Does Cannabis Affect Thinking in Older Adults? A Study of 540 People Says Mostly No

Cross-sectional analysis of 540 older adults (65+) from a well-characterized observational cohort spanning cognitively intact, MCI, and dementia. Cannabis use assessed by standardized questionnaire (past 6 months). Comprehensive neuropsychological assessment across 5 domains. Analysis: multivariate and univariate traditional methods plus propensity score matching. Subgroup analysis of cannabis-related problem severity among users.

The 65+ population is the fastest-growing demographic of cannabis users, and many are using it while navigating age-related cognitive concerns. Knowing that moderate cannabis use doesn't appear to worsen cognitive test performance across the dementia spectrum is relevant for clinical counseling—though the caveat about problem use severity is equally important.

This provides a reassuring counterpoint to concerns about cannabis and cognition in older adults. RTHC-00172 showed persistent brain network changes in chronic users even when sober, but this study suggests those neural changes don't necessarily translate to measurable cognitive deficits—at least at the moderate use levels typical of older adults. RTHC-00167 and RTHC-00178's cardiovascular findings remain relevant: even if cognition isn't affected, other health domains may be.

Cross-sectional design can't determine if cannabis use affects cognitive trajectories over time. Self-reported cannabis use (potential underreporting). The 11% use rate and moderate frequency mean heavy or daily users are underrepresented. Selection bias is possible—older adults who use cannabis may be healthier or more cognitively resilient to begin with. Neuropsychological tests may not capture subtle impairments in real-world functioning.