Open Library Archives of Kagawa University (OLIVE)
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Elderly Labor and Fertility
Full text linkThis paper investigates the impact of elderly labor contribution rates on fertility. A key feature of the model is the dual role of elderly individuals , who both receive pension benefits and actively participate in the labor market , contributing to social insurance. Within this framework, the study theoretically examines how an increase in the social insurance contribution rate for elderly workers affects fertility outcomes.
The findings indicate that the effect of elderly social insurance contributions on fertility is contingent on the cost of raising children in the economy. In economies with high child-rearing costs, the participation of elderly workers in social insurance contributions can enhance fertility by alleviating the financial burden on younger house holds through increased child allowances. In cont rast , in economies with relatively low
child-rearing costs , such contributions may reduce fertility , as the perceived reduction in net labor income during old age significantly influences younger households' decisions, leading to fewer children being planned during their working years.departmental bulletin pape
Association between Polypharmacy and Adverse Events in Patients with Alzheimer's Disease: An Analysis of the Japanese Adverse Drug Event Report Database (JADER)
Full text link香川大学Kagawa University博士（医学）Background and Objectives: Alzheimer's disease is a global health concern, with a rising prevalence among the elderly. Current pharmacological treatments, including acetylcholinesterase inhibitors (AChEIs) and N-Methyl D-Aspartate (NMDA) receptor antagonists, are associated with adverse events (AEs), particularly in the context of polypharmacy. This study aimed to investigate the relationship between Alzheimer's disease treatment combinations, the number of concomitant medications, and the occurrence of AEs. Materials and Methods: Data from the Japanese Adverse Drug Event Report database, spanning from April 2004 to June 2020, were analyzed. Patients aged 60 and older with Alzheimer's disease treated with AChEIs (donepezil, galantamine, and rivastigmine) or the NMDA receptor antagonist memantine were included. Logistic regression models were employed to assess the association between AEs and Alzheimer's disease drug combinations, as well as the number of concomitant medications. Results: Among 2653 patients, 47.7% were prescribed five or more drugs. The frequency of AEs was 6.4% for bradycardia, 4.6% for pneumonia, 3.6% for altered state of consciousness, 3.5% for seizures, 3.5% for decreased appetite, 3.5% for vomiting, 3.4% for loss of consciousness, 3.4% for fracture, 3.2% for cardiac failure, and 3.0% for falls. The combination of memantine with AChEIs was associated with a higher risk of bradycardia, whereas donepezil alone was linked to a reduced risk of fractures and falls. Polypharmacy was significantly correlated with an increased incidence of AEs, particularly altered state of consciousness, decreased appetite, vomiting, and falls. The adjusted odds ratios for using five or more drugs compared to no drugs was 10.45 for altered state of consciousness, 7.92 for decreased appetite, 4.74 for vomiting, and 5.95 for falls. Conclusions: In the treatment of Alzheimer's disease, the occurrence of AEs is associated with the number of concurrent medications, independently of the known AEs of Alzheimer's disease drugs and their combination patterns.doctoral thesi
