Cannabis use patterns and associations with cognitive impairment in older adults

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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.