Cannabis use patterns and associations with cognitive impairment in older adults

项目摘要/摘要 意义重大。美国老年人(≥65岁)的大麻使用量呈指数级增长，这一人群 预计在未来几十年将占人口的20%以上。老年人尤其容易患上 与大麻使用相关的认知障碍，并显示出日益多样化的模式 大麻使用(包括大麻使用历史和当前使用概况)。因此，这一快速增长的 吸食大麻的人口在未来几年将成为一个公共卫生问题，需要预防和 治疗性干预。关于大麻使用模式及其与认知的关系的现有信息 在这个研究严重不足的人群中，损伤是缺乏的。这项研究提案考察了 在一系列大麻使用措施和认知损害，特别是残余损害(即， 急性中毒后观察到的认知影响)，在老年大麻使用者中。职业生涯 发展计划。利夫内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、老化和认知相关研究以及广义线性建模、因果关系方面的专业知识 建模和纵向分析。这些是实现他成为一名职业选手的职业目标所必需的 独立调查员对大麻使用、认知、 以及老龄化的人口。师徒关系。Livne博士的团队将得到一支成就卓著的导师团队的支持 他们是物质使用流行病学、生物统计学、老龄化和认知方面的专家。研究计划。对于目标1， 利夫内博士将使用健康和退休研究的数据，这是一项具有全国代表性的大型美国老年研究报告 为了检查大麻使用预测因素和特定领域认知障碍之间的关联， 包括残存损害在内，在65岁的成年人中≥。对于Aim 2a，利夫内博士将在网上招募大量样本 通过社交媒体平台描述老年人的大麻使用模式(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，利夫内博士将进行一项试验 对在线样本中的一部分受访者以及社会人口统计学上具有可比性的老年人的研究 终身不吸食大麻的成年人。使用自我管理的神经心理评估，他将评估 在老年人的在线样本中整合认知测试的可行性，并提供关于 大麻使用模式的详细测量与特定领域残留认知之间的关联 损害，在目标1的分析的基础上扩大。公共健康影响。本项目将阐明 老年人中大麻的使用和相关的认知障碍，从而告知临床医生，研究人员， 以及政策制定者在不断增长但未得到充分研究的大麻使用人口中的个人和公共健康风险。 随后，研究结果将为减少危害战略的制定和利用的可行性提供信息。 对老年人物质使用者进行经济有效的认知评估的在线研究工具。

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.