The physical examinations form the core of NAKO’s standardized health assessment protocol. Conducted at all study centers, these non-invasive tests provide a detailed snapshot of participants’ current health. From blood pressure readings and retinal photography to fitness evaluations and abdominal ultrasounds, each component helps capture vital data for long-term health research.
All study participants received the programme in the first examination phase in two variants of varying complexity. The basic Level 1 programme comprised medical examinations lasting around four hours. 40,000 participants took part in the additional Level 2 programme, which lasted six hours and contained more tests than the basic programme. Since the start of the follow-up programmes no distinction has been made between Level 1 and Level 2 examinations.
Cardiovascular System
- Blood pressure, Measurement of systolic and diastolic blood pressure to assess cardiovascular function and hypertension risk.
- Examples of generated data:
- Systolic/diastolic blood pressure
- Pulse rate
- Hypertension
- Examples of generated data:
- Echocardiography, Ultrasound imaging of the heart to evaluate its structure and function.
- Examples of generated data:
- Heart Valve Function (Mitral, Aortic, and Tricuspid Valves)
- Chamber Volumes & Dimensions
- Diastolic Function (E/A Ratio, E/E’, A’ Velocities)
- Tissue Doppler & Synchrony (Tmsv Indices, RR Interval, Segmental Timing)
- ultrasound loops and images
- Examples of generated data:
- Vascular Explorer, Measures arterial stiffness and central blood pressure to evaluate vascular health.
- Examples of generated data:
- Heart rate
- Pulse transit time (PTT)
- Anthropometric Distances
- Pulse Wave Velocity (PWV)
- Augmentation Index (AIx)
- Blood Pressures (e.g. systolic, diastolic, mean, and pulse pressures)
- Ankle-Brachial Index (ABI)
- Examples of generated data:
Physical Fitness
- Accelerometry, Objective monitoring of physical activity levels using a wearable device.
- Examples of generated Data:
- time per day spent in certain acceleration ranges
- Estimates of time (in minutes per day, averaged over available days as appropriate) spent in MVPA based on various algorithm parameters
- acceleration values per quarter hour averaged over all available days
- automated evaluation data (physical exertion, energy consumption per day, number of steps)
- Examples of generated Data:
- Handgrip force, Assesses muscle strength using a dynamometer as a proxy for overall physical fitness.
- Examples of generated Data:
- Max. gripping strength left/right
- Examples of generated Data:
- Ergometry, Physical stress test using a cycle ergometer to measure endurance and cardiovascular response.
- Examples of generated Data:
- Power & Oxygen Uptake Estimates (Estimated maximum power, HR-related power thresholds, Maximum oxygen uptake, Power at perceived exertion levels)Heart Rate Recovery (HRR) (Heart rate at intervals post-exercise, HR decline at each timepoint, Model-based recovery parameters)
- HR Achievement Indicators (HR targets reached, Max HR calculated vs. reached, Max HR)
- Examples of generated Data:
- PAR-Q (Physical Activity Readiness Questionnaire), Level-2, A brief questionnaire to screen for health risks before engaging in physical activity.
Body Composition
- Anthropometry/ Bioelectrical Impedance Analysis (BIA), Measurement of body dimensions and composition, including fat and muscle mass.
- Examples for generated data:
- Measured & Self-Reported Data
- Basic Body Measurements (Height, Weight, Quality indicators for height/weight)
- BMI & Weight Categories
- Body Composition (BIA-based) (Body fat percentage, Phase angle, Impedance, Reactance, Resistance)
- Examples for generated data:
- Abdominal ultrasound, Imaging to assess internal abdominal organs and general abdominal health.
- Abdominal fat ultrasound, Targeted ultrasound to quantify visceral and subcutaneous abdominal fat.
- Examples for generated data:
- Subcutaneous/visceral fat thickness
- Examples for generated data:
Lung Function
- FeNO (Fractional exhaled Nitric Oxide) measurement, Assesses airway inflammation by measuring nitric oxide in exhaled air.
- Spirometry, Measures lung volume and airflow to evaluate respiratory function and detect obstruction.
- Examples for generated data:
- Lung Volume Measures
- Expiratory Flow Parameters
- Timing and Derived Metrics
- Examples for generated data:
Neuropsychological Tests
- Neuropsychological test battery, Assesses memory, attention, and cognitive flexibility through standardized tasks.
- Includes Purdue Pegboard Test, Evaluates fine motor skills and manual dexterity. Numerical series test, Measures short-term memory and attention span using a sequence recall task.
- Examples for generated data:
- Number of words
- Length of longest correct number span
- Number of pin pairs
Sensory Function
- Retinal photography, Captures images of the retina to screen for eye diseases and vascular health.
- Examples for generated data:
- Image Data
- Macula Region Findings (drusen, edema, exsudates, hemorrhages, detachment types, dystrophies, scars)
- Optic Disc Region Findings (excavations, pigment changes, glaucoma indicators, neovascularisations)
- Retina Region Findings (degeneration, ischemic areas, detachment, scars, hemorrhages, tumors)
- Vascular Region Findings (occlusions, aneurysms, ischemia, neovascularisations, diameter changes)
- Examples for generated data:
- Visual acuity test, Assesses the sharpness and clarity of vision.
- Olfactory test, Evaluates the ability to identify and differentiate odors.
- Examples for generated data:
- Number of correctly recognised scents
- Olfactory function categorized
- Examples for generated data:
Sleep (SOMNOwatch)
- Sleep analysis, Objective sleep monitoring using wearable technology to assess sleep stages and disturbances.
- Examples for generated data:
- Bed-/Wake-up time
- Night sleep duration
- Examples for generated data:
Other Examinations
- AGE Reader, Non-invasive device that measures advanced glycation end products (AGEs) in the skin as a marker of biological aging.
- Examples for generated data:
- Autofluorescence and Reflection Measurements
- Examples for generated data:
- Hand examination, Assesses joint function and signs of musculoskeletal disorders in the hands.
- Examples for generated data:
- Swelling, Pain
- Heberden’s Nodes (DIP joints)
- Bouchard’s Nodes (PIP joints)
- Rhizarthrosis (Thumb saddle joint)
- Examples for generated data:
Dental Status
- Dental status, Documentation of oral health, including the presence of caries and restorations.
- Examples for generated data:
- Pocket depth measurements (per tooth: medial and mesial)
- Tooth status (individual tooth assessments)
- Prosthetic status
- Orthodontic history
- Jaw and facial pain
- Mouth opening (active and maximum)
- Temporomandibular disorders (joint and muscle pain)
- Occlusion measurements (overjet and overbite)
- Palpation findings (temporal and masticatory muscles)
- Examples for generated data:
- Number of teeth, Counts remaining natural teeth as an indicator of oral and overall health.
