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)

Social isolation, loneliness and accelerated tooth loss among Chinese older adults: A longitudinal study

Qi, X., Pei, Y., Wang, K., Han, S., & Wu, B. (2023). Community Dentistry and Oral Epidemiology, 51(2), 201-210. 10.1111/cdoe.12727
Abstract
Abstract
Objective: Social isolation and loneliness have been linked to numerous determinants of health and well-being. However, the effects of social isolation and loneliness on oral health remain unclear. The purpose of this study was to examine the effects of social isolation and loneliness on the number of remaining teeth and the rate of tooth loss over time among Chinese older adults. Methods: We used three waves of data (2011/2012, 2014 and 2018) from the Chinese Longitudinal Healthy Longevity Survey with 4268 older adults aged 65 and older who were interviewed in at least two waves. The number of remaining teeth was first evaluated at baseline and then subsequently at follow-up visits. Mixed-effects Poisson regression was used to examine the associations between social isolation, loneliness, and both the number of remaining teeth and the rate of tooth loss. Results: Social isolation was associated with fewer remaining teeth (β = −.06, 95% CI = −0.13 to 0.00, p <.05) and accelerated tooth loss (β = −.02, 95% CI = −0.02 to −0.01, p <.01) after adjusting for sociodemographic covariates, lifestyle and oral hygiene behaviours, physical and cognitive health, and loneliness. Loneliness was neither associated with the number of remaining teeth (β =.15, 95% CI = −0.01 to 0.30, p =.06) nor with the rate of tooth loss (β = −.01, 95% CI = −0.02 to 0.00, p =.16) after adjusting for all other factors. Conclusions: This study provides strong evidence that social isolation was associated with fewer remaining teeth and accelerated tooth loss among Chinese older adults. These findings expand our knowledge about the impact of social disconnection on tooth loss. More future studies are needed to further examine the associations between social connections and oral conditions using longitudinal cohort studies and intervention studies.

Social Isolation, Sleep Disturbance, and Cognitive Functioning (HRS): A Longitudinal Mediation Study

Qi, X., Pei, Y., Malone, S. K., & Wu, B. (2023). Journals of Gerontology - Series A Biological Sciences and Medical Sciences, 78(10), 1826-1833. 10.1093/gerona/glad004
Abstract
Abstract
Background: Social isolation is prevalent and associated with dementia, yet the directionality and mechanisms are less understood. This study examined the association between social isolation and cognitive functioning and explored the mediating role of sleep disturbance on the social isolation–cognition relationship. Methods: Data from 5 753 dementia-free Americans aged ≥50 of 2006 (T1), 2010 (T2), and 2014 (T3) waves of the Health and Retirement Study. Social isolation was measured by the Steptoe Social Isolation Index. Cognitive functioning was measured by the Telephone Interview of Cognitive Status. Sleep disturbance was measured with the modified Jenkins Sleep Scale. We used cross-lagged panel models to determine the associations between social isolation, sleep disturbance, and cognitive functioning. Results: Social isolation is significantly associated with subsequent cognitive functioning (T1 to T2: β = −0.055, standard error [SE] = 0.014, p < .001; T2 to T3: β = −0.044, SE = 0.016, p < .001). Lower cognitive functioning is significantly associated with greater subsequent social isolation (T1 to T2: β = −0.101, SE = 0.020, p < .001; T2 to T3: β = −0.058, SE = .011, p < .001). Sleep disturbance at T2 partially mediated the effect of social isolation (T1) on cognitive functioning (T3), accounting for 6.2% of the total effect (β = −0.003, SE = 0.001, p < .01). Conclusions: Social isolation may deteriorate cognitive functioning and vice versa. The association between social isolation and cognition is partially explained by sleep disturbance.

Socioeconomic Status Disparities in Cognitive and Physical Functional Impairment among Older Adults: Comparison of Asians with other Major Racial/Ethnic Groups

Wang, K., Zhu, Z., & Qi, X. (2023). Journal of Urban Health, 100(4), 839-851. 10.1007/s11524-023-00768-1
Abstract
Abstract
This study investigated to what extent socioeconomic status (SES) disparity associates with cognitive and physical impairment within older Asian Americans in comparison with other races/ethnicities. Data were from the National Health and Nutrition Examination Survey 2011–2018 that included 3,297 White, 1,755 Black, 1,708 Hispanic, and 730 Asian Americans aged ≥ 60. Physical functioning was measured by activities of daily living (ADL) or instrumental activities of daily living (IADL). Memory and language fluency were evaluated using the Alzheimer's Disease Word List Memory Task and Animal Fluency Tests, respectively. Multivariate logistic regressions were conducted to investigate the association between SES and physical and cognitive impairment within racial/ethnic groups, and seemingly unrelated regressions compared coefficients across subgroups. Asians with ≤ high school education had the highest prevalence of age- and sex-adjusted memory impairment among all races/ethnicities, while no difference was observed for those with > high school education. ADL/IADL disability odds did not differ between Asians and Whites, but Asians were more likely to exhibit impaired verbal fluency. Education disparity for ADL disability (OR, 3.40; 95% CI, 2.20–5.25) and memory impairment (OR, 11.57; 95% CI, 6.59–20.31) were largest among Asians compared to Whites, Blacks, and Hispanics. Income disparity for function impairment showed no significant difference across racial/ethnic groups (all P > 0.05). Asians experienced the highest burden of physical functioning and memory impairment due to education disparity. Efforts should focus on strengthening research infrastructure and creating targeted programs and services to improve cognitive and physical health for racially/ethnically underrepresented older adults with lower education attainment.

Technology-Based Interventions to Address Social Isolation and Loneliness Among Informal Dementia Caregivers: A Scoping Review

Mao, W., Qi, X., Chi, I., Wichinsky, L., & Wu, B. (2023). Journal of the American Medical Directors Association, 24(11), 1700-1707. 10.1016/j.jamda.2023.08.005
Abstract
Abstract
Objective: Social isolation and loneliness are major public health concerns. Informal dementia caregivers are particularly vulnerable, as many are older adults themselves and at elevated risk of adverse mental and physical health outcomes. Technology-based interventions could offer accessible, affordable, and convenient solutions. A previous review included Internet-based supportive interventions for informal dementia caregivers published up to 2013; however, new publications, technological advances, and targeted outcomes justify conducting this scoping review. Here, we identified and synthesized recent technology-based interventions that addressed social isolation and loneliness among informal dementia caregivers. Design: Scoping review. Setting and Participants: Informal dementia caregivers in the community. Methods: Following Arksey and O'Malley's scoping review framework, we conducted a systematic search of peer-reviewed studies across 6 databases within the last 11 years, including identifying research questions, selecting relevant studies, charting data, and summarizing results. Results: From the 2937 articles identified, 10 eligible studies were included in this review. The intervention type, format, and duration varied widely. Three categories of interventions to address social isolation and loneliness among informal dementia caregivers included technology-assisted peer support, newly developed Web-based multicomponent psychoeducational programs and platforms, and virtual adaptation and modification of existing programs. Predominantly qualitative evidence suggests that technology-based interventions have the potential to reduce feelings of loneliness and improve caregiver well-being. Quantitative evidence tends to be preliminary and inconclusive. Conclusions and Implications: The findings offer preliminary evidence for technology-based interventions to reduce or prevent social isolation and loneliness in informal dementia caregivers. Technology-based interventions addressing social isolation and loneliness in informal dementia caregivers have the potential to overcome barriers to low uptake of services and withdrawal from interventions and improve the sustainability of the interventions. In the long run, by reducing or preventing social isolation and loneliness in informal dementia caregivers, the transition from home care to facility-based care might be delayed.

Chinese American Caregivers’ Attitudes Toward Tube Feeding for Persons with Dementia — USA, 2021–2022

Pei, Y., Qi, X., Cong, Z., & Wu, B. (2022). China CDC Weekly, 4(47), 1051-1054. 10.46234/ccdcw2022.211
Abstract
Abstract
What is already known about this topic? Little is known about Chinese American dementia caregivers’ attitudes toward tube feeding. What is added by this report? To address this knowledge gap, the paper seeks to characterize participants’ attitudes toward tube feeding based on a survey conducted among Chinese American dementia caregivers. What are the implications for public health practice? It is crucial to develop culturally tailored interventions to promote knowledge on tube feeding and advance care planning engagement in Chinese American communities.

Decision Aid Interventions for Family Caregivers of Persons With Advanced Dementia in Decision-Making About Feeding Options: A Scoping Review

Pei, Y., Qi, X., Schulman-Green, D., Hu, M., Wang, K., & Wu, B. (2022). Journal of the American Medical Directors Association, 23(12), 1927.e1-1927.e6. 10.1016/j.jamda.2022.08.014
Abstract
Abstract
Objectives: We provided an overview of the literature on decision aid interventions for family caregivers of older adults with advanced dementia regarding decision making about tube feeding. We synthesized (1) the use of theory during the development, implementation, and evaluation of decision aids; (2) the development, content, and delivery of decision aid interventions; (3) caregivers’ experience with decision aid interventions; and (4) the effect of decision aid interventions on caregivers’ quality of decision-making about feeding options. Design: Scoping review. Methods: We conducted a scoping review of peer-reviewed studies published January 1, 2000–June 30, 2022, in MEDLINE, EMBASE, The Cochrane Library, CINAHL, and Web of Science databases. The process was guided by Arksey and O'Malley's methodological framework, which includes identifying the research question, choosing related studies, charting the data, and summarizing results. Empirical articles concerning the decision aid interventions about feeding options were selected. Results: Six publications reporting 4 unique decision aid interventions were included. All the interventions targeted caregivers of older adults with advanced dementia. Three decision aids were culturally adapted from existing decision aids. The Ottawa Decision Support Framework and the International Patient Decision Aid Standards Framework were used in these 6 publications. Interventions aimed to improve decision making regarding tube feeding for caregivers through static delivery methods. Caregivers rated these decision aids as helpful and acceptable. Decisional conflict and knowledge of feeding options were the most common outcomes evaluated. Reduction in decisional conflict and increase in knowledge were consistently found among dementia caregivers, but no intervention effects were found on preferences for the use of tube feeding. Conclusions and Implications: Decision aid interventions effectively improve decision-making regarding tube feeding among the target population. Cultural adaptation of an existing decision aid intervention is the main strategy. However, the lack of guidance of a cultural adaptation framework in this process may lead to difficulties explaining caregivers’ behavioral changes. Moreover, merely providing information is not enough to change caregivers’ preferences or behavior of use of tube feeding. A systematic approach to cultural adaptation and interactive intervention is needed in future studies.

Oral Health, Diabetes, and Inflammation: Effects of Oral Hygiene Behaviour

Luo, H., Wu, B., Kamer, A. R., Adhikari, S., Sloan, F., Plassman, B. L., Tan, C., Qi, X., & Schwartz, M. D. (2022). International Dental Journal, 72(4), 484-490. 10.1016/j.identj.2021.10.001
Abstract
Abstract
Introduction: The aim of this research was to assess the association between inflammation and oral health and diabetes, as well as the mediating role of oral hygiene practice in this association. Methods: Data were from the 2009–2010 National Health and Nutrition Examination Survey. The analytical sample consisted of 2,191 respondents aged 50 and older. Poor oral health was clinically defined by significant tooth loss (STL) and periodontal disease (PD). Diabetes mellitus (DM) was determined by glycemic levels. The outcome variable was serum C-reactive protein (CRP) level, dichotomised as ≥1 mg/dL (elevated CRP) vs <1 mg/dL (not elevated CRP). Two path models, one using STL and DM as the independent variable, the other using PD and DM as the independent variable, were estimated to assess the direct effects of having poor oral health and DM on elevated CRP and the mediating effects of dental flossing. Results: In path model 1, individuals having both STL and DM (adjusted odds ratio [AOR], 1.92; 95% confidence interval [CI], 1.30–2.82) or having STL alone (AOR, 2.30; 95% CI, 1.68–3.15) were more likely to have elevated CRP than those with neither STL nor DM; dental flossing (AOR, 0.92, 95% CI, 0.88–0.96) was associated with lower risk of elevated CRP. In path model 2, no significant association was found between having both PD and DM and elevated CRP; dental flossing (AOR, 0.91; 95% CI:, 0.86–0.94) was associated with lower risk of elevated CRP. Conclusions: Findings from this study highlight the importance of improving oral health and oral hygiene practice to mitigate inflammation. Further research is needed to assess the longer-term effects of reducing inflammation.

Orofacial pain among Chinese older adults in the last year of life

Pei, Y., Qi, X., Chen, X., & Wu, B. (2022). Gerodontology, 39(4), 384-390. 10.1111/ger.12608
Abstract
Abstract
Objective: To examine the prevalence of orofacial pain and associated factors in Chinese older adults at the end of life. Methods: This cross-sectional study included 1646 participants (65 years or older) in their last year of life from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). We used the 6-month prevalence questions to measure two specific orofacial pain symptoms: toothache, and jaw or facial pain. Logistic regression analyses were used to examine factors, such as socioeconomic status, health behaviours and chronic diseases, that were associated with these two orofacial pain symptoms in the last year of life. Results: The 6-month prevalence estimates for toothache and jaw pain or facial pain for older adults in the last year of life were 14.1% and 4.5% respectively. Higher socioeconomic status was associated with lower odds of toothache and jaw pain or facial pain. Smoking was associated with high odds of toothache. Participants who brushed their teeth at least once a day were more likely to have toothache and jaw or facial pain than those who did not. Having any chronic conditions was associated with higher odds of toothache and jaw or facial pain. Older adults who had at least one tooth were more likely to have jaw or facial pain than those without any teeth. Conclusion: A considerable proportion of Chinese older adults in their last year of life reported toothache and/or jaw pain or facial pain. These findings suggest that appropriate measures need to be taken to address the oral health needs in these vulnerable individuals, especially those of low socioeconomic status and chronic conditions.

Social isolation and psychological well-being among older Chinese Americans: Does resilience mediate the association?

Qi, X., Zhang, W., Wang, K., Pei, Y., & Wu, B. (2022). International Journal of Geriatric Psychiatry, 37(8). 10.1002/gps.5791
Abstract
Abstract
Objectives: Social isolation imposes risks to an individual's psychological well-being. However, few studies have examined the role of resilience on these associations among older Chinese Americans, the fastest-growing aging population across all racial/ethnic groups in the United States. We aim to examine the associations of social isolation with indicators of psychological well-being and the mediating role of resilience in these associations. Methods: Data were derived from 398 Chinese older adults aged over 55 residing in Honolulu, Hawaii, in 2018. Psychological well-being was measured by psychological distress, life satisfaction, and happiness. Multivariate linear regressions and ordered logistic regressions were conducted. Results: Social isolation was positively associated with psychological distress and negatively associated with life satisfaction and happiness (all p < 0.05). By contrast, resilience was associated with lower levels of psychological distress and higher levels of life satisfaction and happiness (all p < 0.05). Moreover, the findings supported our hypothesis that resilience mediated the association between social isolation and psychological well-being. With regard to social isolation, resilience contributed to 32.0% of its association with distress, 24.9% of the association with life satisfaction, and 16.3% of the association with happiness. Conclusion: Our findings revealed a significant association between social isolation and psychological well-being and the mediating role of resilience in the association of older Chinese Americans in Hawaii. The study findings expand our understanding of psychological resources in older Chinese Americans and emphasize the importance of developing intervention programs to foster social connection and resilience among an understudied population.

The development of a personalized symptom management mobile health application for persons living with hiv in China

Han, S., Pei, Y., Wang, L., Hu, Y., Qi, X., Zhao, R., Zhang, L., Sun, W., Zhu, Z., & Wu, B. (2021). Journal of Personalized Medicine, 11(5). 10.3390/jpm11050346
Abstract
Abstract
Persons living with HIV (PLWH) continuously experience symptom burdens. Their symptom prevalence and severity are also quite different. Mobile health (mHealth) applications (apps) offer exceptional opportunities for using personalized interventions when and where PLWH are needed. This study aimed to demonstrate the development process of the symptom management (SM) app and the structure and content of it. Our research team systematically searched for evidence-based resources and summarized up-to-date evidence for symptom management and health education. Our multidisciplinary research team that included physicians, nurses, software engineers, and nursing professors, evaluated the structure and content of the drafted app. Both quantitative data and qualitative results were collected at a group discussion meeting. Quantitative data were scores of sufficient evidence, situational suitability, practicability, cost-effectiveness, and understandability (ranged from one to four) for 119 items of the app contents, including the health tracking module, the self-assessment module, coping strategies for 18 symptoms (80 items), medication management, complementary therapy, diet management, exercise, relaxation techniques, and the obtaining support module. The SM app was comprised of eight modules and provided several personalized symptom management functions, including assessing symptoms and receiving different symptom management strategies, tracking health indicators, and communicating with medical staff. The SM app was a promising and flexible tool for HIV symptom management. It provided PLWH with personalized symptom management strategies and facilitated the case management for medical staff. Future studies are needed to further test the app’s usability among PLWH users and its effects on symptom management.