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

Dose‒Response Effects of Patient Engagement on Anxiety and Depression in a Cognitive-Behavioral Intervention: Secondary Analysis of a Pilot Randomized Controlled Trial and a Clinical Controlled Trial

Yang, Z., Han, S., Zhang, L., Sun, M., Hu, Q., Hu, Y., & Wu, B. (2024). AIDS and Behavior, 28(6), 1923-1935. 10.1007/s10461-024-04290-6

Abstract

Abstract

Understanding the dose‒response relationship between patient engagement in cognitive behavioral therapy (CBT) and health outcomes is critical for developing and implementing effective CBT programs. In studies of CBT interventions, patient engagement is measured only at a single time point, and outcomes are typically assessed before and after the intervention. Examination of the dose‒response relationship between patient engagement in CBT and outcomes is limited. It is unclear whether a dose‒response relationship exists between patient engagement in on-site CBT intervention and anxiety and depression in people living with HIV (PLWH). If present, does this dose‒response relationship occur early or later in the intervention? This study aimed to address this gap by examining the dose‒response relationships between patient engagement and anxiety and depression in CBT interventions among PLWH. Utilizing data from a pilot randomized trial (10 participants) and a clinical controlled trial (70 participants), our secondary analysis spans baseline, 3-month, and 6-month assessments. Both trials implemented the nurse-led CBT intervention. Cluster analysis identified two groups based on on-site attendance and WeChat activity. Patients with good adherence (6–10 times) of on-site attendance exhibited significantly lower anxiety and depression scores at 3 months (β = 1.220, P = 0.047; β = 1.270, P = 0.019), with no significant differences observed at 6 months. WeChat activity did not significantly influence anxiety or depression scores. The findings highlight a significant short-term dose‒response relationship, endorsing nurse-led CBT interventions for mental health in PLWH. Organizational strategies should focus on incentivizing and facilitating patient engagement, particularly through enhancing WeChat features.

Dyadic analysis of illness perceptions among individuals with stroke and their caregivers: effects on activity engagement in community living

Shi, Y., Howe, T. H., Halpin, P. F., Hu, L., & Wu, B. (2024). Disability and Rehabilitation, 46(15), 3342-3354. 10.1080/09638288.2023.2246378

Abstract

Abstract

Purpose: To explore the relationship between activity engagement and dyadic illness perceptions of community-dwelling individuals with stroke and their caregivers. Methods: We performed a secondary analysis on a cross-sectional study encompassing eight rehabilitation settings. Participants were recruited from June to December 2019 via the distribution of flyers, use of admission databases, and direct onsite interactions. Activity engagement of individuals with stroke was measured by the Assessment of Life Habits. Dyadic illness perceptions were measured using the Stroke-Specific Illness Perceptions Questionnaire-Revised. Results: Data from 202 dyads of individuals with stroke (mean age 61.3 ± 8.3 years; 76.7% male; stroke duration 314.3 ± 170.5 days), and caregivers (mean age 52.6 ± 11.6 years; 73.3% female) were analyzed. Results show that individuals with stroke who shared similar optimistic illness perceptions with their caregivers concerning the consequences of stroke had a higher level of activity engagement (ΔR 2 = .020, F(2,193) = 5.42, p = .005). Gender differences were found in the dyadic illness perception components concerning acute/chronic and cyclical timeline (ΔR 2 = .017, F(2,191) = 4.72, p = .01; ΔR 2 = .02, F(2,190) = 3.45, p = .034) and illness coherence (ΔR 2 = .012, F(2,191) = 3.42, p = .035). Conclusions: Illness perceptions and post-stroke activity engagement with gender differences should be considered at a dyadic level, as the individuals with stroke and their caregivers influence each other’s beliefs.

Factors Associated with Patient–Caregiver Concordance about Life-Sustaining Treatment Preferences among Advanced Cancer Patients: A Cross-Sectional Study

Liao, J., Wu, B., Mao, J., & Ni, P. (2024). Seminars in Oncology Nursing, 40(5). 10.1016/j.soncn.2024.151697

Abstract

Abstract

Objectives: Concordance of preferences for end-of-life care regarding patients between patients with advanced cancer and family caregivers can improve the likelihood of honoring dying patients’ wishes. However, there is a dearth of knowledge in mainland China. The purpose of this study was to examine patient–family caregiver concordance about patients’ life-sustaining treatment preferences and associated factors among patients with advanced cancer in China. Methods: From September 2019 to December 2021, a convenience sample of 406 dyads of advanced cancer patient–family caregiver were recruited from 2 tertiary hospitals in Wuhan, China. Participants completed a questionnaire about patient's preferences for life-sustaining treatment, respectively. The concordance was assessed by percent agreement and kappa coefficients. Associated factors were identified by univariate analysis and binary logistic regression. Results: The average concordance rate on the preferences for life-sustaining treatment was 56.1%, ranging from 52.9% to 59.3%. Factors associated with a higher level of patient–family caregiver concordance were following: patients who were married, whose educational levels were at college or above, who had not been informed of diagnosis by a physician, who had been informed of the effects and side effects of related drugs by a physician, and who cared for a seriously ill family member or friend and caregivers whose educational level were primary or below. Conclusions: The patient–family caregiver concordance about patients’ life-sustaining treatment preferences among patients with advanced cancer was poor. Patients’ and caregivers’ understanding of life-sustaining treatment and its efficacy in end-of-life should be facilitated. Relevant conversation should be encouraged between patients and caregivers, thus providing value-concordant end-of-life care for patients with cancer. Implications for Nursing Practice: Health professionals need to carry out advanced care planning in oncology departments on mainland China to encourage patients and caregivers to discuss patients’ end-of-life care preferences. Facilitating patients’ and caregivers’ understanding of life-sustaining treatment preferences may help improve the patient–caregiver concordance on life-sustaining treatment preferences among patients with advanced cancer.

Having sex with partners met online among bachelors in China: application of the theory of planned behavior

Wang, Y., Liu, H., Pei, Y., & Wu, B. (2024). Sexual and Relationship Therapy, 39(3), 777-790. 10.1080/14681994.2022.2025776

Abstract

Abstract

Due to a sex ratio imbalance and marriage squeeze in China, many males of marriageable ages cannot find wives. To meet their sexual needs, those bachelors tend to use the internet to find sexual partners in recent years. However, studies on the psychosocial mechanisms underlying having sex with partners met online are scarce. This study examined the relationship between attitude, subjective norms, perceived behavior control, and having sex with online partners based on the Theory of Planned Behavior (TPB). The data were obtained from a cross-sectional survey of bachelors (with rural household registration, at least 28 years old and never married) (N = 735) in several regions of China. Logistic regression models show that attitudes and subjective norms were significantly associated with having sex with online partners. The mediation analysis further indicated that the intention of seeking sex partners online partially mediated the relationships across attitudes, subjective norms, and having sex with partners online. This study provides a better understanding of factors associated with having sex with partners met online. It also extends research concerning a population that is understudied. Additionally, it shows the applicability of the TBP model in explaining the factors associated with having sex with partners.

Heterogeneities in sleep duration and quality among U.S. immigrants from different racial and ethnic backgrounds

Liu, X., Li, J., Cho, Y., & Wu, B. (2024). Sleep Health, 10(4), 393-401. 10.1016/j.sleh.2024.03.006

Abstract

Abstract

Objectives: Sleep plays an essential role in well-being. Although U.S. immigrants are considerably growing, few studies have examined sleep in this diverse population, particularly those from Asian backgrounds. It is also unclear how sleep differs by the length of residence across immigrant groups. In this study, we examined the relationships among race/ethnicity, length of residence, and sleep using a nationally representative cohort of U.S. immigrants. Methods: We analyzed data from the 2013-2018 National Health Interview Survey. The sample (N = 27,761; 14% ≥65 years old) included foreign-born adults from the following racial/ethnic backgrounds: non-Hispanic White, non-Hispanic Black, Asian (Chinese, Filipino, Asian Indian), and Hispanic/Latino. Length of residence was categorized as <5, 5-9, 10-14, and ≥15 years. Sleep was assessed with self-reported sleep duration (normal, short, and long) and poor sleep quality (trouble falling asleep, trouble staying asleep, and waking up unrested). Results: Filipino and Hispanic/Latino immigrants reported the highest prevalence of short (41.8%) and long (7.0%) sleep, respectively. Non-Hispanic White immigrants had the highest prevalence rate across all three poor sleep quality measures (range 17.7-41.5%). Length of residence ≥15 years was significantly associated with worse sleep, and it moderated White-Asian differences in sleep quality. Immigrants from different racial/ethnic groups showed variations in sleep patterns as they resided longer in the US. Conclusions: Immigrants exhibited substantial heterogeneities in sleep. Future research should investigate the contributing factors to the variations in their sleep patterns, both between groups and within the same group of immigrants, in order to inform tailored interventions.

Home Health Care and Hospice Use Among Medicare Beneficiaries With and Without a Diagnosis of Dementia

Kim, H., Duberstein, P. R., Lin, H., Wu, B., Zafar, A., & Jarrín, O. F. (2024). Journal of Palliative Medicine, 27(6), 776-783. 10.1089/jpm.2023.0583

Abstract

Abstract

Background: Home health care is a core benefit of Medicare and Medicaid insurance programs and includes services to improve health, maintain health, or slow health decline. Objective: To examine the relationship between home health care use during the last three years of life and hospice use in the last six months of life among Medicare beneficiaries with and without dementia. Design: Nationally representative retrospective cohort study. Setting/Subjects: Medicare beneficiaries with at least three years of continuous enrollment who died in 2019 in the United States (n = 2,169,422). Measurements: The primary outcome was hospice use, and the secondary outcome was hospice duration. The independent variable was a composite of the presence and timing of home health care initiation during the last three years of life. Results: Home health care was used by 46.4% of Medicare beneficiaries and hospice care was used by 53.1% of beneficiaries, with 28.3% using both. Compared with beneficiaries who did not use home health care, those who started home health care before the last year of life (odds ratio [OR] = 1.57, 95% confidence interval [CI] = 1.56-1.58) or during the last year of life (OR = 1.75, 95% CI = 1.74-1.77) were more likely to use hospice. The effects were stronger in those without a diagnosis of dementia (OR = 1.92, 95% CI = 1.90-1.94) compared with those without a dementia diagnosis (OR = 1.34, 95% CI = 1.32-1.35) who started home health in the final year of life. Conclusions: Receiving home health care in the final years of life is associated with increased hospice use at the end-of-life in Medicare beneficiaries with and without a dementia diagnosis.

Home Health Care and Place of Death in Medicare Beneficiaries With and Without Dementia

Kim, H. (Dawn), Duberstein, P. R., Zafar, A., Wu, B., Lin, H., & Jarrín, O. F. (2024). Gerontologist, 64(11). 10.1093/geront/gnae131

Abstract

Abstract

Background and Objectives: Home health care supports patient goals for aging in place. Our objective was to determine if home health care use in the last 3 years of life reduces the risk of inpatient death without hospice. Research Design and Methods: We analyzed the characteristics of 2,065,300 Medicare beneficiaries who died in 2019 and conducted multi¬nomial logistic regression analyses to evaluate the association between the use and timing of home health care, dementia diagnosis, and place of death. Results: Receiving any home health care in the last 3 years of life was associated with a lower probability of inpatient death without hospice (Pr 23.3% vs 31.5%, p < .001), and this effect was stronger when home health care began prior to versus during the last year of life (Pr 22.5% vs 24.3%, p < .001). Among all decedents, the probability of death at home with hospice compared to inpatient death with hospice was greater when any home health care was used (Pr 46.0% vs 36.5%, p < .001), and this association was strongest among beneficiaries with dementia who started home health care at least 1 year prior to death (Pr 55.6%, p < .001). Discussion and Implications: Use of home health care during the last 3 years of life was associated with reduced rates of inpatient death with¬out hospice, and increased rates of home death with hospice. Increasing affordable access to home health care can positively affect end-of-life care outcomes for older Americans and their family caregivers, especially those with dementia.

Hukou Status and Cognitive Function Among Older Chinese Adults: Does Support from Friends Matter?

Peng, C., Burr, J. A., Wu, B., & Li, M. (2024). Journal of Aging and Health, 36(7), 492-503. 10.1177/08982643231206819

Abstract

Abstract

Objectives: This study examined whether older Chinese adults with different types of hukou status (government household registration system) exhibited different cognitive outcomes and whether receiving support from friends, an under-appreciated resource, helped mitigate the negative impacts of agricultural hukou status on cognitive health disparities. Methods: Using nationally representative data from the China Longitudinal Aging Social Survey, this study tested these relationships with well-validated measures. Results: Our results showed that older Chinese adults with agricultural hukou were more likely to have worse cognitive function than those with non-agricultural hukou. Further, friend support characteristics moderated the association between hukou status and cognitive function, whereby having better friend support was related to a weaker negative effect of agricultural hukou status on cognitive function. Discussion: The findings suggested that agricultural hukou status reflects the effects of accumulated disadvantage across the life course with negative consequences for late-life cognition. The cognitive health disparities between agricultural and non-agricultural residents may be reduced in the context of a higher level of friend support, supporting a stress buffering hypothesis.

Impacts of Acculturation on Depressive Symptoms and Activities of Daily Living of U.S. Older Chinese Immigrants

Jiang, Y., Li, M., Kwon, S., Zhu, Y., Wu, B., & Tang, F. (2024). Gerontologist, 64(11). 10.1093/geront/gnae124

Abstract

Abstract

Background and Objectives: Acculturation is a critical aspect of social experience for immigrants, including Asian immigrants. Existing literature has shown mixed findings on the health impacts of acculturation and largely relied on cross-sectional studies, preventing drawing definitive conclusions. This study aimed to examine the long-term effects of acculturation on depressive symptoms and activities of daily living (ADL) limitations in a large sample of older Chinese immigrants in the United States. Research Design and Methods: Data were drawn from 2,811 older Chinese immigrants from the Population Study of Chinese Elderly in Chicago. Acculturation was assessed at baseline, and questionnaires on depressive symptoms and ADL limitations were completed at 4 assessments. Results: Overall, results showed that acculturation was not associated with depressive symptoms at baseline but was associated with a faster decline in depressive symptoms over time. No associations were found between acculturation and ADL limitations. Stratified analyses showed that the significant relationship between acculturation and a faster decline in depressive symptoms was only evident among female participants. Also, acculturation was associated with a lower risk of reporting ADL limitations at baseline in female participants but a higher risk of reporting ADL limitations in male participants. Discussion and Implications: This study indicates the long-term benefits of acculturation on mental health among older Chinese immigrants in the United States, particularly among females. Initiatives supporting the acculturation process need to consider sex disparities and individual preferences, aiming to foster sustained benefits for healthy aging in this population.

The informal discussion of advance care planning among Chinese older adults: Do education and social media use matter?

Pei, Y., Qi, X., Zhu, Z., Zhang, W., Tsay, R. M., & Wu, B. (2024). Geriatric Nursing, 55, 1-5. 10.1016/j.gerinurse.2023.10.023

Abstract

Abstract

This study aimed to examine and compare the associations between education, social media use, and advance care planning (ACP) discussion among Chinese older adults in mainland China (Wuhan), Taiwan (Taichung), and the United States (Honolulu). Community-dwelling older adults (≥ 55) were recruited from 2017 to 2018. The ACP discussion rate in Wuhan, Taichung, and Honolulu were 15.2 %, 19.2 %, and 31.3 %, respectively. Logistic regression models revealed that education was positively associated with ACP discussion in Taichung and Honolulu. Social media use was positively associated with ACP discussions in Wuhan and Honolulu, and it attenuated the association between education and ACP discussion in Honolulu. The present study contributes to previous studies by comparing the associations between education, social media use, and ACP discussion in different settings within the same ethnicity. Policy and practice implications were also discussed.