Marijuana Use in Older Adults: Health, Function and Fall-Related Injury

老年人吸食大麻：健康、功能和跌倒相关伤害

• 批准号: 10132223
• 负责人: Salomeh Keyhani
• 金额: $ 59.78万
• 依托单位: NORTHERN CALIFORNIA INSTITUTE/RES/EDU
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-06-15 至 2024-02-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10132223
• 关键词: Address; Adult; Adverse effects; Adverse event; Area; Benefits and Risks; Benzodiazepines; Caregivers; Cessation of life; Characteristics; Cognition; Cognitive deficits; Confusion; Data; Databases; Disorientation; Dizziness; Dose; Drowsiness; Elderly; Equilibrium; Event; Fatigue; Goals; Hallucinations; Health; Health Benefit; Health Status; Health behavior; Hospitalization; Injury; Interview; Legal; Link; Literature; Marijuana; Medical Records; Medicare; Memory impairment; Methods; Mood Disorders; Multiple Sclerosis; Nausea; Opioid; Outcome; Pain; Pain management; Paranoia; Patients; Perception; Pharmaceutical Preparations; Pharmacologic Substance; Plants; Polypharmacy; Population; Prevalence; Prospective cohort; Psyche structure; Psychoses; Psychotropic Drugs; Recording of previous events; Reporting; Research; Respiratory Tract Infections; Risk; Serious Adverse Event; Sleep; Sleeplessness; Smoking; Stress; Subgroup; Surveys; Telephone; Telephone Interviews; Tetrahydrocannabinol; Text; Veterans Health Administration; Vomiting; Washington; adverse event risk; adverse outcome; base; chronic pain; cohort; design; evidence base; fall injury; fall risk; follow-up; high risk; insight; marijuana use; marijuana user; mental state; older patient; respiratory; response; secondary outcome; side effect; systematic review

The prevalence of marijuana use among older adults is rising dramatically. Marijuana is being promoted as a harmless “herbal” treatment that can be used to treat insomnia, stress, caregiver fatigue, and pain, conditions that are common among the elderly. However, there is a complete lack of data on the effects of marijuana and its active component, tetrahydrocannabinol (THC), among older adults. In trials examining the effect of THC-based pharmaceuticals among younger populations and in specific conditions, serious adverse events reported included dizziness, nausea, somnolence, vomiting, disorientation, confusion, loss of balance, and hallucination. These adverse events of THC-based pharmaceuticals provide a framework to understand the potential harms of plant-based marijuana use in older adults. We hypothesize that marijuana use in older adults is associated with fall-related injury, any injury, and hospitalization for altered mental status and mood disorders. In addition, as smoking is the predominant form of use, respiratory complications are also likely. To address the extensive gap in the literature on the potential harms of marijuana in older adults, we propose to construct a cohort of patients 65 years and older in the Veterans Health Administration (VA) using merged national VA and Medicare data. Specifically, we propose to use validated text processing methods to review medical record notes and identify mentions of marijuana use to preliminarily categorize patients into marijuana users and non-users. We will then perform an in-depth 25-minute telephone health interview with each patient to ascertain exposure history and baseline characteristics. After adjusting for the baseline differences between users and non-users using the comprehensive interview data collected and the national VA data available, we will compare the rates of events among 2250 current marijuana users and 2250 non- users during the follow-up period. Our proposal will accomplish four goals: (1): To use a prospective cohort design to examine the association between marijuana use and the primary adverse outcome of all-cause hospitalization and the secondary composite outcome of all-cause hospitalization and death. (2) To use a prospective cohort design to examine the association between marijuana and the secondary outcomes of fall-related injury, any injury, altered mental status, mood disorders, and respiratory infections. (3) To examine whether specific subgroups of older patients are more likely to experience adverse outcomes. (4) To determine whether there is a level of safe use of marijuana in older adults. Though very little is known about the physical harms of marijuana in older adults, it is likely that use of marijuana is associated with adverse effects. Given increasing use among older adults, a better understanding of the risks of marijuana use in this population is urgently needed to disseminate accurate information to the public.

老年人使用大麻的流行率正在急剧上升。玛丽安娜正在被提升 作为一种无害的“草药”治疗，可用于治疗失眠、压力、护理人员疲劳和疼痛， 这是老年人中常见的情况。然而，完全缺乏关于 大麻及其活性成分四氢大麻酚（THC）在老年人中的作用。在审判中， THC为基础的药物在年轻人群中的影响，在特定条件下，严重不良反应 报告的事件包括头晕、恶心、嗜睡、呕吐、定向障碍、意识模糊、失去平衡， 和幻觉这些不良事件的四氢大麻酚为基础的药物提供了一个框架，了解 老年人使用植物性大麻的潜在危害。我们假设老年人吸食大麻 成年人与跌倒相关的损伤、任何损伤以及因精神状态和情绪改变而住院相关 紊乱此外，由于吸烟是主要的使用形式，呼吸系统并发症也是可能的。 为了解决文献中关于大麻对老年人潜在危害的广泛空白，我们 建议在退伍军人健康管理局（VA）建立一个65岁及以上的患者队列， 合并了全国退伍军人管理局和医疗保险数据具体来说，我们建议使用经过验证的文本处理方法， 审查医疗记录笔记，并确定大麻使用的提及，以初步将患者分类为 大麻使用者和非使用者。然后，我们将进行深入的25分钟电话健康访谈， 每名患者确定暴露史和基线特征。调整基线后 使用者和非使用者之间的差异，使用所收集的全面访谈数据和国家 VA数据可用，我们将比较2250名当前大麻使用者和2250名非大麻使用者的事件发生率。 用户在跟踪期间。 我们的建议将实现四个目标：（1）：使用前瞻性队列设计来检查 大麻使用与全因住院治疗的主要不良后果之间的联系 全因住院和死亡的次要复合结局。(2)采用前瞻性队列设计， 检查大麻和跌倒相关损伤的次要结果之间的关联，任何损伤， 精神状态改变情绪紊乱和呼吸道感染(3)检查特定子组是否 的老年患者更有可能出现不良后果。(4)为了确定是否存在 在老年人中安全使用大麻。 虽然对大麻对老年人的身体危害知之甚少，但使用大麻很可能是一种危险。 大麻有副作用。鉴于老年人越来越多地使用， 在这一人群中使用大麻的风险是迫切需要传播准确的信息， 公众