Table 4.
Evaluation of items included in the eVITAL toolkit(1).
| 1. Domain: health descriptors | ||
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| ||
| Evaluation | Instruments | |
| History—Level 0 | Sociodemographic inventory | |
| History—Level 1 | Family medical history | |
| Personal medical history | ||
| Medication, hormone use, and alternative treatments | ||
| Immunization history | ||
| History—Level 2 | ||
| History—Level 3 | ||
| Examination—Level 0 | ||
| Examination—Level 1 | ||
| Examination—Level 2 | ||
| Examination—Level 2 | ||
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| ||
| 2. Domain: cognition | ||
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| ||
| Evaluation | Instruments | |
| History—Level 0 | Screening for cognitive problems | |
| History—Level 1 | Cognitive reserve (CR) | |
| History—Level 2 | (i) Cognitive risk factors | |
| (ii) Cognitive reserve adjusted for cognitive risk (CRar) | ||
| (iii) Stage of change, objective [17] | ||
| History—Level 3 | Global cognitive reserve (gCR) | |
| Examination—Level 0 | ||
| Examination—Level 1 | ||
| Examination—Level 2 | 7-minute test [19, 20] | |
| Examination—Level 3 | (i) Luria's test [21] | |
| (ii) Benton's visual recognition test [22] | ||
| (iii) Trail making test-A (TMT-A) [23] | ||
| (iv) Finger electronic tapping test (FETT) [24] | ||
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| ||
| 3. Domain: vitalty and stress | ||
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| ||
| Evaluation | Instruments | |
| History—Level 0 | Screening for emotional state | |
| History—Level 1 | (i) Optimism-LOT-R: life orientation test-revised [25] | |
| (ii) Emotional stress—Questions 5–9, SF-36: social functioning-36 question scale [26, 27]/MHI-5. | ||
| (iii) Social isolation—STAKES [28] | ||
| (iv) Social support—Oslo [29] | ||
| (v) Anxiety/depression—HAD: hospital anxiety and depression scale [30] | ||
| History—Level 2 | (i) NEO Pi-R: revised NEO personality inventory [31] | |
| (ii) Psychological well-being [32, 33] | ||
| (iii) Sexuality quality of life: sexuality subscales [34, 35] | ||
| (iv) Stress—HAD [30, 36] | ||
| (v) Stage of change, objective [17] | ||
| History—Level 3 | (i) Social readjustment rating scale [37] | |
| (ii) Type A personality—ERCTA: escala retiro de patrón de conducta tipo A (scale of Type A behavior pattern) [38] | ||
| (iii) Aggression subscale—ZKPQ: Zuckerman-Kuhlman's personality questionnaire [39] | ||
| (iv) Obsessions—SPPI: standardized polyvalent psychiatric interview [40] | ||
| (v) Hypochondriasis—SPPI [40] | ||
| (vi) Gender-specific medical evaluation, including breast cancer risk assessment [41] | ||
| Examination—Level 0 | ||
| Examination—Level 1 | ||
| Examination—Level 2 | Basic allostatic load: blood pressure, waist-to-hip ratio, total/HDL cholesterol, HDL, glycated hemoglobin, CRP | |
| Examination—Level 3 | Expanded allostatic load: add DHEA-S and urinary cortisol | |
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| 4. Domain: sleep | ||
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| ||
| Evaluation | Instruments | |
| History—Level 0 | Screening for insomnia and hypersomnia | |
| History—Level 1 | (i) Insomnia—SPPI [40] | |
| (ii) Somnolence—Epworth sleepiness scale [42–44] | ||
| (iii) Specific sleep-related symptoms | ||
| (iv) Sleep habits | ||
| History—Level 2 | Stage of change, objective [17] | |
| History—Level 3 | ||
| Examination—Level 0 | ||
| Examination—Level 1 | ||
| Examination—Level 2 | ||
| Examination—Level 3 | Polysomnography | |
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| ||
| 5. Domain: diet and exercise | ||
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| ||
| Evaluation | Instruments | |
| Instruments DIET | Instruments EXERCISE | |
| History—Level 0 | Screening for change in appetite (SSPI) | Activity level |
| History—Level 1 | Eating habits | Exercise habits |
| Table of mealtimes | Exercise readiness—Par-Q: physical activity readiness questionnaire [45] | |
| Appetite-SPPI [40] | Fatigue-adapted SPPI [40] | |
| Subclassification BMI | Estimated METs | |
| Metabolic classification (combines weight status and activity level) (16 levels) | ||
| Classification as recommendations: 5 levels | ||
| Readiness to change—diet and exercise—subjective | Readiness to change—diet and exercise—objective | |
| History—Level 2 | CFCA-food frequency questionnaire [46] | |
| Digestive symptoms, food intolerance, dental problems | Musculoskeletal physical barriers to exercise | |
| Readiness to change—diet and exercise—objective | Readiness to change—diet and exercise—objective | |
| History—Level 3 | ||
| Examination—Level 0 | (i) Waist circumference | |
| (ii) Reported body mass index (BMI) from reported weight and height | ||
| Examination—Level 1 | (i) Body composition—subclassification BMI | |
| (ii) Waist-to-hip ratio | ||
| (iii) BMI adjusted for waist circumference [47], (BMIa) | ||
| Examination—Level 2 | (i) Basic lab work: total/HDL cholesterol, HDL, glycated hemoglobin, C-reactive protein, microalbumin, glucose, insulin | |
| (ii) Blood pressure, heart rate. | ||
| (iii) Adjusted BMI (for adult weight gain, triglyceride/HDL, blood pressure, fasting glucose, and presence or absence of sleep apnea and osteoarthritis (BMIar)) | ||
| (iv) Body composition (triceps skin fold), estimated muscle mass (arm circumference) | ||
| (v) Insulin resistance-HOMA-IR [48] | ||
| Examination—Level 3 | 3-day food record analyzed by nutritionist | Indirect METs calculated through compendium of physical activities—CPHA [49] |
| Hand strength via dynamometry | ||
| (i) Body composition via BIA or DEXA | (i) Somatometry | |
| (ii) Nutritional calculator | (ii) Ergometry | |
| (iii) Direct METs measurement | ||
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| 6. Domain: substance abuse | ||
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| Evaluation | Instruments | |
| History—Level 0 | Screening for substance abuse | |
| History—Level 1 | Inventory: use and abuse of prescription medications, use of caffeine, nicotine, alcohol, and illicit drugs | |
| Adapted CAGE questionnaire for each substance [50, 51] | ||
| Stage of change for each substance, subjective | ||
| History—Level 2 | (i) Stage of change for each substance, objective | |
| (ii) For smokers: Fagerström's test of nicotine dependence [52, 53] | ||
| History—Level 3 | ||
| Examination—Level 0 | ||
| Examination—Level 1 | ||
| Examination—Level 2 | ||
| Examination—Level 3 | Nicotine—CO-oximetry | |
| Alcohol—GGT, MCV | ||
| Drug levels in urine/blood/hair tests | ||
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| 7. Domain: other risk habits | ||
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| ||
| Evaluation | Instruments | |
| History—Level 0 | ||
| History—Level 1 | (i) Medication adherence. | |
| (ii) Inventory of risk behaviors: risky sexual behavior, dangerous sports, gambling, dangerous driving, potentially dangerous travel, internet/technology addiction. | ||
| (iii) Readiness to change—subjective | ||
| History—Level 2 | Readiness to change—objective | |
| History—Level 3 | ||
| Examination—Level 0 | ||
| Examination—Level 1 | ||
| Examination—Level 2 | ||
| Examination—Level 3 | ||
(1)All tests are fully described at the eVITAL webpage (http://www.longevidad.org/). References can be downloaded at http://www.longevidad.org/descargas/011anexo_bibliografia_final.pdf.
BIA: bioelectrical impedance analysis; CO: carbon monoxide; CRP: C-reactive protein; DEXA: dual-energy X-ray absorptiometry; GGT: gamma-glutamyl transpeptidase; HDL: high-density lipoprotein; HOMA: homeostatic model assessment; MCV: mean corpuscular volume; MHI: mental health index.