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: 10576324
• 负责人: Salomeh Keyhani
• 金额: $ 56.27万
• 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 2025-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10576324
• 关键词: Address; Adult; Adverse effects; Adverse event; Area; Benefits and Risks; Benzodiazepines; Caregivers; Categories; 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; Medicine; Memory impairment; Methods; Mood Disorders; Multiple Sclerosis; Nausea; Opioid; Outcome; Pain; Pain management; Paranoia; Patients; Perception; Pharmaceutical Preparations; Pharmacologic Substance; Plants; Policy Maker; 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; 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.

老年人吸食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、护理人员疲劳和疼痛， 老年人中常见的情况。然而，完全缺乏关于其影响的数据。 老年人吸食大麻及其活性成分四氢大麻酚 (THC)。在试验中检验 基于 THC 的药物对年轻人和特定条件下的影响，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、精神错乱、失去平衡、 和幻觉。基于 THC 的药物的这些不良事件提供了一个框架来理解 老年人吸食植物性大麻的潜在危害。我们假设老年人吸食大麻 成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有关 失调。此外，由于吸烟是主要的使用方式，因此也可能出现呼吸系统并发症。 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空白，我们 建议在退伍军人健康管理局 (VA) 中构建一组 65 岁及以上的患者队列，使用 merged national VA and Medicare data.具体来说，我们建议使用经过验证的文本处理方法 审查病历笔记并确定提及大麻的使用，以将患者初步分类为 大麻使用者和非使用者。然后，我们将与您进行 25 分钟的深入电话健康访谈 每个患者都要确定暴露史和基线特征。调整基线后 使用收集到的综合访谈数据和国家统计数据来了解用户和非用户之间的差异 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 后续期间的用户。 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主要不良结局之间的关联 全因住院和死亡的次要复合结局。 (2) 采用前瞻性队列设计 检查大麻与跌倒相关伤害、任何伤害、 精神状态改变、情绪障碍和呼吸道感染。 (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)判断是否存在等级 老年人安全使用大麻。 尽管人们对大麻对老年人的身体危害知之甚少，但使用大麻很可能 大麻与不良反应有关。鉴于老年人的使用越来越多，人们对 迫切需要了解该人群吸食大麻的风险，以便向公众传播准确的信息 民众。