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)

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.

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.