학술논문

A longitudinal study of cannabis use and risk for cognitive and functional decline among older adults with HIV
Document Type
article
Source
AIDS and Behavior. 27(10)
Subject
Public Health
Health Sciences
Behavioral and Social Science
Drug Abuse (NIDA only)
Clinical Research
Cannabinoid Research
Neurosciences
Infectious Diseases
Neurodegenerative
HIV/AIDS
Brain Disorders
Substance Misuse
Aging
Acquired Cognitive Impairment
2.1 Biological and endogenous factors
Aetiology
Mental health
Good Health and Well Being
Humans
Aged
Cannabis
Longitudinal Studies
HIV Infections
Hallucinogens
Cognition
Elderly
Marijuana
Memory
Cognitive decline
HIV
AIDS
Public Health and Health Services
Social Work
Public health
Language
Abstract
Cannabis use is rapidly increasing among older adults in the United States, in part to treat symptoms of common health conditions (e.g., chronic pain, sleep problems). Longitudinal studies of cannabis use and cognitive decline in aging populations living with chronic disease are lacking. We examined different levels of cannabis use and cognitive and everyday function over time among 297 older adults with HIV (ages 50-84 at baseline). Participants were classified based on average cannabis use: frequent (> weekly) (n = 23), occasional (≤ weekly) (n = 83), and non-cannabis users (n=191) and were followed longitudinally for up to 10 years (average years of follow-up = 3.9). Multi-level models examined the effects of average and recent cannabis use on global cognition, global cognitive decline, and functional independence. Occasional cannabis users showed better global cognitive performance overall compared to non-cannabis users. Rates of cognitive decline and functional problems did not vary by average cannabis use. Recent cannabis use was linked to worse cognition at study visits when participants had THC+ urine toxicology-this short-term decrement in cognition was driven by worse memory and did not extend to reports of functional declines. Occasional (≤ weekly) cannabis use was associated with better global cognition over time in older adults with HIV, a group vulnerable to chronic inflammation and cognitive impairment. Recent THC exposure may have a temporary adverse impact on memory. To inform safe and efficacious medical cannabis use, the effects of specific cannabinoid doses on cognition and biological mechanisms must be investigated in older adults.