N. Maritza Dowling

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Bio

N. Maritza Dowling, PhD, is tenure track assistant professor of biostatistics and associate director of research at the Center for Aging, Health and Humanities at the George Washington University School of Nursing. She also holds a joint appointment at the Milken Institute School of Public Health in the Department of Epidemiology and Biostatistics. Her research focuses on measurement issues in the longitudinal assessment of cognitive decline in older adults and the application of novel statistical approaches to model the complex interplay between risk and protective factors in Alzheimer's disease (AD) related brain changes and biomarkers for disease prognosis. Her research also aims to optimize cognitive outcome measures for early diagnosis and patient selection in clinical studies of AD modifying therapies. She was previously an associate scientist in the Department of Biostatistics & Medical Informatics and co-director of the Biostatistics and Data Management Unit at the Wisconsin Alzheimer’s Disease Research Center where she conducted independent and collaborative methodological research designed to better understand the mechanisms underlying increased risk for Alzheimer’s disease and the neural substrates of cognitive processes that differentiate normal from pathological aging in individuals at risk of Alzheimer’s and related dementias due to autopsy confirmed family history.

Dr. Dowling has authored more than 60 peer-reviewed articles in the areas of neuroimaging and biomarkers for AD, neuropsychology of aging, MCI, and dementia, cognitive assessment, biomarkers for early detection of cognitive decline, digital technologies to measure cognitive decline and attenuate risk, and telemedicine for AD populations. Dr Dowling holds a master degree in Statistics and a doctoral degrees in Quantitative Methods (Statistics and Psychometrics) (University of Wisconsin-Madison).

Expertise

Education:

Doctor of Philosophy Degree in Quantitative Methods (Statistics; Psychometrics), University of Wisconsin-Madison
Master of Science in Statistics
Bachelor of Science in Mathematics

Expertise:

Modern psychometric methodology applications of item response theory
Latent/structural equation modeling
Mixture modeling to study disease heterogeneity
Longitudinal data analysis
Causality and mediation analysis
Machine learning

Context:

Alzheimer's disease and Alzheimer's disease-related dementias.

Teaching:

Biostatistics for Health Care Reseach (NURS6208)
Statistics for Health Care Research II (NURS8442)

Research

Research:

Dr. Dowling's methodological research aims at understanding the mechanisms underlying increased risk for neurological diseases, the neural substrates of cognitive processes, and the heterogeneity of changes that differentiate normal from pathological aging in asymptomatic or pre-symptomatic individuals. Her recent research has focused on measurement issues in the longitudinal assessment of health constructs and cognitive function and the optimization of outcomes measures for patient selection for clinical trials and early diagnosis and detection of disease progression

For the next five years, she will serve as a co-investigator and lead statistician on a multi-site NIH-NIA funded study, “Prevention of Alzheimer’s disease in women: risks and benefits of hormone therapy.” The project will examine the differences in amyloid deposition, cerebrovascular lesions, cognitive function, mood and brain structure in women who were treated with different formulations of hormone therapy compared to placebo during early postmenopause. Presently, she is also a co-Investigator and lead statistician of another multisite study funded by the Gordon & Betty Moore Foundation to study the Effect of changing the culture of care to a more patient-centered approach in improving end of life care in seriously ill and frail dialysis patients.

Publications

Publications:

Miller,V., Asthana,S., Black, D., Brinton,E., Budoff, M., Cedars, M., Dowling, N. M., Gleason,C.E., Hodis, N., Jayachandran, M., Kantarci, K., Lobo1, R., Manson, J.E., Naftolin,F., Pal, L., Santoro, N., Taylor, H.S., Harman, S.M. (2019). The Kronos Early Estrogen Prevention Study (KEEPS): what has it taught us? Menopause: The Journal of the North American Menopause Society. https://www.ncbi.nlm.nih.gov/pubmed/30939537

Dowling, N. M., Jain, V., Krause, M., Shabeeb, R. A., Hunley, A., & Cho, M. J. (2019). Does Sleep Mediate the Relationship between Concussion Symptoms and Cognition in mildTBI Adults?. Sleep, 42(Supplement_1), A374-A374.

Barzgari1, A., Sojkova, J., Dowling, N. M., Pozorski, V., Okonkwo, O., Starks, E. J., Oh, J., Thiesen, F., Wey, A., Nicholas, C. R., & Gallagher, C.L. (2019). Arterial spin labeling reveals relationships between resting cerebral perfusion and motor learning in Parkinson’s disease. Brain, Imaging, and Behavior, 13 (3), 577-587. https://link.springer.com/article/10.1007%2Fs11682-018-9877-1

Dowling, N. M., Raykov, T., Marcoulides, G. (2018). A Method for Examining the Equating of Psychometric Scales and Tests: An Application Using Dementia Screening Tests. Educational & Psychological Measurement. https://doi.org/10.1177/0013164418775785

Kantarci, K., Tosakulwong, N., Lesnick, T., Zuk, S., Lowe, V., Fields, J., Gunter, J., Senjem, M., Settell, M., Gleason, C., Dowling, N.M., Jack, C. R., Rocca, W. Miller, V. (2018, In Press). Brain Structure and Cognition Three Years after an Early Menopausal Hormone Therapy Trial. JAMA Neurology. http://dx.doi.org/10.1212/WNL.0000000000005325

Dowling, N. M., Raykov, T., Marcoulides, G. (2019). Examining Population Differences in Within-Person Variability in Longitudinal Designs Using Latent Variable Modeling: An Application to the Study of Cognitive Functioning of Older Adults. Educational & Psychological Measurement, 79 (3), 598-609. http://journals.sagepub.com/doi/abs/10.1177/0013164418758834

Gleason, C, Norton, D, Anderson,E, Wahoske,M, Washington,D, Koscik,R, Dowling, NM, Johnson, S. Asthana, S. (2018) Cognitive variability predicts incident Alzheimer’s disease and mild cognitive impairment comparable to a cerebrospinal fluid biomarker. Journal of Alzheimer's Disease, 61 (1).

Bolt, D., Dowling, N. M., Shih, Y-S., Loh, W-Y. (2017). Using Blinder-Oaxaca Decomposition to Explore Differential Item Functioning: Application to PISA, (2017) In H. Jiao & R. W. Lissitz (Eds.), Test Fairness in the New Generation of Large-Scale Assessment (pp. 161-180). Charlotte, NC: Information Age.

Nicholas, C., Hoscheidt, S., Clark, L., Racine, A., Berman, S., Koscik, R., Dowling, N.M., Christian, B., Sager, M., Johnson, S. (2017) Positive affect predicts cerebral glucose metabolism in late middle-aged adults. Social Cognitive and Affective Neuroscience, 12, 993-1000.

Nicholas, C., Dowling, N. M. Oh, J., Illingworth, C., Herman, B., Bendlin, B.., Sager, M., Johnson, S. (2017). Longitudinal Assessment of Self- and Informant-Subjective Cognitive Complaints in a Sample of Healthy Late-Middle Aged Adults Enriched with a Family History of Alzheimer’s Disease, Journal of the International Neuropsychological Society, 23, 1-10. PMCID: PMC5754023

Willette,A., Webb,J. Lutz, M., Bendlin,B. Wennberg,A.,Oh, J., Koscik, R., Roses, A., Hermann, B., Dowling, N.M, Sager, M., Johnson, S. (2017) Family history and TOMM40 '523 interactive associations with memory in middle-aged and AD cohorts. Alzheimer’s & Dementia. DOI: http://dx.doi.org/10.1016/j.jalz.2017.03.009. .

Law, L. L. Schultz, S., Boots, E., Einerson, J., Dougherty, R., Korcarz, C., Edwards, D. Koscik, R. Dowling, N. M., Gallagher, C., Bendlin, B., Carlsson, C. Asthana, A., Hermann, B., Sager, M., Johnson, S., Cook,D., Stein, J., Okonkwo,O. (2017). Chronotropic response and cognitive function in a cohort at risk for Alzheimer’s disease, Journal of Alzheimer's Disease, 56, 351-359.

Santoro, N.F., Neal-Perry, G., Pal, L., Lobo, R., Naftolin, F., Asberry, P., Black, D., Brinton, E., Budoff, M., Cedars, M., Dowling, N. M., Dunn, M., Gleason, C.E, Hodis, H.N., Isaac, B., Magnani, M., Manson, J.E., Miller, V.M., Taylor, H.S., Wharton, W., Wolff, E., Zepeda, V., Harman, S.M. (2017). Longitudinal Changes in Menopausal Symptoms in Women Randomized to Low-Dose Oral or Transdermal E2 Plus Micronized Progesterone Versus Placebo: the Kronos Early Estrogen Prevention Study, Menopause: The Journal of the North American Menopause Society, 24(3), 238-246.

Dowling, N. M., Bolt, D. M., Deng, S., Li, C. (2016) Measurement and Control of Bias in Patient-Reported Outcomes Using Multidimensional Item Response Theory Models. BMC Medical Research Methodology. doi: 10.1186/s12874-016-0161-z.

Dowling, N. M., Bolt, D. M., Deng, S. (2016). An Approach for Item Sensitivity to Within-Person Change Over Time: An Illustration Using the ADAS-Cog. Psychological Assessment. doi.org/10.1037/pas0000285.

Kantarci, K., Tosakulwong, N., Lesnick, T., Zuk, S., Gunter, J., Gleason, C., Dowling, N. M., Vemuri, P., Senjem, M., Shuster, L.T., Bailey, K.R., Rocca, W., Jack, C., Asthana, S., & Miller, V. M. (2016). Effects of Hormone Therapy on Brain Structure in Post-Menopausal Women: A Randomized Controlled Trial. JAMA Neurology, 87, 887-889.

Gleason, C, Dowling, N. M., Flowers, S., Kaseroff, A., Gunn, W., Edwards, D. (2016). Common Sense Model Factors affecting African American's disclosure of symptoms of mild cognitive impairment to providers. American Journal of Geriatric Psychiatry. doi:10.1016/j.jagp.2015.08.005.

Melah, K.E., Lu, S.Y., Hoscheidt, S.M., Alexander, A.L., Adluru, N., Destiche, D.J., Carlsson, C., Zetterberg, H., Blennow, K., Gleason, C., Dowling, N. M., Bratzke, L.C., Rowley, H.A., Sager, M.A., Asthana, S., Johnson, S.C., Bendlin, B.B. (2016). CSF markers of Alzheimer’s pathology and microglial activation are associated with altered white matter microstructure in asymptomatic adults at risk for Alzheimer’s disease. Journal of Alzheimer's Disease, 50, 873-886.

Miller, V. M., Raz, L., Hunter, L., Dowling, N. M., Wharton, W., Gleason, C.; Jayachandran, M.; Anderson, L. (2016). Differential Effects of Hormone Therapy on Platelet Serotonin and Mood in Women of the KEEPS. Climacteric, 9, 49-59.

Racine, A., Koscik, R., Nicholas, C., Clark L., Okonkwo, O., Hillmer, A., Murali, D, Barnhart, T., Betthauser, T., Gallagher, C., Rowley, H., Dowling, N. M., Asthana, S,, Bendlin, BB, Zetterberg, H, Carlsson, CM, Christian, BT, Johnson, SC. (2016) Cerebrospinal fluid ratios with Aß42 predict preclinical brain ß-amyloid accumulation. Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring, 2, 27-38.

Dougherty, R., Ellingson, L., Schultz, S., Boots, E., Meyer, J., Lindheimer, J., Stegner, A., Edwards, D, Oh, J, Koscik, R, Dowling, N.M., Gallagher, C.L., Carlsson, C., Rowley, H. A., Bendlin, B.B., Asthana, S., Hermann, B.P., Sager, M., Johnson, S., Cook, D.B. (2016). Meeting physical activity recommendations may be protective against temporal lobe atrophy in older adults at risk for Alzheimer's disease. Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring, 4, 14-17.

Dowling, N. M., Johnson, S.C., Gleason, C.E., Jagust, W. (2015). The Mediational Effects of FDG Hypometabolism on the Association between Cerebrospinal Fluid Biomarkers and Neurocognitive Function. NeuroImage, 105, 357-368.

Li, C., Dowling, N. M., & Chappell, R. (2015). Quantile regression with a change-point model for longitudinal data: An application to the study of cognitive changes in preclinical Alzheimer's disease. Biometrics. doi: 10.1111/biom.12313.

Ithapu, V.K., Singh, V., Chappell, R., Dowling, N. M., Johnson, S. C. (2015). Imaging-based enrichment criteria using deep learning algorithms for efficient clinical trials in MCI. Alzheimer's & Dementia. doi:10.1016/j.jalz.2015.01.010.

Gleason, C., Dowling, N. M., Wharton, W., Manson, J.E., Miller, V.M., Atwood, C.S., Brinton, E.A., Cedars, M., Lobo, R.A., Merriam, G.R., Neal-Perry, G., Santoro, N.F., Taylor, H.S., Black, D.M., Budoff, M.J., Hodis, H.N., Naftolin, F., Harman, S.M. (2015). Effects of Hormone Therapy on Cognition and Mood in Recently Postmenopausal Women: Findings from the Randomized, Controlled KEEPS-Cognitive and Affective Study. PLoS Medicine 2(6): e1001833. PMCID: PMC4452757

Gleason, C, Fischer, B.L., Dowling, N. M., Setchell, K.R., Carlsson, C.M., Asthana, S. (2015). Cognitive effects of soy isoflavones in patients with Alzheimer’s disease. Journal of Alzheimer’s Disease, 47, 1009-1019.

Almeida, R.P., Schultz, S., Austin, B., Boots, E., Dowling, N. M., Gleason, C.E., Bendlin, B.B., Sager, M.A., Hermann, B.P., Zetterberg, H., Carlsson, C.M., Johnson, S.C., Asthana, S., & Okonwo, O.C. (2015). Effect of cognitive reserve as a modifier of age-related changes in CSF biomarkers of Alzheimer's disease. JAMA Neurology, 72, 699-706.

Schultz, S.A., Oh, J.M., Koscik, R.L., Dowling, N. M., Gallagher, C. L., Carlsson, C. M., Bendlin, B. B., LaRue, A., Hermann, B. P., Rowley, H. A., Asthana, S., Sager, M. A., Johnson, S. C., Okonwo, O. (2015). Subjective memory complaints, cortical thinning, and cognitive dysfunction in middle-aged adults at risk for AD. Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring, 1, 33-40.

Doherty, B., Schultz, S., Oh, J., Koscik, R., Dowling, N. M., Barnhart, T.E., Gallagher, C.L., Carlsson, C.M., Bendlin, B.B., LaRue, A., Hermann, B.P., Rowley, H.A., Asthana, S., Sager, M.A., Okonwo, O. (2015). Amyloid burden, cortical thickness, and cognitive function in the Wisconsin Registry for Alzheimer’s Prevention. Alzheimer’s & Dementia: Diagnosis, Assessment, and Disease Monitoring, 1, 160-169.

Boots, E, Schultz, Oh, J, Larson, J, Edwards, D, Cook, D, Koscik, R, Dowling, N.M., Gallagher, C.L., Carlsson, C.M., Howard, H.A., Bendlin, B.B., LaRue, A., Asthana, S, Hermann, B, Sager, M, Johnson, S.C., Okonwo. O. (2015). Cardiorespiratory fitness is associated with brain structure, cognition, and mood in a middle-aged cohort at risk for Alzheimer's disease. Brain Imaging and Behavior, 9, 639-649.

Schultz, S, Boots, EA, Almeida, R, Oh, JM, Einerson, J, Korcarz, CE, Edwards, DF, Koscik, RL, Dowling, N.M., Gallagher, CL, Bendlin, BB, Christian, BT, Zetterberg, H, Blennow, K, Carlsson, CM, Asthana, S, Hermann, BP, Sager, MA, Johnson, SC, Stein, JH, Okonkwo, OC. (2015) Cardiorespiratory Fitness Attenuates the Influence of Amyloid on Cognition. Journal of the International Neuropsychological Society, 21, 841-850.

Boots, EA, Schultz, SA, Almeida, RP, Koscik, RL, Dowling, N.M., Gallagher, CL, Carlsson, CM, Rowley, HA, Bendlin, BB, Asthana, S., Sager, MA, Hermann, BP, Johnson, SC, Okonkwo, O (2015) Occupational Complexity and Cognitive Reserve in a Middle-Aged Cohort at Risk for Alzheimer's Disease. Archives of Clinical Neuropsychology, 30, 634-642.

Dowling, N. M., Gleason,C.E, Manson, J.E., Hodis, H.N., Miller, V., Brinton, E.A., Neal-Perry, G., Santorro, N., Wharton,W., Cedars, M., Lobo, R, Merriam, G., Naftolin, F., Taylor, H., Harman, S.M., Asthana, S. (2014). Characterization of Vascular Disease Risk in Postmenopausal Women and its Association with Cognitive Performance. PLoS One, 8(7), e68741.

Schultz, S., Larson, J., Oh, J., Koscik, R., Dowling, N. M., Gallagher, C. L., Carlsson, C.M., Rowley, H.A., Bendlin, B.B., Hermann, B.P., Johnson, S.C., Sager, M., LaRue, A., Okonwo, O. (2014). Participation in cognitively-stimulating activities is associated with brain structure and cognitive function in preclinical Alzheimer's disease. Brain Imaging and Behavior. doi 10.1007/s11682-014-9329-5.

Wharton, W., Gleason,C.E, Dowling, N. M., Carlsson, C, Brinton, E.A., Santoro, M.N., Neal-Perry, G., Taylor, H., Naftolin, F., Lobo, RA, Merriam, G, Manson, J.E., Cedars, M.I., Miller, V.M., Black, D. M., Budoff, M., Hodis, H. N., Harman, S. M. (2014). The KEEPS-Cognitive and Affective Study: Baseline Associations between Vascular Risk Factors and Cognition. Journal of the Alzheimer’s Disease, 40, 331-341.

Okonkwo, O., Xu, G., Oh, J., Dowling, N. M., Carlsson, C.M., Gallagher, C.L., Birdsill, A.C., Palotti, M., Wharton, W., Hermann, B.P., Larue, A., Bendlin, B.B., Rowley, H.A., Asthana, S., Sager M.A., Johnson, S. C. (2014). Cerebral Blood Flow is Diminished in Asymptomatic Middle-Aged Adults with Maternal History of Alzheimer's Disease. Cerebral Cortex, 24, 978-988.

Adluru, N., Destiche, D., Yuan, S., Doran, S., Birdsill, A., Melah, K., Alexander, A., Dowling, N. M., Johnson, S. C., Sager, M. A., Bendlin, B. (2014). White matter microstructure in late middle-age: Effects of apolipoprotein E4 and parental family history of Alzheimer's disease. NeuroImage: Clinical, 4, 730–742.

Okonkwo, O., Oh, J., Schultz, S., Larson, J., Edwards, D., Cook, D., Koscik, R, Gallagher, C., Dowling, N. M., Carlsson, C., Bendlin, B., , Larue, A., Rowley, H., Christian, B., Asthana, S., Johnson, S., Hermann, B., Sager M.A. (2014). Physical Activity Attenuates Age-Related Biomarker Alterations in Preclinical AD. JAMA Neurology, 83, 1753-1760.

Ly, M, Canu, E., Xu,G., Oh,J., McLaren, D., Dowling, N.M., Alexander, A.L., Sager, M., Johnson, S., Bendlin, B. (2014). Midlife measurements of white matter microstructure predict subsequent regional white matter atrophy in healthy adults. Human Brain Mapping, 35, 2044-2054.

Johnson, S. C., Christian, B. T., Okonkwo, O. C., Oh, J. M., Harding, S., Xu, G., ... & Hall, L. T. (2014). Amyloid burden and neural function in people at risk for Alzheimer's disease. Neurobiology of aging, 35(3), 576-584.

Racine, A., Adluru, N., Alexanderd, A., Christian, B.T., Okonco, O., Oh, J. ,Cleary, C.A., Birdsill, A., Hillmer, A., Murali, D., Barnhart, T., Gallager, C., Carlsson, C., Rowley, H., Dowling, N. M., Asthana, S., Sager, M., Bendlin, B.B., Johnson, S.C. (2014). Associations between white matter microstructure and amyloid burden in preclinical Alzheimer’s disease: A multimodal imaging investigation. Neuroimage: Clinical. 4, 604-614.

Okonkwo,O., Oh, J., Koscik.,R., Jonaitis, E., Cleary, C., Dowling, N. M., Bendlin,B., LaRue, A., Hermann, B., Barnhart, T.E., Murali, D., Rowley, H.D., Carlsson, C.M., Gallagher, C., Asthana, S., Christian, B., Johnson, S.C. (2014). Amyloid burden, neuronal function, and cognitive decline in middle-aged adults at risk for Alzheimer’s disease. Journal of the International Neuropsychological Society, 20, 422-433.

Dowling, N. M., Olson, N., Mish, T., Kaprakattu, P., & Gleason, C. (2012). A Model for the Design and Implementation of a Participant Recruitment Registry for Clinical Studies of Older Adults. Clinical Trials: Journal of the Society for Clinical Trials, 9, 204-214.

Stricker, N., Dodge, H., Dowling, N.M., Han, D., Erosheva, E., Jagust, W. (2012). CSF biomarker associations with change in hippocampal volume and precuneus thickness: implications for the Alzheimer’s pathological cascade, Brain, Imaging, and Behavior Journal, 6, 599-609.

Hinrichs, C., Dowling, N.M., Johnson, S.C., & Singh, V. (2012). MKL-based sample enrichment and customized outcomes enable smaller AD clinical trials. Machine Learning and Interpretation in Neuroimaging (MLINI) 2011, Lecture Notes in Artificial Intelligence (LNAI) 7263, pp. 124-131.

Gleason, C.E., Dowling, N.M., Friedman, E., Wharton, W., & Asthana, S. (2012). Using predictors of hormone therapy use to model the healthy user bias: How does healthy user status influence cognitive effects of hormone therapy? Menopause: The Journal of the North American Menopause Society, 9, 524-533.

Okonkwo, O., Xu, G. Dowling N.M., Bendlin, B.B., Larue, A., Hermann, B., Koscik, R., Jonaitis, E., Rowley H.A., Carlsson, C.M., Asthana,S., Sager, M.A., Johnson, S.C . (2012). Family history of Alzheimer disease predicts hippocampal atrophy in healthy middle-aged adults. JAMA Neurology, 78, 1769-1776.

Dowling, N. M, Tomaszewski-Farias, S., D., Reed, B., Sonnen, J., Strauss, M., Schneider, J. A., Bennett, D. A., & Mungas, D. (2011). Neuropathological determinants of multiple cognitive functions in two community-based cohorts of older adults. Journal of the International Neuropsychological Society, 17, 602-614.

Reed, B., Dowling, N. M., Mungas, D., Sonnen, J., Tomaszewski-Farias, S., & Strauss, M. (2011). Cognitive activities during adulthood are more important than Education in building reserve. Journal of the International Neuropsychological Society, 17, 650-675.

Wharton, W., Baker, L.D., Gleason, C.E., Dowling, N. M., Barnet, J.H., Johnson, S, Carlsson, C. Asthana, S. (2011). Short-term hormone therapy with transdermal estradiol improves cognition for postmenopausal women with Alzheimer’s: results of a randomized controlled trial. Journal of Alzheimer’s Disease, 26, 495-505.

Dowling, N. M., Hermann, B. La Rue, A., & Sager, M. (2010). An Examination of the Latent Structure of the Neuropsychological Test Battery of the Wisconsin Registry for Alzheimer’s Prevention. Neuropsychology, 24, 742-756.

Lin, F., Wharton, W. Dowling, N. M., Ries, M., Johnson, S., Carlsson, C., Gleason, C. (2010). Awareness of Memory Abilities in Community-Dwelling Older Adults with Suspected Dementia and Mild Cognitive Impairment. Dementia and Geriatric Cognitive Disorders, 30, 83-92.

Xu, G., Rowley, H.A., Wu, G., Alsop, D.C., Shankaryanan, A., Dowling, N. M., Christian, B.T., Oakes, T.R, & Johnson, S.C. (2010). Reliability and Precision of Pseudo-continuous Arterial Spin Labeling Perfusion MRI on 3.0 T and Comparison with 15O-water PET in Elderly Subjects at Risk for Alzheimer’s Disease. NMR in Biomedicine Journal, 23, 286-293.

Web 2019 Update - CSS

N. Maritza

Dowling

Assistant Professor

N. Maritza Dowling

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