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

老年人使用大麻的流行率正在急剧上升。大麻正在被推广 作为一种无害的草药疗法，可用于治疗失眠、压力、照顾者疲劳和疼痛， 老年人中常见的疾病。然而，完全缺乏关于这种影响的数据。 大麻及其活性成分四氢大麻酚(THC)在老年人中的作用。在试验中检查 THC类药物在年轻人群中的作用及在特定条件下的严重不良反应 报告的事件包括头晕、恶心、嗜睡、呕吐、迷失方向、神志不清、失去平衡、 还有幻觉。这些以THC为基础的药物的不良事件提供了一个框架来理解 在老年人中使用植物性大麻的潜在危害。我们假设大麻在老年人中的使用 成年人与跌倒相关的伤害、任何伤害以及因精神状态和情绪改变而住院治疗有关 精神错乱。此外，由于吸烟是主要的使用形式，呼吸系统并发症也很可能发生。 为了解决有关大麻对老年人潜在危害的文献中存在的巨大差距，我们 建议在退伍军人健康管理局(VA)中建立65岁及以上患者队列，使用 合并了全国退伍军人管理局和联邦医疗保险数据。具体地说，我们建议使用有效的文本处理方法来 审查病历笔记并识别使用大麻的提及，以初步将患者归类为 吸食大麻和不吸食大麻。然后，我们将进行一次25分钟的深入电话健康采访 以确定每个患者的接触史和基线特征。对基线进行调整后 使用收集到的综合访谈数据和全国范围内的用户和非用户之间的差异 根据已有的VA数据，我们将比较2250名当前吸食大麻的人和2250名非吸食大麻者的发生率 随访期内的用户数量。 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的主要不良后果和 全因住院和死亡的次要综合结果。(2)使用前瞻性队列设计 检查大麻与跌倒相关伤害的次要后果之间的关系， 精神状态改变、情绪紊乱和呼吸道感染。(3)检查特定的子组是否 的老年患者更有可能经历不良后果。(四)确定是否存在 在老年人中安全使用大麻。 尽管人们对大麻对老年人的身体危害知之甚少，但很可能使用大麻 大麻与不良反应有关。鉴于老年人越来越多地使用，更好地理解 迫切需要了解在这一人群中使用大麻的风险，以便向 公开的。

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.