As cannabis use among older adults continues to rise, clinicians are increasingly tasked with navigating its complex health implications. While some seniors report benefits such as pain relief and improved sleep, emerging research underscores the need for cautious, individualized care due to potential risks.
A study published in JAMA Neurology found that individuals aged 45 and older who had emergency medical visits related to cannabis use faced a 23% higher risk of developing dementia within five years compared to those hospitalized for other reasons. The risk was even higher—72%—when compared to the general population. Researchers suggest that cannabis may directly affect brain structure or indirectly contribute to dementia risk through associated factors like depression, high blood pressure, brain injuries, and social isolation.
Physiological changes associated with aging can amplify cannabis's effects. Older adults metabolize cannabis more slowly, and increased body fat can lead to prolonged THC retention. This can heighten the risk of side effects such as dizziness, confusion, and impaired coordination, increasing the likelihood of falls. Additionally, cannabis may interact with medications commonly prescribed to older adults, necessitating thorough medication reviews before initiating cannabis use.
Despite these risks, some studies highlight potential benefits. A multi-site, prospective study involving patients over 50 reported clinically significant improvements in pain, sleep, and quality of life, along with reductions in the use of other medications. No serious adverse events were reported, suggesting that, under medical supervision, cannabis could be a relatively safe therapeutic option for certain older adults.
Given the nuanced effects of cannabis in older populations, healthcare providers should adopt a personalized approach. This includes comprehensive screening for cardiovascular, respiratory, and mental health risks, as well as careful consideration of potential drug interactions. Educating patients about the risks and benefits, starting with low doses, and choosing appropriate administration methods are crucial steps in minimizing harm and optimizing therapeutic outcomes.