Mental Health and Cognition in Older Cannabis Users: a Review

Vacaflor, Blanca; Beauchet, Olivier; Jarvis, G. Eric; Schavietto, Alessandra; Rej, Soham

doi:10.5770/cgj.23.399

Cited by 19 publications

(15 citation statements)

References 40 publications

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“…Despite these limitations, three reviews have summarized findings on cannabis use and cognition in samples that include older adults. One recent review of cannabis use in older adults (Vacaflor et al, 2020) found that 17.5% of participants across seven studies (three prospective observational studies, one retrospective survey, and three double-blind randomized controlled trials) reported SMC, although study authors concluded that low-dose, short-term medical cannabis use was generally well tolerated in older adults and did not confer significant risk for adverse cognitive outcomes. These findings were similar to a review of recreational and medical cannabis use in middle to older adulthood (Scott et al, 2019) that found modest reductions in cognitive performance associated with higher doses and heavier lifetime use of cannabis, although negative cognitive effects were less evident in older adults using medical cannabis.…”

Section: Introductionmentioning

confidence: 99%

The association between cannabis use and subjective memory complaints in older adults in the United States

Mulhauser

Hampstead

Coughlin

et al. 2023

J Int Neuropsychol Soc

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Objective: The U.S. population is aging and increasing numbers of older adults are using cannabis. Cognitive decline is common in older age and subjective memory complaints (SMC) have been associated with increased risk for dementia. While residual cognitive effects of cannabis use at younger ages are well understood, the links between cannabis use and cognition in older adults is less clear. The present study represents the first population-level analysis of cannabis use and SMC in older adults in the U.S. Method: We used the National Survey of Drug Use and Health (NSDUH) dataset to evaluate SMC in respondents over age 50 (N = 26,399) according to past-year cannabis use. Results: Results revealed that 13.2% (95%CI: 11.5%−15.0%) of those who reported cannabis use also reported SMC, compared to 6.4% (95%CI: 6.1%–6.8%) among individuals with no cannabis use. Logistic regression revealed a two-fold increase (OR = 2.21, 95%CI: 1.88–2.60) of reporting SMC in respondents who had used cannabis in the past year, which was attenuated (OR = 1.38, 95%CI: 1.10–1.72) when controlling for additional factors. Other covariates, including physical health conditions, misuse of other substances, and mental illness also significantly contributed to SMC outcomes. Conclusions: Cannabis use represents a modifiable lifestyle factor that has potential for both risk and protective properties that may impact the trajectory of cognitive decline in older age. These hypothesis generating results are important for characterizing and contextualizing population-level trends related to cannabis use and SMC in older adults.

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Section: Introductionmentioning

confidence: 99%

The association between cannabis use and subjective memory complaints in older adults in the United States

Mulhauser

Hampstead

Coughlin

et al. 2023

J Int Neuropsychol Soc

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“…32 There is also need for better characterization of the behavioral symptoms that may be most responsive to the effects of cannabinoid drugs, in addition to detailed profiling of compounds, doses, and treatment duration. 33,35 In the present study, we analyzed the available publications that were systematically retrieved from the literature according to the criteria established, using The level of evidence provided by the different studies will be discussed across the topics "efficacy," "safety/ tolerability," and "limitations. "…”

Section: Discussionmentioning

confidence: 99%

Medical cannabinoids for treatment of neuropsychiatric symptoms in dementia: a systematic review

Stella¹,

Valiengo²,

Paula³

et al. 2021

Trends Psychiatry Psychother

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Introduction: Neuropsychiatric symptoms are an integral component of the natural history of dementia, occurring from prodromal to advanced stages of the disease process and causing increased burden and morbidity. Clinical presentations are pleomorphic and clinical management often requires combinations of pharmacological and non-pharmacological interventions. However, limited efficacy and a non-negligible incidence of adverse psychotropic drug events emphasize the need for novel therapeutic options. Objectives: To review the evidence supporting use of medical cannabinoids for treatment of neuropsychiatric symptoms (NPS) of dementia. Methods: We conducted a systematic review of the medical literature to examine scientific publications reporting use of medical cannabinoids for treatment of NPS. Medical Subject Headings (MeSH) were used to search for relevant publications and only papers reporting original clinical information were included. A secondary search was performed within selected publications to capture relevant citations that were not retrieved by the systematic review. The papers selected were categorized according to the level of evidence generated by the studies in relation to this clinical application, i.e. (1) controlled clinical trials;(2) open-label or observational studies; and (3) case reports. Results: Fifteen publications with original clinical data were retrieved: five controlled clinical trials, three open-label/observational studies, and seven case reports. Most studies indicated that use of medical cannabinoids engendered favorable outcomes for treatment of NPS related to moderate and advanced stages of dementia, particularly agitation, aggressive behavior, sleep disorder, and sexual disinhibition. Conclusion: Medical cannabinoids constitute a promising pharmacological approach to treatment of NPS with preliminary evidence of benefit in at least moderate to severe dementia. Controlled trials with longitudinal designs and larger samples are required to examine the long-term efficacy of these drugs in different types and stages of dementia, in addition to their adverse events and risk of interactions with other drugs. Many pharmacological details are yet to be determined, such as dosing, treatment duration, and concentrations of active compounds (e.g., cannabidiol [CBD]/ Δ 9 -tetrahydrocannabinol [THC] ratio) in commercial preparations of medical cannabinoids.

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“…This apparent effectiveness is not without caveat; although prior studies suggest short-term side effects are minimal,27 abuse and dependence are well-documented. Furthermore, certain populations, specifically pregnant women, children and teenagers, and people with mental illness may be at greater risk of negative consequences from cannabis 37,38. Research suggests cannabis use has been increasing among pregnant women39 and likely among children as well, given its widespread availability.…”

Section: Discussionmentioning

confidence: 99%

The Effectiveness of Common Cannabis Products for Treatment of Nausea

Stith

Orozco³

et al. 2021

Journal of Clinical Gastroenterology

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Goals: We measure for the first time how a wide range of cannabis products affect nausea intensity in actual time. Background: Even though the Cannabis plant has been used to treat nausea for millennia, few studies have measured real-time effects of common and commercially available cannabis-based products. Study: Using the Releaf App, 886 people completed 2220 cannabis self-administration sessions intended to treat nausea between June 6, 2016 and July 8, 2019. They recorded the characteristics of self-administered cannabis products and baseline symptom intensity levels before tracking real-time changes in the intensity of their nausea. Results: By 1 hour postconsumption, 96.4% of people had experienced symptom relief with an average symptom intensity reduction of −3.85 points on a 0 to 10 visual analog scale (SD=2.45, d=1.85, P<0.001). Symptom relief was statistically significant at 5 minutes and increased with time. Among product characteristics, flower and concentrates yielded the strongest, yet similar results; products labeled as Cannabis indica underperformed those labeled as Cannabis sativa or hybrid; and joints were associated with greater symptom relief than pipes or vaporizers. In sessions using flower, higher tetrahydrocannbinol and lower cannabidiol were generally associated with greater symptom relief (eg, within 5 min). Conclusions: The findings suggest that the vast majority of patients self-selecting into cannabis use for treatment of nausea likely experience relief within a relative short duration of time, but the level of antiemetic effect varies with the characteristics of the cannabis products consumed in vivo. Future research should focus on longer term symptom relief, including nausea-free intervals and dosing frequency; the risks of consumption of medical cannabis, especially among high-risk populations, such as pregnant women and children; and potential interactions between cannabis, conventional antiemetics, other medications, food, tobacco, alcohol, and street drugs among specific patient populations.

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Mental Health and Cognition in Older Cannabis Users: a Review

Cited by 19 publications

References 40 publications

The association between cannabis use and subjective memory complaints in older adults in the United States

The association between cannabis use and subjective memory complaints in older adults in the United States

Medical cannabinoids for treatment of neuropsychiatric symptoms in dementia: a systematic review

The Effectiveness of Common Cannabis Products for Treatment of Nausea

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