Relationship Between Sleep Duration and Coronary Artery Disease in Older Adults

Purpose: Insomnia, a frequent geriatric syndrome, is thought to be linked with coronary artery disease and increased mortality. The aim of our study was to examine the relationship between sleep duration and coronary artery disease (CAD) and cardiovascular risk factors. Materials and Methods: In this study, patients who applied to the geriatric outpatient clinic for comprehensive geriatric assessment were retrospectively evaluated. Patients were divided into two groups according to the six hours of ideal sleep assumption: those who slept less than six hours and those who slept six hours or more. Results: A total of 2255 patients (age 72±6 years, 63.3% female) were included in this study. Patients who were sleeping less than 6 hours were older (14.4% vs. 10.3%; p=0.005) and most of them were female (69.5% vs. 60.2%; p<001). Coronary artery disease (31.9% vs. 25.9%; p= 0.003), falls (31.8% vs. 25.3%; p=0.002) and depression (25.7% vs. 21.3%; p=0.022) were more common, while hypertension ( 68.5% and 72.5%; p=0.049) were less common in the short sleep duration group. The regression analysis showed that short sleep duration was significantly associated with CAD (OR:1.39; 95% CI:1.14-1.7; p=0.001), falls history (OR:1.25; 95% CI:1.02-1.5; p=0.026), age (OR:1.01; 95% CI:1.01-1.04; p=0.001), male gender (OR:0.63; 95% CI:0.51-0.76; p<0.001), and hypertension (OR:0.74; %95 CI:0.6-0.9; p=0.003). Conclusion: Similar to the literature, CAD was observed more frequently in patients who slept less than 6 hours in our results. Considering this relationship between short sleep duration and CAD, it is important to question sleep duration in comprehensive geriatric assessment

Teaching geriatric medicine through gamification: a tool for enhancing postgraduate education in geriatric medicine

Background Polypharmacy is becoming increasingly common and all doctors must be prepared to manage it competently. Aims The aim of this project is to evaluate the feasibility and use of a novel gamification-based teaching intervention on polypharmacy among doctors undergoing advanced geriatric training. Among others, one of the learning goals for the students was to be able to describe the adherence to medication. Methods Electronic questionnaire sent to students of the third session “evidence-based medicine in geriatrics” of advanced postgraduate course in geriatrics of the European Academy for Medicine of Ageing. Results Most students reported issues with forgetting doses and remembering sufficiently to establish a medication routine due to busy schedules as well as social influences around medication taking. Reflecting on the challenges of the game, most students reported that their own prescribing practice was likely to change. Discussion and conclusion The current model of learning appears to be a feasible approach for postgraduate medical education or in other areas of healthcare such as nursing or physiotherapy. Learning through action and reflection promotes deeper thinking and can lead to behavioral change, in this case thus enhancing the attitudes and understanding regarding pharmacological issues associated with ageing. Recommendations for future research in medical education about medication adherence are outlined.publishedVersio