Assessing Planning Ability Across the Adult Life Span in a Large Population-Representative Sample: Reliability Estimates and Normative Data for the Tower of London (TOL-F) Task

AbstractObjectives:The Tower of London (TOL) test has probably become the most often used task to assess planning ability in clinical and experimental settings. Since its implementation, efforts were made to provide a task version with adequate psychometric properties, but extensive normative data are not publicly available until now. The computerized TOL-Freiburg Version (TOL-F) was developed based on theory-grounded task analyses, and its psychometric adequacy has been repeatedly demonstrated in several studies but often with small and selective samples.Method:In the present study, we now report reliability estimates and normative data for the TOL-F stratified for age, sex, and education from a large population-representative sample collected in the Gutenberg Health Study in Mainz, Germany (n=7703; 40–80 years).Results:The present data confirm previously reported adequate indices of reliability (>.70) of the TOL-F. We also provide normative data for the TOL-F stratified for age (5-year intervals), sex, and education (lowvs. high education).Conclusions:Together, its adequate reliability and the representative age-, sex-, and education-fair normative data render the computerized TOL-F a suitable diagnostic instrument to assess planning ability. (JINS, 2019,25, 520–529)

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Assessing Planning Ability Across the Adult Life Span: Population-Representative and Age-Adjusted Reliability Estimates for the Tower of London (TOL-F)

Archives of Clinical Neuropsychology ◽

10.1093/arclin/acv088 ◽

2015 ◽

pp. acv088 ◽

Cited By ~ 6

Author(s):

Christoph P. Kaller ◽

Rudolf Debelak ◽

Lena Köstering ◽

Johanna Egle ◽

Benjamin Rahm ◽

...

Keyword(s):

Life Span ◽

Adult Life ◽

Tower Of London ◽

Adult Life Span ◽

Reliability Estimates ◽

Planning Ability

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High-sensitivity cardiac troponin I in the general population – defining reference populations for the determination of the 99th percentile in the Gutenberg Health Study

Clinical Chemistry and Laboratory Medicine (CCLM) ◽

10.1515/cclm-2014-0619 ◽

2015 ◽

Vol 53 (5) ◽

Cited By ~ 37

Author(s):

Tanja Zeller ◽

Francisco Ojeda ◽

Fabian J. Brunner ◽

Philipp Peitsmeyer ◽

Thomas Münzel ◽

...

Keyword(s):

Myocardial Infarction ◽

General Population ◽

Cardiac Troponin ◽

Troponin I ◽

Large Population ◽

High Sensitivity ◽

Reference Population ◽

Health Study ◽

Cardiac Abnormalities ◽

Gutenberg Health Study

AbstractThe 99th percentile of cardiac troponin levels, determined in a reference population, is accepted as threshold for diagnosis of acute myocardial infarction (AMI). However, there is no common consensus of how to define the reference population. The aim of the present study was to determine 99th percentile reference values, determined by a high-sensitivity assay (hsTnI), according to different health status and cardiovascular risk factor prevalence in a large population-based sample.Troponin I was determined using the Abbott ARCHITECT STAT highly sensitive troponin I immunoassay in 4138 participants of the Gutenberg Health Study.hsTnI was detectable in 81.6% of all individuals. The 99th percentile of the overall population was 27 ng/L. Age and gender had a prominent influence on these values. Exclusion of individuals with elevated natriuretic peptide levels or cardiac abnormalities resulted in lower 99th percentile values, whereas exclusion of individuals with an impaired estimated glomerular filtration rate (eGFR) or with prevalent coronary artery disease/myocardial infarction (CAD/MI) did not result in a meaningful change.Troponin I, measured by a high-sensitivity assay, can be reliably detected in the vast majority of the general population. hsTnI values were dependent on age, gender as well as structural and functional cardiac abnormalities.

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Sex-specific differences in genetic and nongenetic determinants of mean platelet volume: results from the Gutenberg Health Study

Blood ◽

10.1182/blood-2015-07-660308 ◽

2016 ◽

Vol 127 (2) ◽

pp. 251-259 ◽

Cited By ~ 29

Author(s):

Marina Panova-Noeva ◽

Andreas Schulz ◽

M. Iris Hermanns ◽

Vera Grossmann ◽

Evgenia Pefani ◽

...

Keyword(s):

Mean Platelet Volume ◽

Large Population ◽

Population Based ◽

Health Study ◽

Platelet Volume ◽

Population Based Study ◽

Risk Of Death ◽

Gutenberg Health Study ◽

Key Points ◽

Males And Females

Key Points Genetic and nongenetic determiners of MPV substantially differ between males and females in a large population-based study. MPV in males is significantly determined by the traditional CVRFs, and males with higher MPV are at higher risk of death.

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DECLINE IN INSULIN-LIKE GROWTH FACTOR-I LEVELS ACROSS ADULT LIFE SPAN IN TWO LARGE POPULATION STUDIES

The Journals of Gerontology Series A ◽

10.1093/gerona/61.2.182 ◽

2006 ◽

Vol 61 (2) ◽

pp. 182-183 ◽

Cited By ~ 22

Author(s):

Marcello Maggio ◽

Alessandro Ble ◽

Gian Paolo Ceda ◽

E. Jeffrey Metter

Keyword(s):

Growth Factor ◽

Life Span ◽

Population Studies ◽

Large Population ◽

Adult Life ◽

Insulin Like Growth Factor ◽

Adult Life Span ◽

Factor I ◽

Growth Factor I

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Distribution of antiphospholipid antibodies in a large population-based German cohort

Clinical Chemistry and Laboratory Medicine (CCLM) ◽

10.1515/cclm-2016-0014 ◽

2016 ◽

Vol 54 (10) ◽

Cited By ~ 10

Author(s):

Davit Manukyan ◽

Heidi Rossmann ◽

Andreas Schulz ◽

Tanja Zeller ◽

Norbert Pfeiffer ◽

...

Keyword(s):

Antiphospholipid Antibodies ◽

Reference Group ◽

Large Population ◽

Population Based ◽

Health Study ◽

Reference Ranges ◽

Clinical Criteria ◽

Gutenberg Health Study ◽

Age Dependent ◽

History Of

AbstractBackground:Antiphospholipid syndrome (APS) is the most common acquired thrombophilia. Diagnosis is based on clinical criteria and the presence of antiphospholipid antibodies (aPLs) above the 99th percentile of a reference group. Data on the distribution of aPL in the population are limited. The distribution of aPL including diagnostic cutoffs should be determined in a population-based cohort.Methods:The Gutenberg Health Study (GHS) is a population-based cohort aged 35–74 years. We determined the presence of antibodies against cardiolipin (aCL, IgG, and IgM), βResults:aPL titers were similar in the whole sample and in an apparently healthy subgroup of 1049 individuals. There was a strong age-dependent increase of both aCL and anti-β2GPI IgM, while aPL IgG titers were stable or tended to decrease with age. A relevant decrease was observed for aCL IgG in women and anti-domain 1 IgG in both sexes. There was no association of aPL titers with a history of venous thromboembolism (VTE).Conclusions:Our data show that for IgM aPL, age-dependent reference ranges should be used. In fact, the controversy regarding the clinical utility of IgM aPL might be related to the use of inappropriate reference ranges among other causes. In our population, aPLs were not associated with a history of VTE.

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Cross-Sectional Associations between Homoarginine, Intermediate Phenotypes, and Atrial Fibrillation in the Community—The Gutenberg Health Study

Biomolecules ◽

10.3390/biom8030086 ◽

2018 ◽

Vol 8 (3) ◽

pp. 86 ◽

Cited By ~ 2

Author(s):

Christoph Niekamp ◽

Dorothee Atzler ◽

Francisco Ojeda ◽

Christoph Sinning ◽

Karl Lackner ◽

...

Keyword(s):

Atrial Fibrillation ◽

Left Atrial ◽

Large Population ◽

Population Based ◽

Health Study ◽

Cross Sectional ◽

Standard Deviation Increase ◽

Gutenberg Health Study ◽

Intermediate Phenotypes ◽

Increased Risk

Homoarginine has come into the focus of interest as a biomarker for cardiovascular disease. Atrial fibrillation (AF) causes a substantial increase in morbidity and mortality. Whether circulating homoarginine is associated with occurrence or persistence of AF and may serve as a new predictive biomarker remains unknown. We measured plasma levels of homoarginine in the population-based Gutenberg health study (3761 patients included, of them 51.7% males), mean age 55.6 ± 10.9 years-old. Associations between homoarginine and intermediate electrocardiographic and echocardiographic phenotypes and manifest AF were examined. Patients with AF (124 patients, of them 73.4% males) had a mean age 64.8 ± 8.6 years-old compared to a mean age of 55.3 ± 10.9 in the population without AF (p-value < 0.001) and showed a less beneficial risk factor profile. The median homoarginine levels in individuals with and without AF were 1.9 μmol/L (interquartile range (IQR) 1.5–2.5) and 2.0 μmol/L (IQR 1.5–2.5), respectively, p = 0.56. In multivariable-adjusted regression analyses homoarginine was not statistically significantly related to electrocardiographic variables. Among echocardiographic variables beta per standard deviation increase was −0.12 (95% confidence interval (CI) −0.23–(−0.02); p = 0.024) for left atrial area and −0.01 (95% CI −0.02–(−0.003); p = 0.013) for E/A ratio. The odds ratio between homoarginine and AF was 0.91 (95% CI 0.70–1.16; p = 0.45). In our large, population-based cross-sectional study, we did not find statistically significant correlations between lower homoarginine levels and occurrence or persistence of AF or most standard electrocardiographic phenotypes, but some moderate inverse associations with echocardiographic left atrial size and E/A. Homoarginine may not represent a strong biomarker to identify individuals at increased risk for AF. Further investigations will be needed to elucidate the role of homoarginine and cardiac function.

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Subclinical levels of anxiety but not depression are associated with planning performance in a large population-based sample

Psychological Medicine ◽

10.1017/s0033291717002562 ◽

2017 ◽

Vol 48 (1) ◽

pp. 168-174 ◽

Cited By ~ 4

Author(s):

J. M. Unterrainer ◽

K. Domschke ◽

B. Rahm ◽

J. Wiltink ◽

A. Schulz ◽

...

Keyword(s):

Linear Regression Analysis ◽

Large Population ◽

Affective State ◽

Multiple Linear Regression Analysis ◽

Population Based ◽

Health Study ◽

Depression And Anxiety ◽

Gutenberg Health Study ◽

Age Range ◽

Negative Affective State

BackgroundMajor depression and anxiety disorders are known to negatively influence cognitive performance. Moreover, there is evidence for greater cognitive decline in older adults with generalized anxiety disorder. Except for clinical studies, complex executive planning functions and subclinical levels of anxiety have not been examined in a population-based sample with a broad age range.MethodsPlanning performance was assessed using the Tower of London task in a population-based sample of 4240 participants aged 40–80 years from the Gutenberg Health Study (GHS) and related to self-reported anxiety and depression by means of multiple linear regression analysis.ResultsHigher anxiety ratings were associated with lower planning performance (β = −0.20; p < 0.0001) independent of age (β = 0.03; p = 0.47). When directly comparing the predictive value of depression and anxiety on cognition, only anxiety attained significance (β = −0.19; p = 0.0047), whereas depression did not (β = −0.01; p = 0.71).ConclusionsSubclinical levels of anxiety but not of depression showed negative associations with cognitive functioning independent of age. Our results demonstrate that associations observed in clinical groups might differ from those in population-based samples, also with regard to the trajectory across the life span. Further studies are needed to uncover causal interrelations of anxiety and cognition, which have been proposed in the literature, in order to develop interventions aimed at reducing this negative affective state and to improve executive functioning.

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