Xiang Qi

Faculty

Xiang Qi headshot

Xiang Qi

PhD RN

Assistant Professor

1 212 992 5797

433 First Ave
New York, NY 10010
United States

Xiang Qi, PhD, RN, is an Assistant Professor at NYU Rory Meyers College of Nursing. His research sits at the intersection of gerontology, social epidemiology & psychiatry, and geriatric oral health. He conducts interdisciplinary research focusing on social disparities of healthy aging and longevity that crosscuts a range of areas in social isolation & loneliness, immigration, and neighborhood environment. The goal of Qi’s work is to reduce health disparities in Alzheimer’s disease and related dementia in the US and globally. Qi is an expert in data science and quantitative methodology, including machine learning, multilevel modeling, and causal inference, and has extensive experience working with large-scale data analyses as well as analyzing electronic health records to understand the social determinants of health disparities.

Qi is the Principal Investigator on NIH-funded projects investigating the disparities in cardiometabolic diseases, mental health, and cognitive health across older Asian American ethnic groups. Prior to joining the faculty at NYU Meyers, he served as a Research Scientist on the “NYUCI-ES: Psychosocial Intervention to Improve Health Outcomes for Chinese and Korean ADRD Caregivers project (P50MD017356)” at the Rutgers-NYU Center for Asian Health Promotion and Equity. He also works on NIH-funded projects to elucidate the neurobiological pathways on the associations between poor oral health and dementia.

Among his many honors, Qi has received the Douglas Holmes Emerging Scholar Paper Award, the ESPO Best Poster Award, and the Minority Issues in Gerontology Student Poster Award, from the Gerontological Society of America. He has also been recognized with the 2022-2023 Outstanding PhD Dissertation Award from NYU Meyers. Additionally, Qi has received the FIRE Doctoral Student Research Leadership Award from the New York Academy of Medicine. His work has been featured in numerous media outlets, including U.S. News & World Reports, Yahoo!, Cable News Network (CNN), Science News, PsyPost, Daily Nurse, Dental Tribute, National Institute of Aging, Dentistry Today, and Neuroscience News. Qi’s research on the associations between social isolation, loneliness, and cognitive health has garnered significant attention and recognition.

Qi earned his PhD from New York University. He completed his Bachelor of Science at Fudan University in Shanghai, China, which included an exchange program at the Department of Neurobiology, Physiology & Behavior, University of California, Davis.

PhD, Nursing Research and Theory Development, New York University
Exchange Program, Neurobiology, Physiology & Behavior, University of California, Davis
BS, Fudan University

Gerontology
Oral-systemic health
Immigrants
Mental health
Underserved populations
Community/population health

Alzheimer’s Association International Society
New York Academy of Medicine
Sigma Theta Tau Nursing Honor Society
Gerontological Society of American
Eastern Nursing Research Society

Minority Issues in Gerontology Student Poster Award, Gerontological Society of American (2023)
2022-2023 Outstanding PhD Dissertation Award, NYU Rory Meyers College of Nursing (2023)
The Emerging Scholar and Professional Organization – Carol Schutz Student Travel Award, Gerontological Society of American (2022)
Minority Issues in Gerontology Student Poster Award, Gerontological Society of American (2022)
Douglas Holmes Emerging Scholar Paper Award, Gerontological Society of American (2022)
The Emerging Scholar and Professional Organization – Best Poster Award, Gerontological Society of American (2022)
FIRE Doctoral Student Research Leadership Award, New York Academy of Medicine (2022)
Student Registration Award, Gerontological Society of American (2021)
Excellent Graduate of Shanghai, Shanghai Municipal Education Commission (2019)
Research and Innovation Award, Fudan University, Fudan University, Shanghai, China (2018)
National Undergraduate Scholarship, Ministry of Education of China (2018)National Undergraduate Scholarship, Ministry of Education of China (2018)
Overseas Exchange Outstanding Student Scholarship, Fudan University, China (2017)
The First Prize Scholarship, Fudan University, China (2016)
Excellent Student Leader, Fudan University, China (2015)

Psychological distress in Asian American informal caregivers: an analysis by disaggregated ethnic groups

Qi, X., Wang, K., Pei, Y., Ðoàn, L. N., Yi, S. S., & Wu, B. (2025). Ethnicity and Health, 30(2), 232-253. 10.1080/13557858.2024.2430287
Abstract
Abstract
Background: Despite Asians being the fastest-growing ethnic group in the US, most studies have focused on Asian Americans as an aggregate racial/ethnic group. The burden of mental health problems is increasing among caregivers due to population aging, yet little is known about the distress experienced by Asian caregivers when examined by disaggregated ethnic groups. Methods: Using 2019–2020 California Health Interview Survey data, we examined disparities in psychological well-beings between non-Hispanic White and Asian American adult caregivers, with an emphasis on understudied Asian ethnic groups. Psychological distress was measured using the Kessler 6 scale, with scores ≥6 indicating mental distress and ≥13 indicating serious mental illness. Multivariable logistic regression adjusted for socio-demographics, physical health, caregiving relationship, intensity of care, and care recipients’ characteristics. Results: The study included 8,722 caregivers (mean age, 58.7 years; 61.3% women; 14.1% Asian [379 Chinese, 260 Filipino, 167 Japanese, 138 South Asian, 105 Korean, 101 Vietnamese, 78 other Asian], 85.9% White). Overall, 26.8% had mental distress, and 8.5% had serious mental illness. Compared to White caregivers, Korean American caregivers had higher odds of mental distress (Odds Ratio [OR], 2.37; 95% CI, 1.47–3.82) and serious mental illness (OR, 2.15; 95% CI, 1.17–3.92), while Chinese (OR, 0.72; 95% CI, 0.55–0.95) and Japanese (OR, 0.67; 95% CI, 0.45–0.99) American caregivers had lower odds of mental distress. Korean American caregivers had the highest prevalence of mental distress (43.1%) and serious mental illness (15.3%), compared with White and other Asian American caregivers. Conclusion: Disaggregating data reveals significant mental health disparities among ethnic subgroups of Asian American caregivers. Tailored resources should address the distinct needs of ethnic subgroups of Asian American caregivers, considering language barriers, acculturation, and cultural norms that may exacerbate psychological distress.

Surge of mental health issues of Chinese Americans under both popular and policy-driven racism

Qi, X. (2025, January 1). In The Lancet Regional Health - Americas (Vols. 41). 10.1016/j.lana.2024.100941

Adult day services: a potential antidote to social isolation and loneliness in marginalized older adults

Sadarangani, T., Fernandez Cajavilca, M., Qi, X., & Zagorski, W. (2024). Frontiers in Public Health, 12. 10.3389/fpubh.2024.1427425
Abstract
Abstract
Loneliness and social isolation affect more than 1 in 4 community-dwelling older adults in the United States, who may also require long-term care support. Despite being seen as a solution to the long-term care crisis, most older adults prefer to age in place rather than using skilled nursing facilities. However, in-home care is unsustainable due to a shortage of direct care workers and may exacerbate social isolation by confining older adults to their homes. Adult Day Services (ADS) addresses both issues. ADS provides care to adults with physical, functional, and or cognitive limitations in non-residential, congregate, community-based settings. ADS also provides daily cognitive and physical stimulation, often with medical support, in a social and supported environment, centered around the needs and preferences of participants. Before the COVID-19 pandemic, nearly 5,000 ADS centers were widely available. However, with limited public support, the ADS industry has struggled as demand by the growing number of older adults and families need health and social support. The ADS industry must be recognized for its unique ability to buffer social isolation and loneliness in chronically ill older adults while serving as an effective platform for chronic disease management. This perspective piece highlights the critical role of ADS centers in reducing loneliness and social isolation and promoting healthy equity. We also explore the benefits of ADS, the financial, policy, and societal barriers to utilizing ADS, and the potential solutions to ensure its sustainability and growth.

Age at diagnosis of diabetes, obesity, and the risk of dementia among adult patients with type 2 diabetes

Qi, X., Zhu, Z., Luo, H., Schwartz, M. D., & Wu, B. (2024). PloS One, 19(11). 10.1371/journal.pone.0310964
Abstract
Abstract
Background While Type 2 Diabetes Mellitus (T2DM) prevalence is increasing among younger individuals, few studies have examined how age at T2DM diagnosis relates to dementia risk in diabetic populations. We aimed to investigate the association between age at T2DM diagnosis and subsequent dementia risk, and to determine whether obesity moderates this relationship. Methods We conducted a prospective cohort study using data from the Health and Retirement Study (2002–2016) matched with its 2003 Diabetes Mail-Out Survey. The study included 1,213 dementia-free adults aged ≥50 with diagnosed T2DM. Primary exposures were age at T2DM diagnosis (categorized as <50, 50–59, 60–69, and ≥70 years) and obesity status (BMI ≥30 kg/m2). The outcome was incident dementia, assessed using the Telephone Interview for Cognitive Status. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs), adjusting for sociodemographic factors, health behaviors, health status, and diabetes medication use. Results Over a median follow-up of 10 (interquartile range, 6–14) years, 216 (17.8%) participants developed dementia. Compared to participants diagnosed with T2DM at age ≥70 years, those diagnosed at younger ages had increased dementia risk: HR 1.70 (95% CI, 1.03–2.80) for 60–69 years, 1.72 (95% CI, 1.06–2.79) for 50–59 years, and 1.90 (95% CI, 1.14–3.18) for <50 years. Obesity significantly moderated this relationship, with obese individuals diagnosed with T2DM before age 50 showing the highest dementia risk (HR 3.05; 95% CI 1.23–7.56) compared to non-obese individuals diagnosed at ≥50 years. Conclusions Younger age at diagnosis of T2DM was significantly associated with a higher risk of dementia, particularly among individuals with obesity. Interventions specifically targeting obesity may be more effective in preventing dementia for adults with a younger onset of T2DM.

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.

Denture use and a slower rate of cognitive decline among older adults with partial tooth loss in China: A 10-year prospective cohort study

Qi, X., Zhu, Z., Pei, Y., & Wu, B. (2024). Aging Medicine, 7(6), 781-789. 10.1002/agm2.12383
Abstract
Abstract
Objective: Denture use has been shown to improve nutritional intake and diet quality in people with tooth loss. Despite evidence linking tooth loss and dementia, few studies have examined the association between denture use and cognitive decline. We investigated the relationship between denture use and cognitive decline among Chinese older adults with tooth loss. Methods: We analyzed data from the Chinese Longitudinal Healthy Longevity Survey 2008–2018, including 27,708 community-dwelling dentate and edentulous (i.e., who have lost all natural teeth) older adults aged 65 and older. Cognitive function was assessed using the Mini-Mental State Examination from 2008 to 2018. Linear mixed-effect models were employed to assess the association of denture use with baseline cognitive function and rate of cognitive decline, adjusting for sociodemographic characteristics, health-related behavior, and health status. Subgroup analyses evaluated differences in associations among dentate participants with varying degrees of tooth loss (1–9, 10–19, 20–31). Results: Compared to non-denture users, dentate participants who used dentures had better baseline cognitive function (β, 1.032; 95% CI, 0.813–1.251; p < 0.001) and a slower annual decline in cognitive function (β, 0.127; 95% CI, 0.047–0.206; p < 0.01). For edentulous participants, denture use was associated with higher baseline cognitive function (β, 3.063; 95% CI, 2.703–3.423; p < 0.001) but not with the rate of cognitive decline (β, 0.011; 95% CI, –0.082 to 0.105; p = 0.818). Results remained consistent across subgroups of dentate participants with various degrees of missing teeth. Conclusions: Denture use may help protect against cognitive decline in older adults with partial tooth loss. This study highlights the potential importance of prosthodontic rehabilitation in preserving cognitive health. Further research is needed to establish a causal relationship between denture use and cognitive function.

How do Asian American young adults influence the health of family members? Structural equation modeling of age, acculturation, interactivity, and closeness

Ali, S. H., Nayak, A., Qi, X., Misra, S., & DiClemente, R. J. (2024). Discover Social Science and Health, 4(1). 10.1007/s44155-024-00128-7
Abstract
Abstract
Family members of Asian Americans (AAs) hold enormous potential as health changemakers to help combat the growing non-communicable disease burden in the community. To inform the development of impactful family-based interventions, there is a need to disentangle the mechanisms behind family influences on health. This study aims to deconstruct how interactivity and closeness mediate the association of age and acculturation with how much AA young adults perceive themselves to influence the health behaviors of family members. 502 AA young adults (48.0% East Asian, 20.9% South Asian, 23.1% Southeast Asian) were recruited in March 2021 to participate in an online survey on family interaction patterns, providing data on 944 unique dyadic family relationships. Associations between age, acculturation, interactivity (shared family activities, living proximity, and interaction frequency), closeness (family connectedness and interaction quality), and family health influence (reflecting influence on diet, exercise, sleep, stress, substance use, and relationship building) were evaluated through structural equation modeling. The final model displayed strong fit (CFI:0.956, RMSEA:0.081, SRMR:0.041), and revealed that an increase in closeness compared to interactivity corresponded with a greater increase in family health influence, with both completely mediating the association between age and family health influence. Acculturation was not associated with closeness, and its effect on family health influence was only partially mediated through interactivity. In subgroup analyses, neither interactivity nor closeness mediated the relationship between age and family health influence among South Asians (unlike East and Southeast Asians). Findings suggest the importance of targeting interactivity and closeness separately when developing AA family-based health interventions, and considering how the age and acculturation profile of AA young adults may shape these dynamics.

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.

Maintaining daily living activities in older adults: The impact of a functional exercise program in long-term nursing homes. A single-group pre-post intervention

Mugica-Errazquin, I., Irazusta, J., Kortajarena, M., Elosegi, S., Wu, B., Qi, X., Rodriguez-Larrad, A., & Rezola-Pardo, C. (2024). Geriatric Nursing, 60, 215-224. 10.1016/j.gerinurse.2024.09.003
Abstract
Abstract
Objective: To evaluate the impact of a function-focused multicomponent exercise program on long-term nursing home (LTNH) residents’ ability to maintain activities of daily living (ADL), physical performance, cognitive function, quality of life, and frailty. Methods: This multicenter single-group pre-post quasi-experimental study involved 148 participants from 16 LTNHs in Gipuzkoa, Spain. Participants underwent a twice-weekly, 6-month function-focused multicomponent exercise program and were assessed both before and after the intervention. Results: Following the intervention, participants significantly maintained ADL ability, improved physical performance and quality of life, and reduced frailty (all p < 0.05). Cognitive function showed a positive trend. Subgroup analysis showed consistent improvements across demographics and health variables. Conclusions: The exercise program effectively maintained or improved ability to perform ADL, cognitive function, physical performance, and quality of life while reducing frailty in LTNH residents, irrespective of individual characteristics. This highlights the importance of exercise interventions to preserve overall function and wellbeing in this population.

The mitigating role of social capital on the association between food insecurity and psychological distress among Chinese adults

Qi, X., Pei, Y., Li, G., Liu, Y., Tang, W., Hall, B. J., & Wu, B. (2024). International Journal of Social Psychiatry, 70(8), 1542-1551. 10.1177/00207640241277152
Abstract
Abstract
Background: Food insecurity, a pervasive global issue exacerbated by the COVID-19 pandemic, has been linked to adverse mental health outcomes. However, the role of social capital in mitigating this relationship remains understudied, particularly in the Chinese context. Aims: This study investigated the associations between food insecurity and psychological distress (depressive and anxiety symptoms) and examined the potential moderating effects of bonding and bridging social capital among Chinese adults in Shanghai. Methods: This cross-sectional study included 3,220 Chinese adults (mean age: 34.45; 51.5% male) in Shanghai. Food insecurity was assessed using the modified Household Food Insecurity Access Scale, psychological distress was measured using the Patient Health Questionnaire-9 and the Generalized Anxiety Disorder-7, and social capital was evaluated using the Revised Personal Social Capital Scale. Results: Multivariable linear regression analyses revealed that food insecurity was significantly positively associated with both depressive (β = 0.449, SE = 0.024) and anxiety symptoms (β = 0.391, SE = 0.022), after adjusting for sociodemographic characteristics, health status, and COVID-19-related factors. Higher levels of bonding and bridging social capital were significantly associated with fewer depressive and anxiety symptoms. Significant interactions (p <.001) between bonding social capital and food insecurity indicated that the associations between food insecurity and psychological distress were less pronounced among adults with higher bonding social capital. Conclusions: These findings highlight the critical role of food insecurity as a risk factor for psychological distress and the importance of bonding social capital in mitigating its impact on mental health. Policies and interventions targeting food insecurity prevention and bonding social capital enhancement may promote better mental health outcomes among Chinese adults.