anxiety among older adults in rural China.

Family type and cognitive function in older Chinese Americans: acculturation as a moderator

Li, M., Lu, S. E., Hoover, D. R., Flynn, L., Silverstein, M., Wu, B., & Dong, X. Q. (2022). Aging and Mental Health, 26(8), 1642-1653. 10.1080/13607863.2021.1926426

Abstract

Abstract

Objectives: Acculturation to the mainstream culture and the settlement contexts could shape cognitive function of older immigrants. Guided by ecological theory, this study examines the interaction effect between individual acculturation and ecology of family on cognitive function among older Chinese Americans. Methods: Data were derived from the Population Study of Chinese Elderly in Chicago (n = 3,019). Family types included tight-knit (high solidarity and low conflicts), unobligated-ambivalent (high solidarity and conflicts), commanding-conflicted (low solidarity and high conflicts), and detached (low solidarity and low conflicts). Acculturation was measured via language ability, media use, and ethnic social relations. Cognitive function was evaluated by global cognition, episodic memory, working memory, processing speed, and mini-mental state examination. Multiple regression analyses and interaction terms were used. Results: Older adults in the commanding-conflicted type had the lowest cognitive function. After controlling confounding variables, higher levels of acculturation (b = 0.009, SE = 0.003, p <.01) were associated with higher levels of global cognition. Acculturation buffered the negative impact of having a commanding-conflicted relationship with children on global cognition (b = 0.070, SE = 0.016, p <.001). Language ability, media use, and ethnic social relations played a unique role in the relationships between family types and cognitive domains. Conclusion: Acculturation to the dominant culture is identified as a cultural asset for cognitive function in older Chinese Americans. Social services could protect cognitive function of older immigrants in the commanding-conflicted type through enhancing cultural participation. Future research could test how affective and cognitive aspects of acculturation affect health.

Findings of Sequential Pilot Trials of Aliviado Dementia Care to Inform an Embedded Pragmatic Clinical Trial

Lin, S. Y., Schneider, C. E., Bristol, A. A., Clancy, M., Sprague, S. A., Aldridge, M., Cortes, T., Goldfeld, K. S., Kutner, J. S., Mitchell, S. L., Shega, J. W., Wu, B., Zhu, C. W., & Brody, A. A. (2022). Gerontologist, 62(2). 10.1093/geront/gnaa220

Abstract

Abstract

Background and Objectives: Many investigators of Alzheimer's disease and related dementias (AD/ADRD) are unfamiliar with the embedded pragmatic clinical trials (ePCTs) and the indispensable pilot phase preceding ePCTs. This paper provides a much-needed example for such a pilot phase and discusses implementation barriers and additional infrastructure and implementation strategies developed in preparation for a nationwide AD/ADRD ePCT. Research Design and Methods: Two pilot trials were conducted in 2 hospices sequentially to refine and test Aliviado Dementia Care - Hospice Edition, a complex quality improvement intervention for advanced dementia symptom management. Readiness for the subsequent full-scale ePCT was assessed by three milestones: ≥80% training completion rate ("feasibility"), ≥80% posttraining survey respondents indicating intention for practice changes ("applicability"), and at least 1 Aliviado care plan/assessment instrument administered in ≥75% of dementia patients admitted to home hospice within 1-month posttraining ("fidelity"). Results: Participants included 72 interdisciplinary team members and 11 patients with AD/ADRD across the pilots. Feasibility, applicability, and fidelity outcomes (92%, 93%, and 100%, respectively) all surpassed the preestablished milestones (80%, 80%, and 75%). Main implementation challenges were related to hospice staff turnover, integration of the Aliviado toolbox materials within the electronic health records, and hospices' limited research experience and infrastructure. Discussion and Implications: This pilot phase demonstrated feasibility, applicability, and fidelity required to proceed to the full-scale ePCT. Our study findings and discussions of additional infrastructure and implementation strategies developed following the pilot phase can inform researchers and clinicians interested in conducting AD/ADRD-related pilot studies for ePTCs or quality improvement initiatives. Clinical Trials Registration Number: NCT03681119.

Fireside Chat on the Asian American, Native Hawaiian, and Pacific Islander Special Edition of the Health Equity Journal Featuring Authors

McLemore, M., Chen, Z. A., Lett, E., Samoa, R., Moreno, A., Wu, B., Yin, L., Zhang, D., Montalvo, W., & Nguyen, C. (2022). Health Equity, 6(1), 953-964. 10.1089/heq.2022.29016.rtd

Gendered leisure time-use and its impact on cognitive function among older adults in rural China

Liu, H., Pei, Y., & Wu, B. (2022). Ageing and Society, 42(11), 2533-2555. 10.1017/S0144686X21000118

Abstract

Abstract

Increasing evidence has shown that an active, socially engaged lifestyle in leisure time might protect older adults against the decline of cognitive function. It remains unclear, however, which types of leisure activities are more beneficial to maintain cognitive function, and whether there are gender differences in the association between leisure activities and cognitive function. We used a two-wave of panel data from 1,018 older adults aged 60 and older in rural China to examine the lag effects of different types of leisure activities on cognitive functioning and to identify the gender differences in their impacts on cognition in rural China. Ordinary least-squares regression models showed that high physical activities were associated with better cognitive function. High intensity of cognitive activities and engaging in physical activities have a protective effect on cognitive function among older men rather than older women. Further, we found that cognitive activities had a stronger effect on cognitive function among older men than older women. It is important to consider gender-specific intervention in leisure activities to maintain cognitive function among older adults.

Health behaviors and tooth retention among older adults in China: findings from the 4th Chinese national oral health survey

Ou, X., Zeng, L., Zeng, Y., Pei, Y., Zhang, X., Wu, W., Siamdoust, S., & Wu, B. (2022). BMC Oral Health, 22(1). 10.1186/s12903-022-02283-2

Abstract

Abstract

Background: This study aimed to examine the association between oral health behaviors and tooth retention among Chinese older adults. Methods: Data were used from the 4th Chinese National Oral Health Survey, a nationally representative sample. The sample included 9054 older adults aged 55 to 74. Control variables and oral health behaviors were measured through a questionnaire interview, and the number of remaining teeth and periodontal health were obtained from an oral health examination. A chi-square test was used for univariate analysis. Multivariate Logistic regression was used to explore the association between health behaviors and the number of remaining teeth. Results: The average number of remaining teeth in the sample was 24.4 ± 7.7. There was a higher proportion of older adults living in urban areas with 20 or more teeth than those living in rural areas (83.2% vs. 79.4%, P < 0.001); and a higher proportion of individuals with high education levels with 20 or more teeth compared to those with low education levels (P < 0.001). Logistic regression models showed that older adults who used toothpicks `(OR = 3.37, 95% CI 2.94–3.85), dental floss (OR = 1.93, 95% CI 1.05–3.53), toothpaste (OR = 3.89, 95% CI 3.14–4.83); and never smoked (OR = 1.43 95% CI 1.20–1.70) were more likely to retain 20 or more natural teeth; whereas older adults who had a dental visit were less likely to retain 20 or more natural teeth (OR = 0.45, 95% CI 0.39–052). Conclusion: Good oral hygiene practices, never smoking, and regular dental visits focusing on prevention are significantly associated with teeth retention. It is critical to promote a healthy lifestyle and improve prevention-oriented oral health care systems.

Hospice Care Preferences and Its Associated Factors among Community-Dwelling Residents in China

Lin, H., Ko, E., Wu, B., & Ni, P. (2022). International Journal of Environmental Research and Public Health, 19(15). 10.3390/ijerph19159197

Abstract

Abstract

Hospice care is a comprehensive approach addressing patients’ physical, psychosocial, and spiritual needs at the end of life (EoL). Despite the recognition of its effectiveness in improving the quality of EoL care, little is known about hospice care in mainland China. In this study, we aimed to examine the preferences for hospice care and its related factors among community-dwelling residents in mainland China. Participants were recruited using a convenience sampling method, and 992 community-dwelling residents responded to an online survey from June 2018 to August 2019. The majority (66.7%) of the participants were female, and the mean age was 48.4 years. Approximately 28% of the participants had heard of hospice care, and 91.2% preferred to receive hospice care if diagnosed with a terminal illness. Participants who had heard of hospice care, and with higher levels of education (bachelor’s degree or above) and health insurance coverage were more likely to accept hospice care than their counterparts. Community-based education on hospice care is imperative to improve public knowledge and the acceptance of hospice care. Meanwhile, there is a need to develop policies to integrate and expand hospice care into clinical settings.

Identifying subtypes of HIV/AIDS-related symptoms in China using latent profile analysis and symptom networks

Yang, Z., Zhu, Z., Wen, H., Han, S., Zhang, L., Fu, Y., Hu, Y., & Wu, B. (2022). Scientific Reports, 12(1). 10.1038/s41598-022-17720-z

Abstract

Abstract

The identification of subgroups of people living with HIV in China based on the severity of symptom clusters and individual symptoms is crucial to determine group-specific symptom management strategies. Participants reported 27 highly prevalent HIV/AIDS-related symptoms. Latent profile analysis based on symptom severity was used to identify person-centered subtypes of HIV/AIDS-related symptoms. Symptom networks were compared among subgroups identified by latent profile analysis. A total of 2927 eligible people living with HIV (PWH) were included in the analysis. Five profiles were identified: “Profile 1: all low symptom severity” (n2 = 2094, 71.54%), “Profile 2: medium symptom severity with syndemic conditions” (n3 = 109, 3.72%), “Profile 3: medium symptom severity with low functional status” (n1 = 165, 5.64%), “Profile 4: medium symptom severity in transitional period” (n4 = 448, 15.31%), and “Profile 5: all high symptom severity” (n5 = 111, 3.79%). Except for Profile 1 and Profile 5, the symptom severity was similar among the other three profiles. Profiles 1 (2.09 ± 0.52) and 4 (2.44 ± 0.66) had the smallest ∑s values, and Profiles 2 (4.38 ± 1.40) and 5 (4.39 ± 1.22) had the largest ∑s values. Our study demonstrates the need for health care professionals to provide PWH with group-specific symptom management interventions based on five profiles to improve their physical and psychological well-being. Future studies should be conducted in different contexts using different symptom checklists to further validate our results.

International migration and its influence on health

Squires, A., Thompson, R., Sadarangani, T., Amburg, P., Sliwinski, K., Curtis, C., & Wu, B. (2022). Research in Nursing & Health, 45(5), 503-511. 10.1002/nur.22262

Is Living in an Ethnic Enclave Associated With Cognitive Function? Results From the Population Study of Chinese Elderly (PINE) in Chicago

Guo, M., Wang, Y., Xu, H., Li, M., Wu, B., & Dong, X. (2022). Gerontologist, 62(5), 662-673. 10.1093/geront/gnab158

Abstract

Abstract

Background and Objectives: Ethnic enclaves provide pivotal coping resources for immigrants, having important implications for cognitive health. This study examined the association between living in an ethnic enclave (i.e., Chinatown) and cognition, and potential moderating effect of education on such an association among Chinese older immigrants in the United States. We further examined subgroup differences based on preferred language (Mandarin, Cantonese, and Taishanese). Research Designs and Methods: Data were derived from the Population Study of Chinese Elderly in Chicago (N = 3,105, mean age = 73). Global cognition, assessed by a battery including Mini-Mental State Examination, working memory, episodic memory, and executive function, was compared between those who lived in Chinatown (n = 1,870) and those who did not (n = 1,235). Linear regressions with interaction terms were performed in the entire sample and subsamples with different language preferences. Results: Chinatown residents had significantly poorer cognition than non-Chinatown residents. Regression results identified both protective and risk factors for cognition associated with living in Chinatown. Among them, education (β = 0.072, p <. 001) played a salient role in explaining the cognitive disadvantage of Chinatown residents. Education also moderated the influence of Chinatown residence on cognition, but only among Mandarin speakers (β = -0.027, p =. 04). Discussion and Implications: Living in an ethnic enclave may be a risk factor for poor cognition for Chinese immigrants. Neighborhood-specific health assessment may facilitate early identification and prevention of cognitive impairment in this population. Studies need to examine divergent aging experiences of immigrants within single ethnic groups.