Scientific Concept of the National Cohort (status ... - Nationale Kohorte

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A.3 Study design
fluency (e.g., animal names), processing speed (e.g., letter digit substitution test), and executive
functioning.
Both established and more recently developed measures of cognitive functions which may
be affected in diseases targeted by the National Cohort study will be examined during a
feasibility study with the aim to derive a battery of feasible, age- and disease-sensitive measures
of attention, executive function, and episodic memory. All tested instruments will be
validated and simple to implement, even if applied by using a PC.
Based on the results of the feasibility study, a set of instruments will be selected for the
National Cohort with a maximum total duration time of 15 min (10 min for testing and 5 min
for touch screen).
A.3.3.5 respiratory disease-related measures
lung function: spirometry
Spirometry is a well-established technique for assessing lung function and can easily be
performed in terms of technical requirements and with minimal inconvenience to the study
participant. Spirometry assesses lung function by measuring inhaled and exhaled volumes
of air as a function of time. Parameters usually assessed are FEV1 and forced vital capacity
(FVC) 202, 612-615 .
Spirometry provides an integrative signal covering the mechanically relevant aspects of
lung structure by fully noninvasive means. The results demonstrate chronic repair and remodeling
processes in the lung and therefore correspond with disease development and
progression but also with loss of function due to organ aging. Spirometry is used to assess
conditions such as asthma and COPD and to distinguish between obstructive and restrictive
lung disease. In addition, spirometric data are considered to be a powerful predictor of
longevity and aging.
Procedure of measurement:
To guarantee valid results, cooperation between the participant and study nurse and patient
effort are necessary. After adequate explanation of the maneuver, the participant will be
asked to exhale several times as fast and hard as possible until three measurements without
artifacts have been obtained 616 . It takes about 8 min to obtain a set of valid, reproducible data.
Airway inflammation: NO in exhaled air (feNO)
The analysis of exhaled NO provides information on presence and severity of allergic airway
inflammation in airways disease such as allergic asthma and allergic rhinitis. Exhaled
NO (FeNO) is the only currently available measure of specific airway inflammation that is
rapid and easily accessible (noninvasive) and at the same time rather informative. Determination
of exhaled NO at an expiratory flow rate of 50 mL/s is clinically established and
accepted 617, 618 .
Measurement of exhaled NO is simple, quick to perform, and shows good reproducibility 619-621 ,
and thus has been applied in several epidemiologic studies 617, 622-624 . Available SOPs provide
for highly standardized measurements 618 to be performed in a multicenter study setting.
Procedure of measurement:
The NIOX ® Flex (Aerocrine) device will be used to measure NO in exhaled air. After having
placed the filter in the mouth, subjects will be asked to inhale to total lung capacity NO-free
A.3