In a population-based study of adults 65+, 20% had a history of marijuana use and 5% used recently — primarily for pain and relaxation — with current users showing more depression, anxiety, and functional impairment.
Read this if you're an older adult using marijuana or a clinician advising elderly patients — the population-level picture is more nuanced than dispensary-based studies suggest.
What the researchers found
Cannabis research in older adults has mostly relied on convenience samples — people recruited from dispensaries or cannabis clinics who are already enthusiastic users. This study is different: it drew from a random, age-stratified sample of 910 adults aged 65 and older living in a small American town, giving a true population-level picture.
One in five participants reported a lifetime history of marijuana use, and 5% reported recent use. Among current users, the top reasons were pain (41%) and recreation/relaxation (37%) — a practical, unsurprising pattern for this age group.
But the associations with mental health and functioning are where the data gets complicated. Recent marijuana use was associated with cigarette and alcohol use, symptoms of depression and anxiety, and functional impairment. This doesn't mean marijuana caused these problems — it's equally possible that people with depression, anxiety, and functional limitations are more likely to turn to marijuana for relief. The cross-sectional design can't tell us which direction the arrow points.
The cognitive findings add another layer. Recent users did not differ from non-users on basic cognitive screening (Mini-Mental State Examination), but the association with functional impairment on Activities of Daily Living measures raises questions about whether cannabis use affects real-world functioning in ways that brief cognitive tests don't capture.
The demographics of this sample — a small, predominantly non-Hispanic White American town — limit generalizability but provide a clean population-level snapshot that's been missing from the geriatric cannabis literature.
Why it matters
As cannabis legalization expands, use among older adults is the fastest-growing demographic segment. But most research has studied self-selected users. This population-based approach reveals the actual prevalence (higher than many assume) and the concerning associations with depression, anxiety, and functional impairment that may not be visible in studies of motivated medical cannabis patients.
The numbers in context
910 adults aged 65+ (mean age 77, 50% female, mostly non-Hispanic White). 20% lifetime marijuana use. 5% recent use. Reasons: pain (41%), recreation/relaxation (37%). Recent use associated with cigarette use, alcohol use, depression symptoms, anxiety symptoms, and functional impairment.
How the study worked
Cross-sectional analysis of data from the Monongahela-Youghiogheny Healthy Aging Team (MYHAT) study, an age-stratified random sample of 910 adults aged 65+ from a small town in the USA. Marijuana use assessed by self-report. Mental health screened with modified CES-Depression Scale and GAD screener. Cognition assessed by MMSE and neuropsychological battery. Functioning assessed by OARS ADL/IADL scales and Clinical Dementia Rating.
Who was studied
N=910 adults aged 65 and older, 50% female, from a small-town in the USA
What this study cannot tell us
Cross-sectional design — cannot determine whether marijuana use causes or results from depression, anxiety, and functional impairment. Predominantly White, small-town American sample limits generalizability. Self-reported marijuana use may be underreported due to stigma, especially in this age group. 5% recent use rate is based on a small absolute number of users, limiting statistical power for subgroup analyses. No data on specific cannabis products, doses, or routes of administration.
How to read the evidence
Population-based cross-sectional study with a well-characterized random sample — stronger than convenience samples but cannot establish causation. The association between current use and mental health symptoms could run in either direction.
When this study was published
Published in 2024. Cannabis use among older adults continues to increase with expanding legalization.
The bigger picture
This complements RTHC-00095 (geriatric sleep cannabis use) by providing a broader view of elderly cannabis use beyond just sleep. Together, these studies show that older adults are using cannabis in significant numbers, often for pain and sleep, but the mental health associations are more complex than 'cannabis helps.' The functional impairment finding is particularly important given the fall risk and medication interaction concerns unique to this age group.
Replication
Not stated in abstract.
Funding
Not reported in abstract.
Conflicts of interest
Not reported in abstract.
Questions still open
- Does marijuana use in older adults worsen depression and anxiety, or do people with these symptoms self-medicate with marijuana? Would longitudinal follow-up reveal cognitive changes in elderly cannabis users that cross-sectional studies miss? How does the association with functional impairment translate to practical outcomes like falls, hospitalizations, or loss of independence?
Read the original research
Marijuana use among community-dwelling older adults: A population-based study.
International journal of geriatric psychiatry, 39(4), e6086
The International Journal of Geriatric Psychiatry is a reputable journal focusing on mental health in older populations.
Citation
De Genna, Natacha M; Jacobsen, Erin; Ganguli, Mary. (2024). Marijuana use among community-dwelling older adults: A population-based study.. International journal of geriatric psychiatry, 39(4), e6086. https://doi.org/10.1002/gps.6086
Explore the wider topic
- LGBTQ+ and Cannabis: Higher Use Rates and Recovery
- Cannabis-Induced Psychosis: What It Is, Who's at Risk, and What to Do
- BetterHelp, Cerebral, and Online Therapy: Honest Review
- Quitting Weed with ADHD: Why It Is Harder and What Actually Helps
- Quitting Weed with Depression: What You Need to Know
- Quitting Weed with PTSD: A Practical Guide
- Self-Medicating with Weed: Why It Works Until It Doesn't
- Weed and OCD: Self-Medicating Intrusive Thoughts
- Weed and PTSD: What the Research Actually Shows
- Weed and Childhood Trauma: ACEs, Self-Medication, and the Path to Real Healing
- Weed and Suicidal Thoughts: What You Need to Know
- Why Does Weed Make Me Anxious Now When It Didn't Before