Cannabis use and risk of falling in older adults

项目摘要 近年来，美国50岁以上成年人中大麻使用的流行率显著增加。 随着老年人越来越多地获得和使用大麻， 对这些人使用大麻是必要的。衰老的特点是生理和社会的变化 这使得老年人容易患上慢性病和老年病，包括认知障碍， 落3。意外福尔斯是老年人的常见事件，也是发病率和死亡率的主要原因 与功能状态和残疾的下降有关。此外，福尔斯和认知障碍是一个“好- 已知的夫妇”;因为患有中度至重度认知障碍的老年人有更高的福尔斯风险， 年发病率约为60- 80%，是认知正常老年人发病率的两倍。受损 认知功能是大麻使用的一种影响，越来越多的证据表明，这些影响可能会持续下去。 在以后的生活中因此，长期使用大麻的生理影响可能会进一步增加老年人的福尔斯。 成年人通过步态和认知的改变。研究表明额叶神经活动减少 网络和协会增加了老年人对跌倒的恐惧。据了解，在普通的大麻中， 使用者，大麻的效果可能会对认知运动技能和大脑机制产生影响， 调节协调运动。 本申请的目的是调查跌倒风险与认知和运动功能的神经相关性， 50岁以后开始吸毒的人。我们将使用FDG-PET来确定大脑活动。跌倒风险 和认知/运动功能将通过NIH评估和跌倒风险模型进行评估。 我们的中心假设是，老年慢性大麻使用者比老年非使用者跌倒的风险更高， 与脑FDG摄取减少有关。这项工作将为更大的赠款奠定基础（R 01） 探讨不同大麻素类化合物复合作用的影响。这些结果预计将 向公众和卫生专业人员提供关于自我指导的影响的关键和及时的数据， 使用大麻增加跌倒风险，以及临床医生在确定跌倒风险时是否需要使用大麻， 制定预防战略。

PROJECT SUMMARY The prevalence of cannabis use has increased significantly in recent years among US adults aged ≥ 50 years. With increased availability and use of cannabis by older adults, a rigorous evaluation of the benefits and risks of cannabis use in these individuals is necessary. Aging is characterized by physiological and social changes that make older adults vulnerable to chronic disease and geriatric conditions including cognitive impairment and falls3. Unintentional falls are a common event for older adults and a major cause of morbidity and mortality linked with a decline in functional status and disability. Moreover, falls and cognitive impairment are a “well- known couple”; as older adults with moderate to severe cognitive impairment have a higher risk of falls, with an annual incidence of around 60–80%, which is twice the rate of cognitively normal older adults. Impaired cognitive function is an effect of cannabis use, and there is increasing evidence that those effects may persist later in life. Therefore, the physiological effects of chronic cannabis use may further increase falls in older adults via alterations in gait and cognition. Studies have shown reduced neural activity in the frontal brain networks and associations with increased fear of falling in older adults. It is also known that in regular cannabis users, the effects of cannabis may have an impact on cognitive-motor skills and brain mechanisms that modulate coordinated movement. The goal of this application is to investigate the neural correlates of fall risk and cognitive and motor function in individuals who initiate drug use after the age of 50. We will use FDG-PET to determine brain activity. Fall risk and cognitive/motor function will be assessed with the measures from the NIH Toolbox and a fall risk model. Our central hypothesis is that older chronic cannabis users are at a higher fall risk than older non-users, which is associated with reduced cerebral FDG uptake. This work will lay the foundation for larger grants (R01) investigating the influence of the compound action of different cannabinoids. These results are expected to provide critical and timely data to the public and health professionals regarding the effects of self-directed cannabis use on increased fall risk and if clinicians need to access cannabis use when determining fall risk and deciding prevention strategies.