Bei Wu

New York University | NYU · Rory Meyers College of Nursing

Using survey data collected from January to September 2018 (N = 430), this study examined how neighborhood physical conditions and social cohesion were associated with psychological well-being via pathway of self-management abilities among Chinese older adults living in Honolulu, Hawai’i. Results showed that, for the whole sample, neighborhood phy...

Objectives: This study investigated whether older adults with better relationships with their adult children have better subjective and objective sleep quality than older adults with less positive relationships with their children. We also examined whether depressive symptoms and loneliness mediated the association between parent-child relationship...

The role of health behaviors in oral health conditions in individuals of extremely old age remains understudied. This study included 185 participants aged 100 years or older from the Nan-jing Centenarians Study (NCS) to examine the associations between health behaviors and oral health and investigate the potential moderating role of education and l...

Persons with Alzheimer's disease and related dementias (ADRD) have complex care and social needs that are managed primarily by informal caregivers. Asian and Hispanic American caregivers of ADRD share disproportionately high caregiving burden and stress. Developing and implementing culturally and linguistically tailored interventions are particular...

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...

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,...

Objectives The objectives of this study were to explore and visualize the relationships among multiple symptoms in people living with HIV (PLWH) and compare centrality indices and the density of symptom networks among groups of individuals with different HIV-positive durations. Methods We conducted a secondary analysis of data from the HIV-related...

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's megacities, 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...

Objectives To explore the compliance of end-of-life (EOL) care preferences, and the facilitators and barriers of promoting quality of EOL care among older adults. Design A scoping review was used to identify key themes in the compliance of EOL care preferences among older adults. Setting and Participants Studies published between 2009 and 2020 we...

Massive rural-to-urban migration in China has a significant impact on informal caregiving arrangements among Chinese older adults. To stimulate research on the intersection of migration and caregiving, we conducted an inventory of longitudinal aging survey datasets from mainland China. Large publicly available datasets that included measures relate...

This study aims to explore and visualize relationships among multiple psychological symptoms among people living with HIV (PLWH) with different HIV-positive durations and to compare centrality indices and densities of psychological symptom networks. We used subsets of data collected from five designated HIV/AIDS hospitals in China. Networks were co...

Engaging in leisure activities that are cognitively simulating and enjoyable may be protective against cognitive decline in older adults; yet, few studies have examined this topic. We used two waves of data from the Population Study of Chinese Elderly and ran mixed-effects regression models to examine the relationship between baseline art activity...

Objectives: Acculturation to the mainstream culture and the settlement contexts could shape cognitive function of older immigrants. Guided by ecological theory, this study examines the interaction effect between individual acculturation and ecology of family on cognitive function among older Chinese Americans. Methods: Data were derived from the Po...

Objectives To investigate the relationship between acculturation and subsequent oral health problems in older Chinese Americans and to further test the moderating role of neighborhood disorder in such a relationship. Methods The working sample included 2,706 foreign-born community-dwelling older Chinese Americans aged 60 years or older who partici...

Preventing the spread of COVID-19 in long-term care homes is critical for the health of residents who live in these institutions. As a result, broad policies restricting visits to these facilities were put in place internationally. While well meaning, these policies have exacerbated the ongoing social isolation crisis present in long-term care home...

This article aims to examine the disparities in dental service utilization among 3 age groups: younger adults (20–49 y), middle-aged adults (50–64 y), and older adults (65+ y), among Whites, Hispanics, Blacks, Asians, American Indians or Alaska Natives (AIAN), and Native Hawaiian or other Pacific Islanders (NHOPI). Methods: Weighted logistic regres...

Globally, staff, administrators, and community members have devised innovative strategies to maintain quality of life for residents while reducing spread of COVID-19. Although developed as urgent responses to a temporary situation, some innovations could address longstanding quality of life challenges and should, we suggest, be considered for perma...

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 mu...

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 sympto...

ABSTRACT Objectives: This study aimed to examine whether the loss of spouse had similar impacts on psychological well-being as the loss of the only child, and whether the presence of one mitigated the absence of the other. Methods: We used data from a 2013 survey conducted in Shanghai, China. The sample included 1,200 older adults aged 60+, and 200...

Background Socio-demographic transitions have dramatically changed the traditional family care settings in China, caused unmet care needs among older adults. However, whether different primary caregiver types have different influences on disabled older adults’ health outcomes remain poorly understood. We aimed to examine the association between the...

Objectives: This study addressed two questions: (1) Is age at migration associated with cognitive function among Chinese older immigrants? and (2) what personal and environmental factors confound the above relationship? Methods: Data were derived from the Population Study of Chinese Elderly (N = 2957). Quantile and linear regressions were used to e...

Increasing evidence has shown that an active, socially engaged lifestyle in leisure time might protect older adults against the decline of cognitive function. It remains unclear, however, which types of leisure activities are more beneficial to maintain cognitive function, and whether there are gender differences in the association between leisure...

This special issue covers several important topics related to long-term care (LTC) systems and policy development in China. It provides a good contextual background on the development of the LTC system in China as well as the needs and preferences of LTC from family and older adults' perspectives. In addition, this issue covers the topic of evaluat...

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 ol...

Objective COVID-19 has disproportionately impacted nursing homes (NHs) with large shares of Black residents. We examined the associations between the proportion of Black residents in NHs and COVID-19 infections and deaths, accounting for structural bias (operationalized as county-level factors) and stratifying by urbanicity/rurality. Design This w...

Background: To further understand social determinants of oral health, this study examined the relationship between psychological sense of community (PSoC) and oral health problems and investigated whether the relationship would vary by family reunification status among foreign-born older Chinese Americans. Methods: Data came from the Population-Bas...

BACKGROUND Chinese immigrants suffer disproportionately high type 2 diabetes (T2D) burden and have poorly controlled disease. Mobile health (mHealth) interventions have been shown to increase access and improve chronic disease management in minority populations. However, such interventions have not been developed for or tested in Chinese immigrants...

In the present study, we examined self-rated health as a mediator between physical health conditions (chronic diseases and functional disability) and depressive symptoms in older Chinese and Korean Americans. Using harmonized data ( N = 5,063) from the Population Study of Chinese Elderly (PINE) and the Study of Older Korean Americans (SOKA), we tes...

Background and Objectives Older adults with cognitive impairment often experience poor oral health outcomes due to inadequate oral hygiene practices. This pilot study aimed to evaluate the feasibility of a care partner–assisted intervention to improve the oral hygiene of community‐dwelling older adults with cognitive impairment. Material and Metho...

Background and Objectives Many investigators of Alzheimer’s disease and related dementias (AD/ADRD) are unfamiliar with the embedded pragmatic clinical trials (ePCTs) and the indispensable pilot phase preceding ePCTs. This paper provides a much-needed example for such a pilot phase and discusses implementation barriers and additional infrastructure...

Objectives The aim of this study was to examine how the factors suggested by the Terror Management Theory are associated with death anxiety among rural Chinese older adults. Method Data were derived from a longitudinal survey of older adults aged 60 and above, had at least one living child, and were living in rural areas of Anhui Province. The wor...

With the rapid growth of aging populations, the number of older adults with dementia is increasing worldwide. While there is a significant amount of research on dementia caregivers, we know very little about Chinese American (the largest subgroup of the Asian American population in America) caregivers. Therefore, the aims of this study are to 1) co...

The purposes of this study were to identify the patterns of caregiving activities among family caregivers in Hong Kong and to examine their associations with characteristic factors and caregiver burden. The data was from the cross-sectional survey on the profiles of family caregivers of older adults in Hong Kong. 932 family caregivers were classifi...

Increasing evidence suggests that there is a linkage between cognitive function and oral health. However, there are few systematic reviews with meta-analysis have been conducted to evaluate the strength of this association. Moreover, existing studies usually focused on unidirectional associations between cognitive function and oral health; no resea...

This study investigated whether older adults’ relationships with their children were associated with their self-reported subjective sleep quality and actigraphy-measured objective sleep characteristics, as well as whether depressive symptoms and loneliness mediated the association between these parent-child relationships and sleep. Data were taken...

The impact of the COVID-19 infection on older residents and the direct frontline workers in long-term care (LTC) facilities in Wuhan, China deserves close attention. The fatality rate for older residents infected by the COVID-19 is among the highest in China Viral outbreaks are likely to occur in LTC facilities due to group-living arrangements, lac...

To further understand social, cultural, and personal predictors of oral health outcomes, this study addressed the relationship between acculturation and subsequent oral health problems and tested the moderating role of neighborhood disorder in such a relationship among older Chinese Americans. The working sample included 2,706 foreign-born communit...

Adult children play an important role in older immigrants’ health outcomes. Research has indicated that older adults may benefit from adult children caregivers’ support for oral health. However, little is known about children’s support for improving oral health for older immigrants. Using the 2018 survey of 430 Chinese older adults age 55 and older...

This symposium focuses on the wellbeing of older adults with disability/cognitive impairment and their family caregivers. More specifically, it aims to understand how familly support, community resources utilization, internal migration, and immigrant status impact older adults’ caregiving arrangement, health outcomes and end-of-life preferences and...

This study aimed to examine the trajectory of depressive symptoms among Chinese older adults with disabilities and the role of adult children’s support in predicting trajectory classes of depressive symptoms. Data were drawn from three waves of the China Health and Retirement Longitudinal Study (2011-2015). The sample included 1420 disabled older a...

The aims of this study were to examine the prevalence of orofacial pain symptoms in Chinese older adults at the end of life, and to investigate risk factors related to orofacial pain. The sample derived from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), a national respresentative sample of the oldest-old. The results showed that the 6-...

Oral health status and dental care utilization is strongly associated with social and behavioral factors and health outcomes. The five papers in this symposium address how several of these factors affect oral health and dental care among diverse groups of older adults. Using data from the Health and Retirement Study, the first paper examined the im...

Massive rural-to-urban migration in China has a significant impact on caregiving arrangements among Chinese older adults. To stimulate research on the intersection of migration and caregiving, we conducted an inventory of longitudinal aging survey datasets that included older adults from mainland China. Large public available datasets that included...

Many residents of Assisted Living (AL) confront serious illness and therefore might benefit from greater access to Palliative Care Services to improve quality of life. We surveyed resident records and AL nursing staff to identify patients in need of Palliative Care. Preliminary findings showed that nurses predicted 23% would not be alive and 49% wo...

The study aimed to examine how immigrant status and family relationships are associated with advanced care planning (ACP) engagement and end-of-life (EOL) preference over burial plan among older Chinese Americans, the largest subgroup of Asian Americans. Logistic regressions were used to analyze data from a survey of 430 older Chinese Americans age...

The fastest growth of population living with cognitive impairment takes place in China. The estimated prevalence of cognitive impairment among older adults in China is between 13% and 20%. This study focused on persons with cognitive impairment (PWCI) and their spousal care partners to explore how spousal relationships impact dyadic experiences of...

This study aimed to investigate the association between tooth retention and health behaviors among Chinese older adults. Data was used from the Chinese 4th National Oral Health Survey, a national representative sample. The sample included 9054 older adults age 55-74. The control variables included age, gender, residence, region, education level, oc...

The influences of neighborhood characteristics remain understudied in relation to oral health, especially within the context of immigration. Acculturation exerts influences on the oral health of immigrants. This study investigated the relationship between neighborhood cohesion and oral health problems among older Chinese American immigrants and exa...

Healthy aging begins and ends in the community with age friendly health systems and communities. In order to promote healthy aging and help older adults make healthy choices we must engage them as partners in healthcare with access to appropriate information and resources. This symposium will examine four community based studies that engage stakeho...

This study investigated the association between socioeconomic status (SES) and tooth loss in middle-aged and older adults by migrant status. The sample included 2,390 participants aged 45-65 from the 2017 Urbanization and New Migrant Survey conducted from 10 cities in China. Results from the negative binomial regression and the marginal effect anal...

Objective: Primary family caregiver (CG), other family members (FM), and medical professionals (MP) play important roles in medical decision-making for older adults with dementia, who often have lost the capacity to make decisions on their own. Power dynamics within the CG-FM-MP triad relationship determine the process and outcome of the decision-m...

There is limited information on the impact of cognition function on dental care utilization and costs. This study used the Medicare current beneficiaries survey in 2016 and included 4,268 participants 65+. Dental care utilization and costs were measured by self-report and included preventive and treatment events. Negative binomial regression and ge...

The aim of this study was to examine the association between health behaviors and oral health among Chinese centenarians. Data from the Nanjing Centenarians Study (NCS) in China was used (N=185, Mean age = 102). Oral health status was measured by self-reported oral health and edentulous status. Results from ordinal regression and logistic regressio...

With the rapid growth of the aging population around the world, developing support systems for older adults has become increasingly important. It is crucial for researchers， educators, policy makers to share their experience and knowledge to initiate innovative and supportive programs and services that will meet the challenges of the aging populati...

Advance Directive (AD) allows older adults to communicate preferred care at the end of life. Numerous studies reported that ethnic minorities were less likely to complete AD then non-Hispanic Whites. However, determinants of AD completion among older Chinese Americans remain unknown. The present study aims to address this knowledge gap. Data came f...

Multiple studies have reported that hearing and vision loss are linked to cognitive decline. Yet little is known about factors that may influence the association between sensory loss and cognitive decline. This study examined if loneliness mediates or moderates the impact of sensory loss on cognitive decline as individuals age. This was a longitudi...

U.S. Asians are the fastest growing group of older adults in the nation, increasing by 68% from 2000-2018. However, research on the psychological wellbeing of this population is limited. Drawing on the research of Rutgers Asian RCMAR Scientists, this symposium will address the impacts of stress, trauma and resilience on the psychological wellbeing...

Family involvement is critical to end-of-life (EOL) care of older adults. Attitude toward family involvement in EOL care can be influenced by family relationship. Yet, mechanisms explaining such influence have not been examined among older Chinese Americans. This study aims to examine the association between family relationship and older Chinese Am...

Objectives: This study examined the associations between parent-child relationships and sleep difficulty among older parents in the context of Chinese multiple-children and one-child families. Methods: Using the 2014 China Longitudinal Aging Social Survey, this study analyzed older parents' (N = 8,450) reports of sleep quality and relationships wit...

We are experiencing a historical moment with an unprecedented challenge of the COVID-19 global pandemic. The outbreak of COVID-19 will have a long-term and profound impact on older adults’ health and well-being. Social isolation and loneliness are likely to be one of the most affected health outcomes. Social isolation and loneliness are major risk...

Background/objectives: To better understand the role of sensory loss as a potentially modifiable risk factor for cognitive decline, this study examined cognitive decline in relation to single modality hearing or vision loss and dual sensory loss. Design: Longitudinal secondary data analysis. Setting: The Health and Retirement Study (HRS) and i...

Depression and anxiety, which may influence antiretroviral therapy (ART) medication adherence, are prevalent among persons living with HIV (PLWH) in China. This parallel two-arm clinical controlled trial aimed to examine the effects of a nurse-delivered cognitive behavioral intervention (CBI) on depression, anxiety, and ART medication adherence in...

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...

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 multi...

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...

Objectives This study identified the classes (i.e., patterns) of caregivers’ activities, based on their engagements in caregiving activities, and explored the characteristics and the caregiver burden of these classes. Methods This study was a secondary analysis of a cross-sectional survey on the profiles of family caregivers of older adults in Hon...

Purpose: This cross-sectional study aimed to describe personal growth and to analyze its associated factors among patients with chronic obstructive pulmonary disease (COPD) in China. Patients and Methods: A total of 364 Chinese COPD hospitalized patients were included in the study between November 2016 and April 2018. Participants provided demograp...

Introduction: Added sugars and high glycemic index (GI) foods might play a role in cardiometabolic pathogenesis. Our study aimed to describe the top sources of added sugars and types of high GI foods in diets of children by race/ethnicity. Methods: We examined data for 3,112 children, aged 6 to 11 years from the National Health and Nutrition Exa...

Objectives The current study aims to explore person-centered communication between health care professionals and COVID-19 infected older patients in acute care settings. Methods The current qualitative study explored the communication between professionals and COVID-19 infected older adults in the acute care setting through two rounds of interview...

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...

Objective: Previous longitudinal studies have found that cognitive function affected oral health, and vice versa. However, research is lacking on the reciprocal relationships between cognitive function and edentulism simultaneously, especially in developing countries. The present study aimed to examine the reciprocal relationship between cognitive...

Background : Chinese persons living with HIV (PLWH) suffer from prevalent mental health issues. We aimed to develop a tailored cognitive behavioral therapy (CBT), test its feasibility, acceptability, and preliminary effects (depression, anxiety, and medication adherence) for Chinese PLWH. Methods : Twenty PLWH were assigned randomly. Intervention...

Life-sustaining treatments (LSTs) and end-of-life (EOL) care's goal for prolonging one's life are defined as aggressive EOL care among critically ill patients. They have limited effects and add unnecessary financial burden to advanced cancer patients. A questionnaire survey was conducted to collect information on demographics, disease conditions, p...

Introduction This study aimed to evaluate the quality of home care in China using the Home Care Quality Assessment Tool (HCQuAT). Method We recruited 38 home health agencies in Shanghai, China, which included 18 in urban areas, 11 in suburban areas, and nine in rural areas. Data on quality of home care from each agency were collected by trained st...

Objectives: To examine the factors of advance directive (AD) completion among older Chinese Americans. Design: Cross-sectional survey. Setting and Participants: Data came from 435 Chinese Americans aged 55 years and older living in 2 metropolitan areas through self-administered questionnaires and research assistant–administered interviews in 2018...

Objectives To examine how immigrant status and family relationships are associated with advance care planning (ACP) engagement and end-of-life (EOL) preference in burial planning among older Chinese Americans, the largest subgroup of Asian Americans. Design Cross-sectional survey. Setting Communities in Honolulu, Hawai'i. Participants Participan...

As centenarians are the most vulnerable social group among older adults, their quality of life (QoL) is of great significance for the realization of healthy aging and a harmonious society. The purpose of this cross-sectional study was to propose a multidimensional analysis of centenarians’ QoL to examine the factors associated with QoL. In the stud...

Objectives This study investigated the resilience of a growing but largely underserved and understudied population—Chinese American dementia caregivers, whose experience is embedded in their development throughout the life span, process of migration, and sociocultural contexts. Method Narrative data were collected from in-depth interviews with 27...

China has experienced a substantial increase in the number of older adults with dementia and milder forms of cognitive impairment. Being spouses of Persons with cognitive impairment (PWCI) and living with them for several decades does not necessarily mean that it is easier for them to provide person-centered care and maintain a valued and healthy r...

The second King's College London Symposium on Ageing and Long-term Care in China was convened from 4 to 5th July 2019 at King's College London in London. The aim of the Symposium was to have a better understanding of health and social challenges for aging and long-term care in China. This symposium draws research insights from a wide range of disci...

Phenomenon: Ageism is a significant social issue, especially in China. Ageism adversely affects willingness to consider a career in geriatric medicine. However, few studies have examined this topic among Chinese medical students. This study aimed to investigate attitudes toward older people among medical students in China, examine the factors relat...

Background Exercise is known to prevent cognitive decline. Sleep quality and depression symptoms, which are associated with processing speed, are considered as common mediators in the exercise-cognition putative model. However, these mediating mechanisms have not been empirically tested in an intervention study. Objective The aim of this study was...

Background: Most investigators studying Alzheimer’s disease and related dementias (AD/ADRD) are unfamiliar with embedded pragmatic clinical trials (ePCTs) and pilot studies designed to inform ePCTs. This paper provides a much-needed example for the pilot phase proceeding a nationwide AD/ADRD ePCT, reporting feasibility, applicability, and fidelity...

This study aimed to examine the association between health insurance, city of residence, and outpatient visits among older adults living alone in China. A sample of 3173 individuals was derived from "Survey on Older Adults Aged 70 and Above Living Alone in Urban China" in five different cities. Logistic regression models indicated that older adults...

This study examined the impact of current and future long-term care (LTC) policies on the family caregiving burden in China. System dynamics (SD) methodology was used to construct an LTC delivery system model that simulates the demand of LTC, living options, and LTC service use for disabled older adults. The model was based on three policy variable...

Background: Novel Coronavirus Disease 2019 (COVID-19) emerged in Wuhan, Hubei Province, China in December 2019. Since then, there was an outbreak in Wuhan and the coronavirus spread quickly nationwide. Thousands of healthcare providers fought against COVID-19 in Wuhan and other areas of China. The present study aimed to investigate the levels and r...

This study examined the longitudinal association between parent-child relationship quality and a common sleep problem, insomnia, among older parents. This research also investigated whether the link between parent-child relationship quality and insomnia was mediated by depressive symptoms over time. Using three waves of data from the Health and Ret...