Cannabis Could be a Big Player in Aging Gracefully

Cognitive and physical changes are inevitable, but studies show cannabis may help us in aging gracefully. 

Is aging gracefully possible with cannabis? Basically, vastly increasing numbers of older adults are consuming cannabis. A recent study published in JAMA Internal Medicine (2020) found that the prevalence of cannabis consumption among people sixty-five and older almost doubled from about two to four percent between 2015 and 2018 ^[1]Han, B. H., & Palamar, J. J. (2020). Trends in cannabis use among older adults in the United States, 2015-2018. JAMA Internal Medicine, 180(4), 609-611..

Basically, according to Harvard Medical School, there are two possible reasons for this increased interest. The first is a decrease in the stigma attached to consuming cannabis. Older adults may feel that cannabis consumption is more socially acceptable. Further, they may feel more comfortable admitting to their cannabis consumption.

These reasons combine with the establishment’s increasing interest in medical cannabis. Preliminary investigations suggest that cannabis can help treat multiple conditions common to older adults – the kind that contribute to gracefully aging – but small sample sizes and a lack of high-quality evidence limits the research.

Can Brain Aging be Reversed?

Unfortunately, cognitive impairment is a reality for many older adults and it tends to get worse with increasing age. With cannabis consumption and temporary cognitive impairment often going hand-in-hand, it may seem counter-intuitive to give older adults cannabis to help brain aging. New research suggests cannabis may support healthy brain function. In a study published in Nature Medicine (2017), the researchers gave low-dose THC to young and aged mice ^[2]Bilkei-Gorzo, A., Albayram, O., Draffehn, A., Michel, K., Piyanova, A., Oppenheimer, H., … & Bab, I. (2017). A chronic low dose of Δ 9-tetrahydrocannabinol (THC) restores cognitive … Continue reading.

Unsurprisingly, the younger mice experienced increased cognitive impairment following the THC treatment. What about older adult mice? The same low-dose THC treatment actually reversed the age-related decline in cognitive performance among the older mice. The positive behavioral effects appeared to be mediated by improvements in the hippocampus, the region of the brain responsible for memory and learning. THC treatment restored hippocampal gene transcription in twelve-month-old mice to levels comparable to THC-free animals only two months old. So would you call that aging gracefully? Or one better?

Aging Gracefully With THC

Why would age influence the effects of THC? According to Ryan McLaughlin, a researcher from Washington State University, it is a matter of homeostasis and bringing the system back to normal. Basically, McLaughlin says “we know the endogenous cannabinoid system’s primary function is to try to preserve homeostasis within a given brain circuit. It works like an internal regulator; when there’s too much [neuronal] activity, cannabinoids suppress activity to prevent neurotoxicity” says McLaughlin.

As we age, the endocannabinoid system declines. The THC that induces cognitive impairments in young mice with a normally functioning endocannabinoid system may be beneficial for older mice who are producing less endogenous cannabinoids. Although an interesting starting point, it is unclear if similar outcomes exist in humans. However, clinical trials investigating the efficacy of cannabis for improving cognitive impairments are currently underway.

Aging Gracefully Without Arthritis and Chronic Pain

Almost fifty percent of adults aged sixty-five years and older were diagnosed with arthritis between 2013 and 2015, in the United States. In addition to inflammation and stiffness, arthritis can come with debilitating chronic pain. Based on CBD’s reputation as a more natural anti-inflammatory, it presents as an attractive treatment option and seniors are taking notice.

In fact, a study published in Orthopedic Proceedings (2018), discovered that preoperative cannabis consumption increased from nine percent to fifteen percent and opioid use decreased from twenty-four to seventeen percent among severe arthritis patients who had a hip or knee replacement between 2012 and 2017 ^[3]Denduluri, S., Woolson, S. T., Indelli, P. F., Mariano, E. R., Harris, A. H. S., & Giori, N. J. (2018, October). Cannabis use has increased among patients with advanced arthritis who were … Continue reading.

Moreover, tike many other conditions, the preclinical evidence investigating CBD for treating arthritis and the corresponding pain is encouraging. Accordingly, a study published in Pain (2017), found that CBD dose-dependently decreased joint firing, reduced acute joint inflammation, and prevented the future development of joint pain in rat models of osteoarthritis ^[4]Philpott, H. T., O’Brien, M., & McDougall, J. J. (2017). Attenuation of early phase inflammation by cannabidiol prevents pain and nerve damage in rat osteoarthritis. Pain, 158(12), 2442.. Unfortunately, well-designed studies showcasing concrete conclusions that CBD is effective for arthritis pain in humans does not exist.

A Lack of Cannabis Clinical Trials Among the Older Population

There is a lack of well-designed clinical trials investigating cannabis and even less focussing specifically on older adults. Further, a recently published systematic review in Medical Clinics (2020) aimed to compile available high-quality evidence detailing cannabis symptom management for older adults ^[5]Levy, C., Galenbeck, E., & Magid, K. (2020). Cannabis for Symptom Management in Older Adults. Medical Clinics, 104(3), 471-489.. Included studies had to use a randomized, quasi-randomized, or non-randomized clinical trial, consist of more than ten participants, and report data separately for older adults. After screening, only eight studies could be included in the review.

Further, in total, less than two-hundred and fifty older adults have participated in high-quality studies investigating cannabis for symptom management. This highlights the fact that concrete conclusions on the effectiveness of cannabis for treating the symptoms of aging are not yet possible. At a time when the world is experiencing a rapidly aging population and an upward trend in cannabis consumption among older adults, we need research to provide clarity.

Cannabis in Home Healthcare May Change Lives

The number of people aged sixty-five years and older is set to grow from about 524 million in 2010 to nearly 1.5 billion by 2050. The health care system will need to change to account for the evolving needs of the older population. Importantly, home healthcare will likely be a critical part of the future health care continuum.

Moreover, the mainstream healthcare sector may not be able to address growing demand. This comes given the number of patients and the acute shortage of hospital and long-term care beds. Basically, how we think of chronic disease management and end of life care could drastically change. Like home healthcare, prescription medicine may need to adapt further, and turn to innovative strategies for dealing with the sheer scale of future chronic conditions. Cannabis and home healthcare could be a winning combination. However, without additional cannabis research in older adults, the healthcare community may leave cannabis behind. And that would be a shame.