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)

Dose-Response Meta-Analysis on Tooth Loss With the Risk of Cognitive Impairment and Dementia

Qi, X., Zhu, Z., Plassman, B. L., & Wu, B. (2021). Journal of the American Medical Directors Association, 22(10), 2039-2045. 10.1016/j.jamda.2021.05.009
Abstract
Abstract
Objectives: To quantify the dose-response associations between tooth loss and risk of cognitive impairment and dementia. Design: Longitudinal studies that examined the association between tooth loss and cognitive function were systematically searched on 6 databases through March 1, 2020. The study adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines. Risk estimates were pooled using random-effects models. The dose-response associations were assessed using generalized least squares spline models. Setting and Participants: Adults from community, institution, outpatient or in-hospital were included in the meta-analysis. Measures: Cognitive impairment and dementia were defined by neuropsychological tests, diagnostic criteria, or medical records. Tooth loss was self-reported or assessed by clinical examinations. Results: Fourteen studies were entered into the meta-analysis, including 34,074 participants and 4689 cases with diminished cognitive function. Participants with more tooth loss had a 1.48 times higher risk of developing cognitive impairment [95% confidence interval (CI) 1.18–1.87] and 1.28 times higher risk of being diagnosed with dementia (95% CI 1.09–1.49); however, the association was nonsignificant for participants using dentures (relative risk = 1.10, 95% CI 0.90–1.11). Eight studies were included in the dose-response analysis, and data supported the use of linear models. Each additional tooth loss was associated with a 0.014 increased relative risk of cognitive impairment and 0.011 elevated relative risks of dementia. Edentulous participants faced a 1.54 times higher risk of cognitive impairment and a 1.40 times higher risk of being diagnosed with dementia. Conclusions and Implications: Moderate-quality evidence suggested tooth loss was independently associated with cognitive impairment and dementia; risk of diminished cognitive function increased with incremental numbers of teeth lost. Furthermore, timely prosthodontic treatment with dentures may reduce the progression of cognitive decline related to tooth loss.

Effects of a symptom management intervention based on group sessions combined with a mobile health application for persons living with HIV in China: A randomized controlled trial

Han, S., Pei, Y., Zhao, R., Hu, Y., Zhang, L., Qi, X., Zhu, Z., Sun, W., & Wu, B. (2021). International Journal of Nursing Sciences, 8(4), 370-379. 10.1016/j.ijnss.2021.07.002
Abstract
Abstract
Objective: This study aims to evaluate the effects of a symptom management intervention (SMI) based on symptom management group sessions combined with a mobile health (mHealth) application (app) on the knowledge of symptom management, the certainty of symptom self-management, symptom severity, symptom distress, medication adherence, social support, and quality of life among persons living with HIV (PLWH) in China. Methods: A parallel randomized controlled trial with 61 PLWH was conducted in Shanghai, China. The participants in the control group (n = 30) downloaded the Symptom Management (SM) app according to their needs and preferences, and received routine follow-ups. The participants in the intervention group (n = 31) were guided to download and use the SM app, and received four tailored weekly group sessions at routine follow-ups. Each group session lasted for approximately 2 h and targeted one of the major modules of the SM app. All the outcomes were assessed at baseline and post-intervention. The study was registered with the Chinese Clinical Trial Registry (ChiCTR1900024821). Results: The symptom management knowledge and certainty of symptom self-management were significantly improved after the intervention (all P < 0.01). Compared with the control group, the scores of symptoms reasons knowledge score improved 11.47 points (95% CI: 3.41, 19.53) and scores of symptoms self-management knowledge score improved 12.80 points (95% CI: 4.55, 21.05) in the intervention group after controlling for covariates. However, other outcomes did not show statistically significant differences between the intervention group and the control group (P > 0.05). Conclusion: The SMI could improve PLWH's symptom management knowledge and certainty of symptom self-management. Multi-center studies with larger sample sizes and longer follow-ups are needed to further understand the effects of SM app on ameliorating symptom severity and symptom distress. More innovative strategies are also needed to promote and maintain the sustainability of the SM app.

Effects of the Co-occurrence of Diabetes Mellitus and Tooth Loss on Cognitive Function

Luo, H., Tan, C., Adhikari, S., Plassman, B. L., Kamer, A. R., Sloan, F. A., Schwartz, M. D., Qi, X., & Wu, B. (2021). Current Alzheimer Research, 18(13), 1023-1031. 10.2174/1567205019666211223093057
Abstract
Abstract
Objective: Both diabetes mellitus (DM) and poor oral health are common chronic conditions and risk factors of Alzheimer’s disease and related dementia among older adults. This study assessed the effects of DM and complete tooth loss (TL) on cognitive function, accounting for their interactions. Methods: Longitudinal data were obtained from the 2006, 2012, and 2018 waves of the Health and Retirement Study. This cohort study included 7,805 respondents aged 65 years or older with 18,331 person-year observations. DM and complete TL were self-reported. Cognitive function was measured by the Telephone Interview for Cognitive Status. Random-effect regressions were used to test the associations, overall and stratified by sex. Results: Compared with older adults without neither DM nor complete TL, those with both conditions (b =-1.35, 95% confidence interval [CI]:-1.68,-1.02), with complete TL alone (b =-0.67, 95% CI:-0.88,-0.45), or with DM alone (b =-0.40, 95% CI:-0.59,-0.22), had lower cognitive scores. The impact of having both conditions was significantly greater than that of having DM alone (p < .001) or complete TL alone (p = 0.001). Sex-stratified analyses showed the effects were similar in males and females, except having DM alone was not significant in males. Conclusion: The co-occurrence of DM and complete TL poses an additive risk for cognition. Healthcare and family-care providers should pay attention to the cognitive health of patients with both DM and complete TL. Continued efforts are needed to improve older adults’ access to dental care, especially for individuals with DM.

Immigration and Oral Health in Older Adults: An Integrative Approach

Wu, B., Mao, W., Qi, X., & Pei, Y. (2021). Journal of Dental Research, 100(7), 686-692. 10.1177/0022034521990649
Abstract
Abstract
The aim of this study was to develop an integrative framework on aging, immigration, and oral health. The methodology was a critical review that used immigration as a social determinant framework through which to evaluate its impact on the oral health of older immigrants. We reviewed recent empirical evidence on factors related to oral health in older immigrants. In a systematic search across multiple databases, we identified 12 eligible studies in this review. Among the eligible studies, most were conducted among East Asian immigrants (8 articles), followed by non-Hispanic White/European origin (2 articles), Mexican origins (1 article), and Iran and other Middle East regions (1 article). The research revealed knowledge gaps in the evidence base, including the dynamic relationship between acculturation and oral health, the role of environmental factors on oral health for immigrants, psychosocial stressors and their relationship with oral health, and oral health literacy, norms, and attitude to dental care utilization and oral hygiene practices. The development of the integrative framework suggests the pathways/mechanisms through which immigration exerts influences on oral health in later life. This provides opportunities for researchers, practitioners, and policy makers to gain greater insights into the complex associations between immigration and oral health among older adults.

Perceived discrimination and mental health symptoms among persons living with HIV in China: the mediating role of social isolation and loneliness

Han, S., Hu, Y., Wang, L., Pei, Y., Zhu, Z., Qi, X., & Wu, B. (2021). AIDS Care - Psychological and Socio-Medical Aspects of AIDS HIV, 33(5), 575-584. 10.1080/09540121.2020.1847246
Abstract
Abstract
Perceived discrimination is significantly associated with mental health symptoms among persons living with HIV (PLWH). However, little is known about the factors mediating this relationship. We aimed to examine the mediating role of social isolation and loneliness in the association between perceived discrimination and mental health symptoms among PLWH. A multicenter (Shanghai, Kunming, Nanning, Hengyang, and Changning in China) cross-sectional study was conducted in 2017. Data from 883 PLWH were used for statistical analysis. Perceived discrimination, mental health symptoms, loneliness and social isolation were assessed through self-report questionnaires. Structural equation modeling (SEM) showed a satisfactory model fit (CMIN/DF = 2.676, GFI = 0.998, CFI = 0.997, NFI = 0.995, TLI = 0.985, RMSEA = 0.044 [0.000, 0.090]) and a significant total indirect effect (β = 0.058, SE = 0.009, Z = 6.444, p < 0.01). Both loneliness (β = 0.042, SE = 0.008, Z = −5.250, p < 0.01) and social isolation (β = 0.016, SE = 0.004, Z = −4.000, p < 0.01) were determined to be significant mediators of the association between perceived discrimination and mental health symptoms. Interventions that combat loneliness and social isolation may help ameliorate the adverse consequences of perceived discrimination on mental health.

Perceived Discrimination and Symptoms of Cognitive Dysfuntion among Middle-Age and Older Persons Living with HIV in China: A Multicenter Cross-Sectional Study of the Mediating Role of Mental Health Symptoms and Social Isolation

Han, S., Hu, Y., Wang, L., Pei, Y., Zhu, Z., Qi, X., & Wu, B. (2021). Journal of the Association of Nurses in AIDS Care, 32(4), 442-452. 10.1097/JNC.0000000000000264
Abstract
Abstract
Perceived discrimination is associated with symptoms of cognitive dysfunction (SOCD) among middle-age and older persons living with HIV (PLWH). We aimed to explore how the association between perceived discrimination and SOCD was mediated by mental health symptoms and social isolation. The sample included 321 PLWH, ages 45 years and older, for a multicenter cross-sectional study. Structural equation modeling showed an acceptable model fit and a significant total indirect effect between perceived discrimination and SOCD. All three indirect effect pathways were significant, suggesting that perceived discrimination could influence SOCD through mental health symptoms, through social isolation, or through mental health symptoms and then social isolation. Our study demonstrates that perceived discrimination is a concern for the management of cognitive function among middle-age and older PLWH. Both mental health symptoms and social isolation are critical elements in the design and evaluation of interventions for promoting cognitive health.

Sleep satisfaction and cognitive complaints in Chinese middle-aged and older persons living with HIV: the mediating role of anxiety and fatigue

Han, S., Hu, Y., Pei, Y., Zhu, Z., Qi, X., & Wu, B. (2021). AIDS Care - Psychological and Socio-Medical Aspects of AIDS HIV, 33(7), 929-937. 10.1080/09540121.2020.1844861
Abstract
Abstract
Middle-aged and older persons living with HIV (PLWH) suffer from sleep distress and cognitive disorders due to HIV infection and aging. We aim to explore the relationship between sleep satisfaction and cognitive complaints, and the mediating role of anxiety and fatigue in this relationship among middle-aged and older PLWH. We used data from a multicenter cross-sectional study in China (Shanghai, Kunming, Nanning, Hengyang, and Changning) conducted in 2017. The data analysis included 435 PLWH aged 45 years and over. Multiple linear regression models showed that worse sleep satisfaction was significantly associated with lower cognitive complaints after controlling for anxiety, fatigue, demographic variables, and clinical variables (β = −0.246, p < 0.01). Both anxiety and fatigue were significant partial mediators in the relationship between sleep satisfaction and cognitive complaints. The serial multiple mediation models of sleep satisfaction–anxiety (M1)–fatigue (M2)–cognitive complaints were supported and the alternative model of sleep satisfaction–fatigue (M2)–anxiety (M1)–cognitive complaints were both supported. Our study indicates that it is important to improve sleep quality to promote cognitive function among Chinese middle-aged and older PLWH. Prevention and treatment programs for sleep satisfaction and cognitive function should include the assessment and reduction of fatigue and anxiety.

Urban-Rural Disparities in Dental Services Utilization Among Adults in China’s Megacities

Qi, X., Qu, X., & Wu, B. (2021). Frontiers in Oral Health, 2. 10.3389/froh.2021.673296
Abstract
Abstract
Objective: China’s dental care system is bifurcated between urban and rural areas. However, very few studies have examined the dental services utilization inequities in China’smegacities, particularly in these urban and rural areas. This study aims to examine the urban-rural disparities in dental services utilization among adults living in China’s megacities based on the Andersen dental services utilization model. Methods: This study used data from 4,049 residents aged 18–65 who participated in the “2019 New Era and Living Conditions in Megacities Survey.” Multivariate logistic regressions were employed to examine the associations between place of residence and dental services utilization for individuals from ten megacities in China. Predisposing variables (age, gender, marital status, living arrangement, and education), enabling variables (socioeconomic status, occupational status, income, insurance coverage, health attitude, and health behavior), and need variables (self-rated health, oral health status, gum bleeding) were controlled for. Results: The mean age of the 4,049 adults was 45.2 (standard deviation = 13.0), and 30.4% (n = 1,232) had no dental visits at all. Adults who resided in urban areas were more likely to use dental services [odds ratio (OR) = 1.57, 95% confidence interval (CI) = 1.30 to 1.91] than those residing in rural areas after controlling for key covariates. Factors associated with higher odds of visiting dentists include having a higher income (OR = 1.44, P < 0.001), higher education level (OR = 1.53, P = 0.042), being covered by insurance for urban residents/employees (OR = 1.49, P = 0.031), having a positive attitude toward healthy diets (OR = 1.43, P < 0.001), attending regular physical examination (OR = 1.66, P < 0.001), having more tooth loss (OR = 1.05, P < 0.001), and having frequent gum bleeding (OR = 2.29, P < 0.001). Conclusion: The findings confirm that place of residence is associated with dental services utilization while adjusting for key covariates. Despite rapid economic development in China, many adults had never visited dentists at all. More efforts should be taken to encourage widespread dental care, such as providing more dental coverage and better access to dental care services.

Disparities in dental service utilization among adults in chinese megacities: Do health insurance and city of residence matter?

Qu, X., Qi, X., & Wu, B. (2020). International Journal of Environmental Research and Public Health, 17(18), 1-13. 10.3390/ijerph17186851
Abstract
Abstract
The aims of the study were to present the prevalence of dental service utilization among adults (age between 18 and 65) in Chinese megacities and to examine the associations of health insurance and city of residence with dental visits. This study was a cross-sectional analysis of the 2019 New Era and Living Conditions in Megacities Survey data with a sample of 4835 participants aged 18–65 from 10 different megacities in China. The data including gross domestic product (GDP) per capita of each megacity obtained from the National Bureau of Statistics of China as a city-level characteristic. After adjusting sampling weights, approximately 24.28% of the participants had at least one dental visit per year. Findings from multilevel mixed-effects linear models showed that participants residing in megacities with higher GDP per capita (β = 0.07, p < 0.001) who had Urban Employee Basic Medical Insurance (β = 0.25, p < 0.001) or Urban Resident Basic Medical Insurance (β = 0.19, p < 0.01) had more frequent dental visits after adjusting demographic characteristics, socioeconomic status, health status, health behavior and attitude, and oral health indicators. Margins post-estimation model results demonstrated disparities in the predicted probability of having never visited a dentist by types of health insurance and city of residence. In conclusion, the prevalence of dental visits in China was found to be low. This study highlights socioeconomic inequalities in dental service utilization. There is a great need to develop more dental care programs and services and expand health insurance to cover dental care in China.