Hanzhang Xu, Ph.D.: Focused on Improved Health for Older Adults

By Lauren Westbrook

Hanzhang Xu, Ph.D., RN, assistant professor of family medicine and community health, joined the department three years ago as faculty in the research unit. She received a PhD in nursing from the Duke University School of Nursing in 2018. Dr. Xu also completed a Doctoral Certificate in Global Health from the Duke Global Health Institute and a certificate in College Teaching from the Duke Graduate School.

On her career path

Beginning her career as a nurse in China, Dr. Xu quickly focused on a question almost everyone faces: How should we care for older adults in our community, specifically our parents? Dr. Xu says many young adults in China who are single children face the possibility of having to support two parents and up to four grandparents, with an underdeveloped social welfare program. To continue her work in this area, Dr. Xu attended Duke University School of Nursing for nursing science research and global health. Then, she joined the faculty of the Department of Family Medicine and Community Health to continue her research.

On her research interests

Dr. Xu’s earlier work focused on older adults in China and India, including internal migration, chronic disease management, and cognitive aging. For example, there are trends of large people migrating into cities (rural to urban migration), often for educational and occupational purpose, but is this good for an individual’s health and well-being in the long run?

While studying at Duke, Dr. Xu began a quest to focus more on U.S. population disparities, with a racial and ethnic minority focus. In addition, she says there is a growing need to promote equity in dementia care, as some groups have a higher risk of developing the disease, yet have limited access to services and programs to lower their risk. An early diagnosis is critical in this case, but it has been challenging to do so, she says. This may be remedied using electronic health records and interviews with patients and their family members about their interactions with the health system prior to diagnosis.

Dr. Xu has taken part in extensive cardiovascular research with Duke Health for older adults, as well. In partnership with faculty at Duke Clinical Research Institute and Duke Heart Center, she and colleagues are searching for how to provide better access to primary care to prevent patients’ return within 30 days after a cardiovascular episode.

On who she wants to reach with her research

Dr. Xu is well-known within the scientific community and is also active on Twitter. She wants the non-science population to understand how we can better care for the growing aging population. Since most of her work is centered on older adults, there is often a communication barrier to her published work. She is interested in learning more about how to get messaging to older adults, and which format is most effective for this population. Solutions range anywhere from Facebook to posters in medical clinics.

“I would like for older people to understand dementia while we work to break down stigma. Some communities have a higher disease burden, and we want them to be more involved in research so we can share what we’ve found to give back,” Dr. Xu says.

On her next project

Dr. Xu is excited about an upcoming project focused on the delayed diagnosis of dementia in underrepresented communities, which combines her research and training. She is interested in who patients get referred to, and what demographic groups are most likely to be seen in the first place. Family medicine doctors may make the diagnosis or refer patients to a specialist, and she says primary care should always be the first step, giving a holistic perspective to make sure everyone is prepared.

Lauren Westbrook was a communications intern with the Department of Family Medicine & Community Health. She recently graduated from UNC-Chapel Hill with a major in public relations.