6 ms·

Systematic Review of the Neurocognitive Effects of Cannabis Use in Older Adults (2019)

43 points by haltist 3y ago

deleted 3y ago
[deleted]
mtoner23 3y ago
Published in 2019
- navels 3y ago
  lol breaking news
jacobmarble 3y ago
> We conducted a comprehensive systematic search of the recent literature on cognitive outcomes associated with cannabis use and cannabinoids in adults age 50 and older. Although there is evidence of modest negative effects on cognition in this population, larger controlled trials using validated outcome measures are greatly needed to better understand the role of cannabinoids in cognitive aging, as small sample sizes and variability in study designs limit our ability to draw definitive conclusions at this time.
- InSteady 3y ago
  >Although variability in the cannabis products used, outcomes assessed, and study quality limits the conclusions that can be made, modest reductions in cognitive performance were generally detected with higher doses and heavier lifetime use. >However, larger methodologically rigorous trials and longitudinal studies that assess cognition prior to the initiation of cannabis use are greatly needed to infer a causal relationship. This need is highlighted by the fact that many negative effects on cognition that were reported by studies in this review decreased after adjusting for confounding variables (e.g., differences in premorbid IQ for users and nonusers). So heavy lifetime use and high doses may case modest cognitive impairment in older adults... or it is pure correlation, and perhaps older adults seeking strong relief have other things going on prior to heavy cannabis use that also cause cognitive impairment.
  - ltbarcly3 3y ago
    'Modest' just means you don't require a helper to perform every day tasks. It can be be very debilitating, but isn't 'Major' until you can't perform every day activities on your own. For further context, Trisomy 21 (Down Syndrome) is characterized as 'mild to moderate'. Modest: No interference with independence in everyday activities, although these activities may require more time and effort, accommodation, or compensatory strategies
    - InSteady 3y ago
      Greater context, which doesn't seem to line up well with your assertion here: > ...that higher doses and heavier use of cannabis are associated with modest negative effects. These findings are consistent with other systematic reviews and meta-analyses showing similar small adverse effects on cognition in younger populations. With that said, there was also evidence of modest improvements in subjective cognition on patient-reported outcome measures, particularly for medical cannabis users.
      - ltbarcly3 3y ago
        Because of a subjective improvement? I don't follow what you mean. People believe they are subjectively driving fine while hitting every mailbox due to being drunk.
DoingIsLearning 3y ago
> Several limitations must be considered when interpreting the evidence reviewed in this paper. First and foremost, medical and recreational use of cannabis are not the same and their effects on cognition should not be assumed to be equivalent. Adding to this variability are the different constituents of cannabis studied, including whole plant cannabis and isolated compounds. So much this. You need three way split studies (And perhaps different category naming). - +50 year varieties of cannabis - medical cannabis (Higher CBD, lower THC) - Modern dispensary cannabis (high THC) We keep selling the idea that bud is natural but ask anyone older than 60 who smokes and they will tell you 'modern' cannabis is absolutely wild compared with what existed a few decades ago. Anecdata I personally know someone in their early 20 who experienced a major psychotic event following regular heavy use of cannabis. The mental health and neural maturation of 13 to 25 yr old while consuming cannabis is something that also needs very urgent studying.
- InSteady 3y ago
  I am not an "older person" and I was smoking bud a few decades ago, thank you very much. Some of the stuff I got back then was categorically better than a great deal of the dispensary bud found today. Some of the cannabis cup winning strains from the mid 90's to mid 2000's would beat the pants off of the vast majority of mega-THC, mass produced strains sold in your average pot shop in terms of pleasant qualitative effects. It's wonderful to be able to take a few hits and hit the perfect high.. you smoke less bud, experience more of the pleasant effects with less of the mind-numbing, paranoia, and other unpleasant side-effects. In the 70's (and still today with trash-tier cannabis) people had to smoke tons to get any effect. I have done this with Mexican brick weed (purchased in Mexico). It is just straight up an inferior experience, there is nothing more safe or beneficial to smoking a butt load of crappy weed in order to get high. Also, it's kind of a myth that cannabis was terrible back in the 70's. A lot of it was, don't get me wrong. But selective breeding and sophisticated indoor growing techniques were developing at that time, so it was possible to get pretty damn good bud if you happened to know the right people. There is still plenty of outdoor 'Mexican brick weed' going around these days just like it was back in the 70's, and it's pure trash. And there is plenty of mediocre bud masquerading as "top shelf" going around today (including strains in dispensaries advertising astronomical and dubious THC percentages). As ever it takes a lot of time, expertise, equipment, and capital to produce truly great bud. Now if you start talking about distillates and concentrates, that is one area in which I agree there is a notable difference in usage patterns and negative effects. It's kind of comparable to turning cocaine into free-base IMO. >I personally know someone in their early 20 who experienced a major psychotic event following regular heavy use of cannabis This is the classic timeframe for psychosis to develop. Despite millions of gov dollars spent trying to prove a connection, there is no evidence that cannabis causes psychosis: Cannabis and Psychosis: a Critical Overview of the Relationship https://pubmed.ncbi.nlm.nih.gov/26781550/ https://pubmed.ncbi.nlm.nih.gov/26781550/ >Evidence reviewed here suggests that cannabis does not in itself cause a psychosis disorder. Rather, the evidence leads us to conclude that both early use and heavy use of cannabis are more likely in individuals with a vulnerability to psychosis. I don't use at all anymore, btw, so I'm definitely not a cannabis evangelist or any such. Just throwing in my two cents.
chrisco255 3y ago
Anecdotally have definitely known some heavy users of weed that noticeably experienced cognitive declines from their late teens / early 20s to their late 30s. They are not as sharp as they used to be and are burn outs to some extent. I don't think it's good for you long term. That being said, I still think it should be legal, but it should be known up front that this is what you're buying into as a habitual long term user. Maybe not everyone is affected by weed in the same way, but even if it's a 10% chance it should be disclosed and known up front.
- ipaddr 3y ago
  Personally I know people in a similar situation who kept heavy usage into their 40s and their memory is amazingly better than anyone and keeps getting better. They can tell you what happened on a certain day or remember a long number instantly. Very heavy usage but sticks to the same strain might be the key difference.
  - Synaesthesia 3y ago
    Anecdotally I'm finding my cognition has certainly improved after cessation of my heavy use, emotionally I'm also better balanced. Physical exercise seems to be the best thing for my health these days.
    - mkmk3 3y ago
      Similar experience, good job on the change
    - DiggyJohnson 3y ago
      Ditto here, and matches the experience of many close friends and even colleagues. The emotional side of things is especially germane, I was definitely using mj to avoid facing up to some emotional difficulties. It might sound a bit arcane, but I attribute a lot of it to REM sleep. When I quit, I had crazy dreams every night, often nightmares. But frankly, I had dug myself into a pretty deep hole in the real world. These nightmares and unpleasant dreams became much less frequent over time, and I still dream almost every night. When I was smoking every day, I didn’t notice this. I don’t notice that was waking up foggy, it was nothing compared to a hangover or a night with little sleep. But now it’s clear. I feel like I have an entire dimension of sharpness and control I was missing and I’m grateful for that.
jansan 3y ago
I do not work in academia, but to me the summary of the paper sounds completely useless. Shouldn't they at least have have mentioned the core finding first in the summary before saying that more studies are necessary?
- bregma 3y ago
  Unless the core finding was that funding was running out and they need more money.
Octabrain 3y ago
In my personal experience, I can't handle weed. It makes me paranoid. I tried a weekish ago to smoke a bit with some friends and while being high I remembered why I stopped years ago. My mind simply doesn't manage it very well. It makes me feel anxious and can't control negative thoughts (guilt, shame, mistakes etc not related with the action of consumption itself). I think we should avoid to fall into the "it's just a natural plant" fallacy I've personally heard many times. Edit: Why the downvotes? I just mentioned a explicitly stated personal take related to the topic...
ganzuul 3y ago
No mention of combined use with tobacco?

43 points by haltist 3y ago

deleted 3y ago

[deleted]

mtoner23 3y ago

Published in 2019

navels 3y ago
lol breaking news

jacobmarble 3y ago

> We conducted a comprehensive systematic search of the recent literature on cognitive outcomes associated with cannabis use and cannabinoids in adults age 50 and older. Although there is evidence of modest negative effects on cognition in this population, larger controlled trials using validated outcome measures are greatly needed to better understand the role of cannabinoids in cognitive aging, as small sample sizes and variability in study designs limit our ability to draw definitive conclusions at this time.

InSteady 3y ago
>Although variability in the cannabis products used, outcomes assessed, and study quality limits the conclusions that can be made, modest reductions in cognitive performance were generally detected with higher doses and heavier lifetime use. >However, larger methodologically rigorous trials and longitudinal studies that assess cognition prior to the initiation of cannabis use are greatly needed to infer a causal relationship. This need is highlighted by the fact that many negative effects on cognition that were reported by studies in this review decreased after adjusting for confounding variables (e.g., differences in premorbid IQ for users and nonusers). So heavy lifetime use and high doses may case modest cognitive impairment in older adults... or it is pure correlation, and perhaps older adults seeking strong relief have other things going on prior to heavy cannabis use that also cause cognitive impairment.
- ltbarcly3 3y ago
  'Modest' just means you don't require a helper to perform every day tasks. It can be be very debilitating, but isn't 'Major' until you can't perform every day activities on your own. For further context, Trisomy 21 (Down Syndrome) is characterized as 'mild to moderate'. Modest: No interference with independence in everyday activities, although these activities may require more time and effort, accommodation, or compensatory strategies
  - InSteady 3y ago
    Greater context, which doesn't seem to line up well with your assertion here: > ...that higher doses and heavier use of cannabis are associated with modest negative effects. These findings are consistent with other systematic reviews and meta-analyses showing similar small adverse effects on cognition in younger populations. With that said, there was also evidence of modest improvements in subjective cognition on patient-reported outcome measures, particularly for medical cannabis users.
    - ltbarcly3 3y ago
      Because of a subjective improvement? I don't follow what you mean. People believe they are subjectively driving fine while hitting every mailbox due to being drunk.

DoingIsLearning 3y ago

> Several limitations must be considered when interpreting the evidence reviewed in this paper. First and foremost, medical and recreational use of cannabis are not the same and their effects on cognition should not be assumed to be equivalent. Adding to this variability are the different constituents of cannabis studied, including whole plant cannabis and isolated compounds. So much this. You need three way split studies (And perhaps different category naming). - +50 year varieties of cannabis - medical cannabis (Higher CBD, lower THC) - Modern dispensary cannabis (high THC) We keep selling the idea that bud is natural but ask anyone older than 60 who smokes and they will tell you 'modern' cannabis is absolutely wild compared with what existed a few decades ago. Anecdata I personally know someone in their early 20 who experienced a major psychotic event following regular heavy use of cannabis. The mental health and neural maturation of 13 to 25 yr old while consuming cannabis is something that also needs very urgent studying.

InSteady 3y ago
I am not an "older person" and I was smoking bud a few decades ago, thank you very much. Some of the stuff I got back then was categorically better than a great deal of the dispensary bud found today. Some of the cannabis cup winning strains from the mid 90's to mid 2000's would beat the pants off of the vast majority of mega-THC, mass produced strains sold in your average pot shop in terms of pleasant qualitative effects. It's wonderful to be able to take a few hits and hit the perfect high.. you smoke less bud, experience more of the pleasant effects with less of the mind-numbing, paranoia, and other unpleasant side-effects. In the 70's (and still today with trash-tier cannabis) people had to smoke tons to get any effect. I have done this with Mexican brick weed (purchased in Mexico). It is just straight up an inferior experience, there is nothing more safe or beneficial to smoking a butt load of crappy weed in order to get high. Also, it's kind of a myth that cannabis was terrible back in the 70's. A lot of it was, don't get me wrong. But selective breeding and sophisticated indoor growing techniques were developing at that time, so it was possible to get pretty damn good bud if you happened to know the right people. There is still plenty of outdoor 'Mexican brick weed' going around these days just like it was back in the 70's, and it's pure trash. And there is plenty of mediocre bud masquerading as "top shelf" going around today (including strains in dispensaries advertising astronomical and dubious THC percentages). As ever it takes a lot of time, expertise, equipment, and capital to produce truly great bud. Now if you start talking about distillates and concentrates, that is one area in which I agree there is a notable difference in usage patterns and negative effects. It's kind of comparable to turning cocaine into free-base IMO. >I personally know someone in their early 20 who experienced a major psychotic event following regular heavy use of cannabis This is the classic timeframe for psychosis to develop. Despite millions of gov dollars spent trying to prove a connection, there is no evidence that cannabis causes psychosis: Cannabis and Psychosis: a Critical Overview of the Relationship https://pubmed.ncbi.nlm.nih.gov/26781550/ https://pubmed.ncbi.nlm.nih.gov/26781550/ >Evidence reviewed here suggests that cannabis does not in itself cause a psychosis disorder. Rather, the evidence leads us to conclude that both early use and heavy use of cannabis are more likely in individuals with a vulnerability to psychosis. I don't use at all anymore, btw, so I'm definitely not a cannabis evangelist or any such. Just throwing in my two cents.

chrisco255 3y ago

Anecdotally have definitely known some heavy users of weed that noticeably experienced cognitive declines from their late teens / early 20s to their late 30s. They are not as sharp as they used to be and are burn outs to some extent. I don't think it's good for you long term. That being said, I still think it should be legal, but it should be known up front that this is what you're buying into as a habitual long term user. Maybe not everyone is affected by weed in the same way, but even if it's a 10% chance it should be disclosed and known up front.

ipaddr 3y ago
Personally I know people in a similar situation who kept heavy usage into their 40s and their memory is amazingly better than anyone and keeps getting better. They can tell you what happened on a certain day or remember a long number instantly. Very heavy usage but sticks to the same strain might be the key difference.
- Synaesthesia 3y ago
  Anecdotally I'm finding my cognition has certainly improved after cessation of my heavy use, emotionally I'm also better balanced. Physical exercise seems to be the best thing for my health these days.
  - mkmk3 3y ago
    Similar experience, good job on the change
  - DiggyJohnson 3y ago
    Ditto here, and matches the experience of many close friends and even colleagues. The emotional side of things is especially germane, I was definitely using mj to avoid facing up to some emotional difficulties. It might sound a bit arcane, but I attribute a lot of it to REM sleep. When I quit, I had crazy dreams every night, often nightmares. But frankly, I had dug myself into a pretty deep hole in the real world. These nightmares and unpleasant dreams became much less frequent over time, and I still dream almost every night. When I was smoking every day, I didn’t notice this. I don’t notice that was waking up foggy, it was nothing compared to a hangover or a night with little sleep. But now it’s clear. I feel like I have an entire dimension of sharpness and control I was missing and I’m grateful for that.

jansan 3y ago

I do not work in academia, but to me the summary of the paper sounds completely useless. Shouldn't they at least have have mentioned the core finding first in the summary before saying that more studies are necessary?

bregma 3y ago
Unless the core finding was that funding was running out and they need more money.

Octabrain 3y ago

In my personal experience, I can't handle weed. It makes me paranoid. I tried a weekish ago to smoke a bit with some friends and while being high I remembered why I stopped years ago. My mind simply doesn't manage it very well. It makes me feel anxious and can't control negative thoughts (guilt, shame, mistakes etc not related with the action of consumption itself). I think we should avoid to fall into the "it's just a natural plant" fallacy I've personally heard many times. Edit: Why the downvotes? I just mentioned a explicitly stated personal take related to the topic...

ganzuul 3y ago

No mention of combined use with tobacco?