scholarly journals Mental Health and Cognition in Older Cannabis Users: a Review

2020 ◽  
Vol 23 (3) ◽  
pp. 237-244
Author(s):  
Blanca E. Vacaflor ◽  
Olivier Beauchet ◽  
G. Eric Jarvis ◽  
Alessandra Schiavetto ◽  
Soham Rej

Background The impact of cannabis use on mental health and cognition in older adults remains unclear. With the recent legalization of cannabis in Canada, physicians will need up-to-date infor­mation about the mental and cognitive effects of cannabis use in this specific population. Method A narrative review was conducted to summarize the literature on mental health and cognitive effects of cannabis use in older adults using Medline (OvidSP). Results A total of 16 studies were identified, including nine cross-sectional studies on mental health comorbidities reported by older cannabis users. The self-reported prevalence of mental and substance use disorders is approximately two to three times higher in older adults who report past-year cannabis use, compared to older adults who report using more than one year ago or never using. The remaining seven clinical trials found that short-term, low-dose medical cannabis was generally well-tolerated in older adults without prior serious mental illness. However, mental/cognitive adverse effects were not systematically assessed. Conclusion Although preliminary findings suggests that low-dose, short-term medical cannabis does not carry significant risk of serious mental health and cognitive adverse effects in older adults without prior psychiatric history, epidemiological studies find a correlation between past-year cannabis use and poor mental health outcomes in community-dwelling older adults. These findings may indicate that longer term cannabis use in this population is detrimental to their mental health, al­though a direct causal link has not been established. Larger, longitudinal studies on the safety of medical cannabis in older adults are needed.


2020 ◽  
Vol 3 ◽  
Author(s):  
Tara Seibert ◽  
Anthony Perkins ◽  
Nicole Fowler

Background and Hypothesis:  Symptoms of anxiety and depression are prevalent in adults age 65 and older. Numerous factors impact the mental health of older adults including changes in overall health, isolation, and financial stress. Emotional support reduces the risk of mental illness. 12.2% of adults 65 and older “rarely” or “never” receive the social and emotional support they need. We hypothesize that the Covid-19 pandemic and associated shelter in place orders will increase symptoms of anxiety and depression in community dwelling older adults.     Methods:  We conducted a secondary analysis of data collected pre and post Covid-19 from a sample in Indiana from the Caregiver Outcomes of Alzheimer’s Disease Screening Trial (COADS) and a national sample from the Understanding America Study (UAS). 1,299 and 2,465 adults age 65 and older from Indiana and a nationwide sample, respectively, answered the Patient Health Questionnaire-4 (PHQ-4). The PHQ-4 is a validated 4-item screening tool for symptoms of anxiety and depression. Mean PHQ-4 scores were compared pre and post Covid-19 for both samples to explore the impact of Covid-19 on symptoms of anxiety and depression in this population.     Results:  No significant change in PHQ-4 scores pre and post Covid-19 were observed between the Indiana (1.23, 1.13, p-value=0.474) or the national samples (1.38, 1.35, p-value=0.793). An increase was observed in national depression scores, determined by a PHQ-4 subset score, post Covid-19 compared to pre Covid-19, but not statistically significantly higher (0.54, 0.56, p-value=0.679).     Conclusions and Implications:  In a sample of 3,764 participants, the mental health of adults age 65 and older nationwide remained steady despite unprecedented pandemic and social isolation. The mental health of older adults is known to be an important topic and the potential for the pandemic to exacerbate symptoms of anxiety or depression makes this a critical issue for both clinicians and researchers.  



2021 ◽  
Vol 12 ◽  
Author(s):  
Linda Chiu Wa Lam ◽  
Allen T. C. Lee ◽  
Sheung Tak Cheng ◽  
Benjamin H. K. Yip ◽  
Wai Chi Chan ◽  
...  

Background: Apart from depressive disorders, there are great interests in adopting mindfulness based interventions (MBIs) for other mental health conditions. Depression and anxiety are common in people with neurocognitive disorders (NCD). The potential of MBIs as an adjuvant treatment in this cognitively at-risk group should be further explored.Objectives: The current study explored the association between depression and anxiety symptoms with dispositional mindfulness in older adults, and if same association stays in the context of cognitive impairment.Methods: The Hong Kong Mental Morbidity Survey for Older People (MMSOP) is an ongoing epidemiology study of the prevalence of neurocognitive and mental disorders in adults aged 60 years or over in Hong Kong. MMSOP evaluated cognitive function, psychiatric symptoms (Clinical Interview Schedule-revised, CIS-R), chronic physical disease burden, psychosocial support, and resilience factors, including dispositional mindfulness as measured by the Mindful Attention Awareness Scale (MAAS). We analyzed the impact of MAAS on CIS-R and potential moderation effects of mindfulness.Results: In March 2021, 1,218 community dwelling participants completed assessments. The mean age of the sample is 69.0 (SD 6.9) years. Eight hundred and two participants (65.7%) were not demented (CDR 0) and 391 (32%) and 25 (2%) were categorized as having mild NCD (CDR 0.5) and major NCD (CDR 1 or more), respectively. One hundred forty-three (11.7%) satisfied ICD-10 criteria for anxiety or depressive disorder as measured by CIS-R. Linear regression analysis showed that female gender, CIRS, and MAAS scores were significant factors associated with CIS-R scores. MAAS scores moderated and attenuated the impact CIRS on CIS-R (adjusted R2 = 0.447, p < 0.001). MAAS scores remained as significant moderator for CIRS in patients with NCD (CDR ≥ 0.5) (adjusted R2 = 0.33, p < 0.001).Conclusion: Interim findings of the MMSOP suggested that dispositional mindfulness is associated with lower level of mood symptoms in community dwelling older adults in Hong Kong. The interaction effects further suggested that high mindful awareness may reduce the adverse effects of chronic physical morbidity on mental health. The observation stayed in the participants with cognitive impairment. We should further explore MBIs as a non-pharmacological treatment for in older adults at-risk of physical morbidity and cognitive decline.



2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 511-511
Author(s):  
Hyojung Kang

Abstract Previous studies concerning older adults have focused on whether cannabis use leads to positive or negative outcomes. In this study, we identified clusters of negative health outcomes associated with medical cannabis use. In total, we examined eight health outcomes: pain, sleep, falls, memory, digestive issues, mental health conditions, exercise, and general productivity reported by 2,968 persons over 60 who participated in the Illinois Medical Cannabis Program. We used association analysis to simultaneously identify groups of negative outcomes reported by participants. The distribution of non-positive outcomes shows a bell-shaped curve: 1.4% of participants responded that cannabis use improved all outcomes, while 4.1% of participants answered that cannabis use did not. When looking at negative outcomes, 86% of participants reported none worsened, and 11% reported one of the outcomes was affected. Only a small fraction of the participants (3%) claimed more than one negative outcomes after cannabis use.



2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 436-436
Author(s):  
Daniel R Y Gan ◽  
Grand H-L Cheng ◽  
Tze Pin Ng ◽  
John Chye Fung ◽  
Im Sik Cho

Abstract Given reduced life spaces, the neighborhood often functions as a social venue for older adults. Yet how these everyday social spaces affect older adults’ psychosocial wellbeing remains largely unknown. Drawing on the GRP-CARE Survey data, this paper examined the relation between neighborhood experiences and positive mental health. Participants were 601 community-dwelling Singaporeans aged 50+ who lived in public housing neighborhoods. Neighborhood experiences were measured using the four-factorial, 16-item OpenX scale (Gan, Fung, Cho, 2019); positive mental health was measured using a six-factorial, 19-item scale (Vaingankar et al., 2011). Both scales have good psychometric properties and had been validated. Path analysis between relevant factors of both scales was conducted using Stata, within a theorized model of causation from neighborhood environment to social factors to psychosocial health. Age, education, ethnicity and sex were controlled for. Multiple linear regression analysis showed a strong, positive association between neighborhood experiences and mental health (p=0.000) even after controlling for personal traits (operationalized as depressive symptoms, GDS) in addition to sociodemographic variables. Path analysis showed that two distinct neighborhood health processes mediated this association. These were (1) the potential for a sense of community in the neighborhood improved emotional support, and (2) having better neighborly friendships improved interpersonal skills. These neighborhood health processes provide us with new lenses to understand older adults’ everyday experiences of their neighborhoods. Community-based interventions to improve older adults’ psychosocial wellbeing may be developed to facilitate these processes. Spatial and programmatic implications will be discussed in relation to age-friendly cities and communities (AFCC).



2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 169-170
Author(s):  
Brittany Drazich ◽  
Breanna Crane ◽  
Kyle Moored ◽  
Karl Shieh ◽  
Janiece Taylor ◽  
...  

Abstract Due to generational mental illness stigma and under diagnosis of mental illness, older adults do not always receive the mental health help that they need. One unique technology that has the potential to improve mood in older adults is exergames, or exercise video games. The objective of this sub-study (main study: Stimulation With Intricate Movements “SWIM” Study) was to explore older adults’ mood following an exergame intervention called “Bandit the Dolphin,” created by the Johns Hopkins KATA Studio. Researchers conducted three focus groups with 14 community-dwelling older adult participants who took part in the SWIM Study exergame intervention. The semi-structured focus groups were transcribed, coded, and analyzed using deductive and inductive techniques described by Ray Maietta’s “sort and sift, think and shift” method. Three themes related to playing “Bandit the Dolphin” and mood emerged. First, participants described their perceived association between activity and mood. Participants felt that both active and passive activities, “Bandit the Dolphin” and otherwise, improved their mood through the “fun” factor, and through feelings of achievement. Second, the participants described that the competition and frustration of playing “Bandit the Dolphin” increased eventual feelings of achievement. Third, participants described how feelings of immersion, or being absorbed in the game, helped them forget their other life concerns. These findings provide a better understanding of older adults’ perceived relationship between an exergame intervention, “Bandit the Dolphin,” and short-term improved mood. Future health and engineering researchers should explore exergames as a potential tool to improve the mental health of older adults.



Author(s):  
Esther García-Esquinas ◽  
Rosario Ortolá ◽  
Iago Gine-Vázquez ◽  
José A. Carnicero ◽  
Asier Mañas ◽  
...  

We used data from 3041 participants in four cohorts of community-dwelling individuals aged ≥65 years in Spain collected through a pre-pandemic face-to-face interview and a telephone interview conducted between weeks 7 to 15 after the beginning of the COVID-19 lockdown. On average, the confinement was not associated with a deterioration in lifestyle risk factors (smoking, alcohol intake, diet, or weight), except for a decreased physical activity and increased sedentary time, which reversed with the end of confinement. However, chronic pain worsened, and moderate declines in mental health, that did not seem to reverse after restrictions were lifted, were observed. Males, older adults with greater social isolation or greater feelings of loneliness, those with poorer housing conditions, as well as those with a higher prevalence of chronic morbidities were at increased risk of developing unhealthier lifestyles or mental health declines with confinement. On the other hand, previously having a greater adherence to the Mediterranean diet and doing more physical activity protected older adults from developing unhealthier lifestyles with confinement. If another lockdown were imposed during this or future pandemics, public health programs should specially address the needs of older individuals with male sex, greater social isolation, sub-optimal housing conditions, and chronic morbidities because of their greater vulnerability to the enacted movement restrictions.



2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Sarah De Pue ◽  
Céline Gillebert ◽  
Eva Dierckx ◽  
Marie-Anne Vanderhasselt ◽  
Rudi De Raedt ◽  
...  

AbstractCOVID-19 took a heavy toll on older adults. In Belgium, by the end of August, 93% of deaths due to COVID-19 were aged 65 or older. Similar trends were observed in other countries. As a consequence, older adults were identified as a group at risk, and strict governmental restrictions were imposed on them. This has caused concerns about their mental health. Using an online survey, this study established the impact of the COVID-19 pandemic on adults aged 65 years or older, and which factors moderate this impact. Participants reported a significant decrease in activity level, sleep quality and wellbeing during the COVID-19 pandemic. Depression was strongly related to reported declines in activity level, sleep quality, wellbeing and cognitive functioning. Our study shows that the COVID-19 pandemic had a severe impact on the mental health of older adults. This implies that this group at risk requires attention of governments and healthcare.



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