This ultrasound examination provides information about the function of the heart and can detect changes such as enlargement of the heart chambers or thickening of the heart muscle. The measurements are performed in both two and three dimensions.

This examination assesses the area where the carotid arteries divide. The thickness of the vessel wall (intima-media thickness) is measured, which can provide information about early vascular changes (atherosclerosis) and high blood pressure. The area is also examined for calcified deposits (plaques) and narrowing of the blood vessels.

Various methods are used to assess the stiffness and elasticity of the arteries. Arterial stiffness is a sensitive early indicator of the development of cardiovascular disease.

This examination assesses the arteries in your legs for signs of impaired blood circulation.

The condition of the superficial veins in the legs is documented and assessed using photographs. Both legs are also examined for the presence of oedema (fluid accumulation).

This examination assesses your lung function by asking you to breathe deeply in and out several times through the tube of a measuring device.

Your blood pressure is measured several times under standardised conditions to determine whether there are any indications of high blood pressure. Your resting heart rate is also recorded.

An ECG is used to record the electrical activity of your heart.

Your height, weight, and leg, abdominal and waist circumference are measured. Muscle mass and skinfold thickness are also assessed.

As part of the study, various body fluids (biomaterials/samples) are collected. This includes a venous blood sample of up to 140 mL of blood (approximately one quarter of a standard blood donation) and approximately 15 mL of urine. A range of routine laboratory parameters and a complete blood count are determined from part of the samples and included in your medical report. After appropriate processing, the remaining blood and urine samples are stored frozen in secure facilities of the Gutenberg Health Study or in the biobank of the University Medical Center Mainz for future analyses.

To assess your health status and blood count, all medications that you take regularly or have taken as needed during the previous four weeks are recorded online before your visit to the study centre.

As part of a computer-assisted personal interview and various digital questionnaires, which you can complete on a computer, tablet or smartphone, you will be asked about a range of known and suspected factors that may influence your health. These include questions about your lifestyle, potential health-related factors in your home and working environment, and your use of medical services.

Your hearing is assessed in a specially designed soundproof room, where hearing and speech recognition tests are performed.

Your hand grip strength is measured to assess muscle function.

The entire surface of your skin is photographed, and the moisture level of the skin on your arm is measured. The aim is to identify skin conditions as well as signs or risks of internal diseases through analysis of the skin. Images containing personally identifiable features, such as photographs of the face, are stored separately and with additional protection.

This examination includes testing your visual acuity and measuring refractive power, corneal thickness, eye length and intraocular pressure. Your visual field is also tested, and images of the eye and the back of the eye are taken. To obtain certain images, eye drops are administered to one eye to prevent the pupil from constricting. The effects of the eye drops will usually have worn off by the end of the examination programme. However, you should only participate in road traffic again once you no longer feel that your vision is impaired.

Ultrasound and elastography of the abdominal region are used to obtain information on various health-related aspects, such as fatty changes, affecting organs including the kidneys, liver and spleen. Elastography is an advanced ultrasound technique used to measure tissue stiffness or elasticity. An ultrasound examination of the abdominal aorta is also performed to identify signs of abnormalities such as aneurysms (enlargements) or plaques (deposits).

As part of the neurocognitive assessment, a series of short computer-based tests are performed to assess cognitive function, including processing speed, memory and attention.

A tuning fork test is used to assess your ability to perceive vibrations.

Your sense of smell is assessed using a short smell test.

Approximately 0.1 mL of tear fluid is collected using an absorbent paper strip. After appropriate processing, the tear fluid is stored frozen in secure facilities of the Gutenberg Health Study or in the biobank of the University Medical Center Mainz for future analyses.

Before your visit to the study centre, we will send you information and the materials required to collect a stool sample. The stool sample can be used to study the microbiome, which refers to the entirety of bacteria present in the gut. As there is currently not enough knowledge about the microbiome to provide medically relevant individual results, this analysis is initially conducted solely for research purposes. As with the other samples, the stool samples are appropriately processed and stored in the biobank of the University Medical Center Mainz for future analyses.

To assess your physical abilities, we perform tests including a walking test and a sit-to-stand test. This examination is only performed in people over 44 years of age.

To assess your physical activity and mobility in everyday life, we will provide you with an activity monitor that is attached to your lower back using a transparent waterproof patch. The device records your everyday physical activity for seven days. To distinguish between activity during leisure time and work, we also ask you to record the start and end of your working hours each day on an accompanying form. At the end of the measurement period, you can return the activity monitor and the accompanying form to us free of charge.

The MRI examination is performed on a separate day at the Neuroimaging Center (NIC) of the University Medical Center Mainz. The MRI examination is optional and is not required for participation in the study.