Association Between Lifetime Marijuana Use and Cognitive Function in Middle Age The Coronary Artery Risk Development in Young Adults (CARDIA) Study
Association Between Lifetime Marijuana Use and Cognitive Function in Middle Age The Coronary Artery Risk Development in Young Adults (CARDIA) Study
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DOI：
10.1001/jamainternmed.2015.7841
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发表时间：
2016-03-01
影响因子：
39
通讯作者：
Pletcher, Mark J.
中科院分区：
文献类型：
--
作者：
Auer, Reto;Vittinghoff, Eric;Pletcher, Mark J.
重要性在美国，海洋生物的使用越来越普遍。目前还不清楚它是否对记忆和认知功能的其他领域有长期影响。目的研究大麻使用的累积终身暴露与中年认知表现之间的关系。设计、设置和参与者我们使用了来自年轻人冠状动脉风险发展（CARDIA）研究的数据，一组5115名黑人和白色男性和女性，基线年龄为18 - 30岁，从1985年3月25日至1986年6月7日（0年），从1986年6月7日至2011年8月31日随访25年，使用重复测量估计暴露于大麻的累积年数（1年= 365天的大麻使用），并评估与第25年认知功能的关联。线性回归用于调整人口统计学因素、心血管风险因素、吸烟、饮酒和非法药物使用、体力活动、抑郁和第2年镜像星星追踪测试（认知功能的测量）的结果。数据分析时间为1986年6月7日至2011年8月31日。主要结果和指标在25岁时使用Rey听觉言语学习测试评估三个认知功能领域数字符号替代测验（Digital Symbol Substitution Test）（处理速度），Stroop干扰测试结果在3385名参与者中，2852名参与者在25年的访问中进行了认知功能测量，（84.3%）报告过去使用大麻，但只有392（11.6%）继续使用大麻到中年。目前使用大麻与更差的语言记忆和处理速度相关;累积终身暴露与所有3个认知功能领域的表现更差相关。在排除当前用户并调整潜在的混杂因素后，大麻的累积终生暴露仍然与更差的言语记忆显著相关。对于过去每5年的接触，言语记忆降低0.13个标准化单位（95% CI，-0.24至-0.02; P =.02），相当于每5年使用一次，平均每2名参与者中就有1名从15个单词的列表中少记住1个单词。调整后，我们没有发现与执行功能低下有关的联系，（-0.03 [95% CI，-0.12至0.07]; P = 0.56）或处理速度（-0.04 [95% CI，-0.16至0.08]; P = 0.51）结论和相关性过去接触大麻与更差的语言记忆有关，但似乎不影响其他认知领域。功能
IMPORTANCE Marijuana use is increasingly common in the United States. It is unclear whether it has long-term effects on memory and other domains of cognitive function.OBJECTIVE To study the association between cumulative lifetime exposure to marijuana use and cognitive performance in middle age.DESIGN, SETTING, AND PARTICIPANTS We used data from the Coronary Artery Risk Development in Young Adults (CARDIA) study, a cohort of 5115 black and white men and women aged 18 to 30 years at baseline from March 25, 1985, to June 7, 1986 (year 0), and followed up over 25 years from June 7, 1986, to August 31, 2011, to estimate cumulative years of exposure to marijuana (1 year = 365 days of marijuana use) using repeated measures and to assess associations with cognitive function at year 25. Linear regression was used to adjust for demographic factors, cardiovascular risk factors, tobacco smoking, use of alcohol and illicit drugs, physical activity, depression, and results of the mirror star tracing test (a measure of cognitive function) at year 2. Data analysis was conducted from June 7, 1986, to August 31, 2011.MAIN OUTCOMES AND MEASURES Three domains of cognitive function were assessed at year 25 using the Rey Auditory Verbal Learning Test (verbal memory), the Digit Symbol Substitution Test (processing speed), and the Stroop Interference Test (executive function).RESULTS Among 3385 participants with cognitive function measurements at the year 25 visit, 2852 (84.3%) reported past marijuana use, but only 392 (11.6%) continued to use marijuana into middle age. Current use of marijuana was associated with worse verbal memory and processing speed; cumulative lifetime exposure was associated with worse performance in all 3 domains of cognitive function. After excluding current users and adjusting for potential confounders, cumulative lifetime exposure to marijuana remained significantly associated with worse verbal memory. For each 5 years of past exposure, verbal memory was 0.13 standardized units lower (95% CI, -0.24 to -0.02; P =.02), corresponding to a mean of 1 of 2 participants remembering 1 word fewer from a list of 15 words for every 5 years of use. After adjustment, we found no associations with lower executive function (-0.03 [95% CI, -0.12 to 0.07]; P =.56) or processing speed (-0.04 [95% CI, -0.16 to 0.08]; P =.51).CONCLUSIONS AND RELEVANCE Past exposure to marijuana is associated with worse verbal memory but does not appear to affect other domains of cognitive function.