Actigraphy data is acquired using a Philips Respironics Actiwatch 2 which is the size of a standard wristwatch. The unit is given to the participant on the morning of the first visit; they are asked to ware it on their non-dominant wrist and asked to wear it until they return for their second visit. Actigraphy data is obtained for a minimum of 24 hours and up to 1 week, depending on how far apart a participant’s first and second visits are. Participants were asked to wear the actigraphy unit continuously (unit is waterproof) and asked to press the event marker button right before they are about to go to sleep. Movement is recorded through an accelerometer and is analyzed with standard actigraphy software to obtain activity counts over time.

Note: Actigraphy data is acquired from all participants ages 6-85 years old.

References: Gironda, R. J., Lloyd, J., Clark, M. E., & Walker, R. L. (2007). Preliminary evaluation of reliability and criterion validity of actiwatch-score. J Rehabil Res Dev, 44(2), 223-30.

Bike Test

The 6MBK is a simple test that requires a recumbent stationary bicycle. The level of resistance is determined by the age and gender of each participant. The participant is seated on a bike and resting heart rate is obtained. Participant pedals at 70 RPM’s for 6 minutes and heart rate is obtained again. If participant fails to complete the full 6 minutes of pedaling at 70 RPM’s, failure time and heart rate is obtained. This test evaluates the global and integrated responses of all the systems involved during exercise, including the pulmonary and cardiovascular systems, systemic circulation, peripheral circulation, blood, neuromuscular units, and muscle metabolism.

Note: This assessment is administered to all participants ages 6-85 years old unless there are circumstances preventing participant from riding stationary bike (e.g., injured joints, bike is too large for young children).


Astrand P.O., & Ryhming I. (1954). A nomogram for calculation of aerobic capacity from pulse rate during submaximal work. Journal of Applied Physiology, 7, 218 –22.

Legge BJ, Banister EW. (1986). The Astrand-Ryhming momogram revisited. Journal of Applied Physiology, 61, 1203–1209.

Blood Collection

A fasting blood draw is collected for the purpose of obtaining a genetic sample and the following panels: chemistry-7, TSH, T4, lead testing, hemogram, capillary blood glucose and lipid panel.

Note: Blood samples are obtained from all participants ages 6-85 years old.

Edinburgh Handedness Questionnaire (EHQ) – modified by Mark Cohen in 2008

The Edinburgh Handedness Questionnaire is a measurement scale used to assess the dominance of a person’s right or left hand in everyday activities. The inventory can be used by an observer assessing the person, or by a person self-reporting hand use. The EHQ includes a list of activities, and asks the participant to indicate “which hand you prefer for that activity?” and “do you ever use the other hand for that activity?” This questionnaire was updated by Mark Cohen in 2008, and is adapted from Oldfield, 1971 – see Publication.

Note: This modified version of the original EHQ is a 15-item assessment that is given to all participants, ages 6-85 years old.

References: See for modified version which was adapted from Oldfield, R.C. (1971). The assessment and analysis of handedness: The Edinburgh inventory. Neuropsychologia, 9(1), 97-113.

Grip Strength

Grip strength is assessed using a JAMAR Plus Digital Hand Dynamometer. The participant is asked to sit in a chair with their shoulder abducted and neutrally rotated, elbow flexed at 90 degrees, and forearm in neutral position. They are asked to hold and squeeze the Digital Hand Dynamometer starting in their left hand then alternating to the right hand and repeating this process twice. The score is recorded in kilograms.

Note: This will be administered with all participants, ages 6-85 years old.

References: Sammons Preston Roylan. JAMAR Hydraulic Hand Dynamometer Owner’s Manual. Chicago, IL: Sammons Preston Roylan, 2003.


All vitals are obtained and recorded by study staff. Height, waist measurement, and hip measurement are all recorded in centimeters. Weight is recorded in kilograms. Body Mass Index (BMI) is automatically calculated. The systolic and diastolic blood pressures are both taken with a mercury blood pressure gauge, cuff, and stethoscope. Pulse is taken by counting the number of beats felt on the radial artery for 30 seconds, multiplied by 2.

Note: These measurements are obtained from all participants, ages 6-85 years old.

International Physical Activity Questionnaire (IPAQ)

The purpose of the International Physical Activity Questionnaires (IPAQ) is to provide a set of well-developed instruments that can be used internationally to obtain comparable estimates of physical activity. This questionnaire asks the participant about time spent being physically active in the last 7 days, and includes activities that are done at work, as part of house and yard work, getting from place to place, and in spare time for recreation, exercise, and sport. The participant is asked about time spent in vigorous physical activities (referring to activities that take hard physical effort and make you breathe much harder than normal) and moderate activities (referring to activities that take moderate physical effort and make you breathe somewhat harder than normal). The participant is asked to indicate how many days in the last week were spent in either vigorous or moderate activities as part of each aspect of their lives, and further asked to indicate how much time is spend on those activities each day (in hours and minutes).

Note: This self-assessment is given to participants ages 15-85 years old.

References: Craig, C.L., et al. (2003). International Physical activity questionnaire: 12-country reliability and validity. Medicine and Science in Sports & Exercise, 35(8), 1381-1395.

Ishihara’s Test for Color Deficiency

The Ishihara’s Test for Color Deficiency is a clinician-administered assessment of color vision deficiency of congenital origin. The short test consists of 24 plates designed to identify individuals with red-green color vision deficiencies. It distinguishes among people with normal color vision, partial or complete protan type deficiency and partial or complete deutan type deficiency.

Note: The first 17 plates of this assessment are administered to all participants ages 6–85 years old.

References: Ishihara, S. The Series of Plates Designed as a Test for Colour-Deficiency. Tokyo, Japan: Kanehara Trading Inc. (1936).


Blood and urine samples are sent to the Office of Mental Health (OMH) Clinical Laboratories at the Nathan S. Kline Institute for Psychiatric Research. The OMH Clinical Laboratory is a full service clinical laboratory, performing much of the routine lab work for Office of Mental Health (OMH) facilities. Specimens are collected at each facility, pre-processed and transported via couriers to the OMH Clinical Laboratories. Once testing is complete and results verified, the reports are returned by computer. The OMH Clinical Laboratory is accredited by the New York State Department of Health (DOH), [Permit # PFI//; 2283, Code 4395M010], the Health Care Financing Administration (HCFA), [CLIA ID# 33D0142107], the College of American Pathologists (CAP), [Laboratory # 26380-01] and is certified by both Medicare [Provider # 33L008708] and Medicaid [Provider # D1367642]. For further information and inquiries about the OMH Clinical Laboratory, contact Dr. Hilbert at (845) 398-5566 or by FAX at (845) 398-5568.

Note: Labs are obtained for all participants ages 6-85 years old who have been able to successfully provide a blood and/or urine sample.

Physical Activity Scale for the Elderly (PASE)

A physical activity questionnaire developed with a grant from the U.S National Institute on Aging designed to assess current level of activity (occupational, household and leisure) of community dwelling older persons, aged 65 and older, through self report of a one week period. The adult is asked how many days per week, and how much time was spent in each activity over the past week, graded in four categories: less than one hour, one but less than two hours, two to four hours, and more than four hours. The measure was designed for epidemiological studies and exercise interventions. For scoring interpretation, the amount of time spent in each activity is multiplied by PASE item weights and then all scores are added together for a final PASE score. A high score indicates a high level of physical activity.

Note: Typically this assessment is given to adults aged 65 and older. In our study we start at age 38. For participants under 65, we will use the data to validate the PASE against the obtained VO2 max measurement.

References: Hagiwara, A., Ito, N., Sawai, K., & Kazuma, K. (2008). Validity and reliability of the Physical Activity Scale for the Elderly (PASE) in Japanese people. Geriatrics & Gerontology International, 8, 143-151.

Schuit, A. J., Schouten, E. G., Westerterp, K. R., & Saris, W. H. (1997). Validity of the Physical Activity Scale for the Elderly (PASE): According to energy expenditure assessed by the doubly labelled water method. Journal of Clinical Epidemiology, 50(5), 541- 546.

Washburn, R. A., Smith, K. W., Jette, A. M., & Janney, C. A. (1993). The Physical Activity Scale for the Elderly (PASE) : Development and evaluation. Journal of Clinical Epidemiology, 46(2), 153-162.

Washburn, R. A., McAuley, E., Katula, J., Mihalko, S. L., & Boileau, R. A. (1999). The Physical Activity Scale for the Elderly (PASE): Evidence for validity. Journal of Clinical Epidemiology, 52(7), 643- 651.


The Tanner scale is administered to children and adolescents to assess sexual maturity or pubertal development. There are two components of Tanner staging described for each sex, rated separately on a scale of one to five, where stage one is pre-puberty and stage five is adult maturity. For girls, staging is based on breast maturation and pubic hair growth, while for boys it is based on penis and testes development and pubic hair growth.

Note: This assessment is administered with all child participants, ages 6-17 years old.


Marshall, W. A., Tanner, J., M. (1970). Variations in pattern of pubertal changes in boys. Archives of Disease in Childhood, 45 (239), 13.

Marshall W.A., Tanner J.M. (1996). Variations in pattern of pubertal changes in girls. Archives of Disease in Childhood, 44, 291-303.