15 Associations Among Subjective Cognitive Function and Cannabis Use in Older Adults

Abstract

Objective:Cannabis use in older adults is becoming increasingly common as cannabis becomes both more socially acceptable and legally permissible, whether for medical or recreational purposes. While previous research has found harmful effects of cannabis use on cognition in adolescents and younger adults, few studies have explored cognition and cannabis use in older adults. This study aimed to examine the relationship between lifetime cannabis use patterns and subjective cognitive performance in older adults.Participants and Methods:The sample (N=51) consisted of adults ages 60 and older residing in the United States who endorsed cannabis use within the previous year. Participants completed online questionnaires on demographics, mental health [Geriatric Anxiety Scale (GAS) short form and Geriatric Depression Scale (GDS) short form], and measures of subjective cognitive function [Cognitive Failures Questionnaire (CFQ), the Cognitive Problems and Strategies Assessment (CPSA), and part IV of the Cognitive Self Efficacy Questionnaire (CSEQ)]. The Daily Sessions, Frequency, Age of Onset, and Quantity of Cannabis Use Inventory (DFAQCU) and the Cannabis Use Disorder Identification Test (CUDIT) were used to assess cannabis use, and the Alcohol Use Disorders Identification Test Consumption items (AUD-C) were used to assess alcohol use. Partial Pearson’s correlations were used to examine relationships between scores of subjective cognitive functioning and cannabis use patterns while controlling for alcohol consumption.Results:Participants aged 60+ (M=68.06, SD=5.80, 49% women) had 15.39 (SD=2.21, range 12-18) years of education on average. Participants’ race/ethnicity was reported as 90.2% White (n=47), 5.9% Latinx or Hispanic (n=3), 2% Black or African American (n=1), and 1% Other (n=1). Most participants (59%) reported first using cannabis as a child or adolescent (range of ages 7-17 years), while 31% reported first using cannabis as an adult (ages 18-58 years), and only 8% endorsed initial use in older adulthood (62-84 years). On average, this sample reported using cannabis for 19.75 days (SD=11.14) in the last month with n=35 (69%) and having used cannabis for 20 or more years (range 1-60 years). The total CUDIT score was positively correlated with CFQ (rp=.47, p<.001), CPSA problems (rp=.46, p<.001), GAS (rp=.43, p=.002), and GDS (rp=.35, p=.014), and negatively correlated with the CSEQ (rp=-.33, p=.02), all while controlling for alcohol consumption. Days of use in the past month and total years of use were not significantly associated with subjective cognitive function.Conclusions:Among older adult cannabis users, symptoms of Cannabis Use Disorder (CUD) were significantly associated with greater self-reported cognitive failures/problems and worse self-efficacy for cognitive ability, as well as symptoms of anxiety and depression, when controlling for alcohol use. Notably, there was no relationship between subjective cognition and frequency of recent use or lifetime use. For patients who use cannabis, neuropsychologists may find it helpful to focus their clinical interview on CUD symptoms when discussing cognitive complaints rather than other measures of cannabis use. Additional research is needed to examine objective measures of cognitive functioning in older adult cannabis users.