Cannabis use patterns and associations with cognitive impairment in older adults

项目总结/摘要 意义大麻的使用在美国老年人（≥65岁）中呈指数级增长， 预计在未来几十年将占人口的20%以上。老年人特别容易受到 与大麻使用相关的认知障碍，并表现出越来越多的异质性模式， 大麻使用（包括大麻使用历史和当前使用情况）。因此，这种快速增长的 大麻使用者人口将在未来几年成为一个公共卫生问题，值得预防和 治疗干预。关于大麻使用模式及其与认知障碍的关联的现有信息 在这个研究严重不足的人群中缺乏损伤。这项研究计划审查协会 一系列大麻使用措施与认知障碍，特别是残余障碍（即， 急性中毒后观察到的认知影响）。职业生涯 发展规划Livne博士的培训计划将包括课程作业和指导，以发展他的技能 在调查设计，老龄化和认知相关的研究，广义线性模型，因果关系， 建模和纵向分析。这些都是必要的，以实现他的职业目标，成为一个 独立调查员对大麻使用，认知， 和人口老龄化。导师制。Livne博士将得到一个非常有成就的导师团队的支持 他们是物质使用流行病学、生物统计学、衰老和认知方面的专家。研究计划。对于目标1， 博士Livne将使用健康与退休研究的数据，这是一项针对美国老年人的大型全国性代表性研究。 成年人，检查大麻使用预测因素与特定领域认知障碍之间的关联， 包括≥65岁成人中的残余损害。对于Aim 2a，Livne博士将在网上招募大量样本 老年人通过社交媒体平台，描述大麻使用模式（即，大麻使用历史，当前 使用概况），并检查这些模式之间的关联。对于Aim 2b，Livne博士将进行一次试点 研究的一个子集的受访者从网上样本以及社会人口可比的老年人 终身未使用大麻的成年人。使用自我管理的神经心理学评估，他将评估 在老年人在线样本中整合认知测试的可行性，并提供以下方面的初步数据： 大麻使用模式的详细测量与特定领域的残余认知之间的关联 在目标1的分析基础上进行扩展。公共卫生影响。这个项目将阐明 大麻使用和相关的认知障碍，从而告知临床医生，研究人员， 和政策制定者的个人和公共健康风险在不断增长但研究不足的大麻用户群体。 随后，调查结果将为减少危害战略的制定和利用 在线研究工具，用于对老年药物使用者进行成本效益高的认知评估。

PROJECT SUMMARY/ABSTRACT Significance. Cannabis use is increasing exponentially among older US adults (≥65 years), a population that is expected to comprise over 20% of the population in coming decades. Older adults are particularly vulnerable to cognitive impairment associated with cannabis use, and demonstrate increasingly heterogeneous patterns of cannabis use (including cannabis use histories and current use profiles). Consequently, this rapidly growing population of cannabis users will become a public health concern in coming years and merit preventive and therapeutic interventions. Extant information on cannabis use patterns and their associations with cognitive impairment is lacking in this critically understudied population. This research proposal examines associations between a range of cannabis use measures and cognitive impairment, particularly residual impairment (i.e., cognitive effects observed after acute intoxication has passed), in older adult cannabis users. Career Development Plan. Dr. Livne’s training program will include coursework and mentorship to develop his skills and expertise in survey design, aging and cognition-related research, and generalized linear modeling, causal modeling and longitudinal analyses. These are necessary for achieving his career goals of becoming an independent investigator performing impactful research on the intersection between cannabis use, cognition, and the aging population. Mentorship. Dr. Livne’s will be supported by a highly accomplished team of mentors who are experts in substance use epidemiology, biostatistics, aging, and cognition. Research Plan. For Aim 1, Dr. Livne will use data from the Health and Retirement Study, a large nationally representative study of older US adults, to examine associations between cannabis use predictors and domain-specific cognitive impairment, including residual impairment, among adults ≥65 years. For Aim 2a, Dr. Livne will recruit a large online sample of older adults via social media platforms, to describe cannabis use patterns (i.e., cannabis use histories, current profiles of use) and examine the associations between such patterns. For Aim 2b, Dr. Livne will conduct a pilot study of a subset of respondents from the online sample as well as sociodemographically comparable older adults with no lifetime cannabis use. Using self-administered neuropsychological assessments, he will assess the feasibility of integrating cognitive tests in online samples of older adults and provide preliminary data on associations between detailed measures of cannabis use patterns and domain-specific residual cognitive impairment, expanding on analyses from Aim 1. Public Health Impact. This project will illuminate patterns of cannabis use and associated cognitive impairment among older adults, thus informing clinicians, researchers, and policymakers of individual and public health risks in a growing yet understudied cannabis user population. Subsequently, findings will inform the development of harm reduction strategies and the feasibility of utilizing online research tools for cost-effective cognitive assessment of older adult substance users.