Increased Likelihood of Falling in Older Cannabis Users vs. Non-Users

Abstract

Cannabis is one of the most common drugs in the United States and is the third most prevalent substance consumed by adults aged 50 years and older. Normal aging is associated with physiological changes that make older adults vulnerable to impaired function and geriatric conditions (e.g., falls, cognitive impairment). However, the impact of medical cannabis use on fall risk in older adults remains unexplored. The purpose of this study was to investigate if cannabis use in older adults influences fall risk, cognitive function, and motor function. It was hypothesized that older chronic cannabis users would perform worse than non-users on gait, balance, and cognitive tests. Sixteen older adults, split into cannabis Users and age- and sex-matched Non-Users groups (n = 8/group), participated in the study. The results indicate a higher fall risk, worse one leg standing balance performance, and slower gait speed in Users vs. Non-Users. No significant differences in cognitive function were found. Thus, chronic cannabis use was purported to exacerbate the poorer balance control and slower gait velocity associated with normal aging. Future mechanistic (e.g., neuroimaging) investigations of the short- and long-term effects of using a variety of cannabis products (e.g., THC/CBD ratios, routes of administration) on cognitive function, motor function, and fall incidence in older adults are suggested.

Disparity between Perceptual Fall Risk and Physiological Fall Risk in Older Cannabis Users: A Pilot Study

“…All subjects completed the testing as detailed above. As previously described [ 20 ], the results of the analysis indicated that perception of fall risk (i.e., ABC-1; Figure 1 A) and most of the measures of physiological fall risk (i.e., static posturography measures; Table 2 ) were not significantly different between the Users and the Non-Users ( p = 0.28–0.76; see Table 2 for effect size). However, the score on BBS-14 revealed that the Non-Users had a better balance performance than the Users ( p = 0.008, A = 0.89; Figure 1 B).…”

“…The methodology has been detailed previously [ 20 ] and only the information relevant for the present analysis will be addressed below. Importantly, the conditions/symptoms purportedly amenable to medical cannabis use are eclectic, with pain control as the most common [ 21 , 22 ].…”

“…Importantly, the conditions/symptoms purportedly amenable to medical cannabis use are eclectic, with pain control as the most common [ 21 , 22 ]. Given the novelty of investigating fall risk in older cannabis-using adults, our previous study [ 20 ], and by extension the present follow-up analysis, was broadly inclusive of all older cannabis users and did not emphasize or focus on a particular subgroup of users (e.g., those with chronic pain). Therefore, eight community-dwelling medical cannabis users (Users; median [range] = 60 (52–66) years) and eight sex- and age-matched controls (Non-Users; 61 (53–66) years; see Table 1 for additional subject characteristics) were recruited according to the following inclusion criteria: (a) 50–80 years of age, (b) healthy enough to complete the protocol based on information obtained from a clinical exam and past medical history, (c) part of the Iowa Medical Cannabidiol program (Users; any subjects with an approved condition for medical cannabis use were included) or have not used cannabis for ≥5 years (Non-Users), (d) able to comprehend the protocol, as indicated by the ability to respond to questions about the study after reading the consent form, (e) able to use and be contacted by telephone, and (f) able to speak, read, and understand English in order to complete a questionnaire in English.…”

“…In our recent study [ 20 ], we reported that older cannabis users had a higher likelihood of falling than older non-users. However, this analysis did not address whether differences in perceptual or physiological risk, or both together, might help explain this finding.…”

“…However, this analysis did not address whether differences in perceptual or physiological risk, or both together, might help explain this finding. Therefore, the purpose of this pilot study was to report the findings of a follow-up analysis of this dataset [ 20 ] to investigate possible discrepancies between perceptual and physiological fall risk in older cannabis users. It was hypothesized that older cannabis users would exhibit a poor perception of fall risk and have a higher physiological fall risk than non-users, indicating a disparity between the two concepts in the users group.…”