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15 Associations Among Subjective Cognitive Function and Cannabis Use in Older Adults
- Elizabeth Anquillare, Adrianna C Gallegos, Rachel E Thayer
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 328-329
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Objective:
Cannabis use in older adults is becoming increasingly common as cannabis becomes both more socially acceptable and legally permissible, whether for medical or recreational purposes. While previous research has found harmful effects of cannabis use on cognition in adolescents and younger adults, few studies have explored cognition and cannabis use in older adults. This study aimed to examine the relationship between lifetime cannabis use patterns and subjective cognitive performance in older adults.
Participants and Methods:The sample (N=51) consisted of adults ages 60 and older residing in the United States who endorsed cannabis use within the previous year. Participants completed online questionnaires on demographics, mental health [Geriatric Anxiety Scale (GAS) short form and Geriatric Depression Scale (GDS) short form], and measures of subjective cognitive function [Cognitive Failures Questionnaire (CFQ), the Cognitive Problems and Strategies Assessment (CPSA), and part IV of the Cognitive Self Efficacy Questionnaire (CSEQ)]. The Daily Sessions, Frequency, Age of Onset, and Quantity of Cannabis Use Inventory (DFAQCU) and the Cannabis Use Disorder Identification Test (CUDIT) were used to assess cannabis use, and the Alcohol Use Disorders Identification Test Consumption items (AUD-C) were used to assess alcohol use. Partial Pearson’s correlations were used to examine relationships between scores of subjective cognitive functioning and cannabis use patterns while controlling for alcohol consumption.
Results:Participants aged 60+ (M=68.06, SD=5.80, 49% women) had 15.39 (SD=2.21, range 12-18) years of education on average. Participants’ race/ethnicity was reported as 90.2% White (n=47), 5.9% Latinx or Hispanic (n=3), 2% Black or African American (n=1), and 1% Other (n=1). Most participants (59%) reported first using cannabis as a child or adolescent (range of ages 7-17 years), while 31% reported first using cannabis as an adult (ages 18-58 years), and only 8% endorsed initial use in older adulthood (62-84 years). On average, this sample reported using cannabis for 19.75 days (SD=11.14) in the last month with n=35 (69%) and having used cannabis for 20 or more years (range 1-60 years). The total CUDIT score was positively correlated with CFQ (rp=.47, p<.001), CPSA problems (rp=.46, p<.001), GAS (rp=.43, p=.002), and GDS (rp=.35, p=.014), and negatively correlated with the CSEQ (rp=-.33, p=.02), all while controlling for alcohol consumption. Days of use in the past month and total years of use were not significantly associated with subjective cognitive function.
Conclusions:Among older adult cannabis users, symptoms of Cannabis Use Disorder (CUD) were significantly associated with greater self-reported cognitive failures/problems and worse self-efficacy for cognitive ability, as well as symptoms of anxiety and depression, when controlling for alcohol use. Notably, there was no relationship between subjective cognition and frequency of recent use or lifetime use. For patients who use cannabis, neuropsychologists may find it helpful to focus their clinical interview on CUD symptoms when discussing cognitive complaints rather than other measures of cannabis use. Additional research is needed to examine objective measures of cognitive functioning in older adult cannabis users.
84 Preferred Compensatory Cognitive Training Strategies Among Older Adults with Mild Cognitive Difficulties
- Katie Stypulkowski, Rachel E Thayer, Elizabeth Anquillare
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 185-186
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- Article
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Objective:
Older adults experiencing mild cognitive difficulties (MCD) may benefit from compensatory cognitive training (CCT) to address cognitive changes. CCT can be delivered over various lengths of time and can focus on a specific cognitive domain (e.g., memory) or multiple domains. Identifying the most relevant and impactful portions of a CCT intervention could allow for more effective and streamlined delivery of compensatory strategies, perhaps allowing this type of training to be included in feedback sessions or brief interventions. This study sought to investigate which factors older adults with MCD found to be most beneficial and applicable to their daily lives after completion of a brief telehealth CCT program.
Participants and Methods:Adults age 55+ with documented MCD (n=28) and an optional care partner (CP; n=18) were recruited for video-chat delivery of a 6-week, motivationally-enhanced CCT program adapted from CogSMART. The six weeks included content addressing: Education and Lifestyle Strategies (Session 1); Organization, Prioritization, and Prospective Memory (Session 2); Attention, Concentration, and Working Memory (Session 3); Learning and Memory (Session 4); Executive Functions: Decision-Making, Problem-Solving, and Planning (Session 5); and Skills Integration and Next Steps (Session 6). After completing the course, participants (n=25) provided open-ended feedback on course content, including the areas they found most helpful. They were also asked which strategies from the course they had successfully applied in their daily lives, and which they expected to continue using following the course. Qualitative data were coded and analyzed by two researchers.
Results:Participants most often endorsed strategies from Session 2 (44% of participants) and Session 3 (44%) as being helpful and applicable in daily life. Session 1 content was also frequently endorsed (36%). Content from Session 5 was noted to have been helpful/applicable least often (12%). Participants also reported having found common factors of the program to be helpful (35%), such as interaction with the clinician, education on relevant resources, or greater self-reflection and self-awareness through the program. A minority of participants reported “all” (22%) or “none” (24%) of the content to be helpful.
Conclusions:Among older adults with MCD, strategies related to prospective memory (e.g., calendar training) and attention (e.g., mindfulness) were most frequently reported as being helpful and applicable in daily life. Participants reported confidence in their ability to continue using these strategies after the program, along with continued implementation of lifestyle factors to promote healthy brain aging (e.g., exercise). Clinicians interested in providing CCT to older adults with MCD may find the most benefit from emphasizing and prioritizing strategies within these domains. Future research could use ecological momentary assessment techniques to gather real-time measures of how these learned strategies are employed in daily life. Continued exploration of the most salient and effective compensatory strategies for older adults with MCD will support effective intervention and promote independence among aging patients.