Marijuana Use in Older Adults: Health, Function and Fall-Related Injury

老年人吸食大麻：健康、功能和跌倒相关伤害

• 批准号: 10576324
• 负责人: Salomeh Keyhani
• 金额: $ 56.27万
• 依托单位: NORTHERN CALIFORNIA INSTITUTE/RES/EDU
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-06-15 至 2025-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10576324
• 关键词: Address; Adult; Adverse effects; Adverse event; Area; Benefits and Risks; Benzodiazepines; Caregivers; Categories; Cessation of life; Characteristics; Cognition; Cognitive deficits; Confusion; Data; Databases; Disorientation; Dizziness; Dose; Drowsiness; Elderly; Equilibrium; Event; Fatigue; Goals; Hallucinations; Health; Health Benefit; Health Status; Health behavior; Hospitalization; Injury; Interview; Legal; Link; Literature; Marijuana; Medical Records; Medicare; Medicine; Memory impairment; Methods; Mood Disorders; Multiple Sclerosis; Nausea; Opioid; Outcome; Pain; Pain management; Paranoia; Patients; Perception; Pharmaceutical Preparations; Pharmacologic Substance; Plants; Policy Maker; Polypharmacy; Population; Prevalence; Prospective cohort; Psyche structure; Psychoses; Psychotropic Drugs; Recording of previous events; Reporting; Research; Respiratory Tract Infections; Risk; Serious Adverse Event; Sleep; Sleeplessness; Smoking; Stress; Subgroup; Surveys; Telephone; Telephone Interviews; Tetrahydrocannabinol; Text; Veterans Health Administration; Vomiting; Washington; adverse event risk; adverse outcome; chronic pain; cohort; design; evidence base; fall injury; fall risk; follow-up; high risk; insight; marijuana use; marijuana user; mental state; older patient; respiratory; response; secondary outcome; side effect; systematic review

The prevalence of marijuana use among older adults is rising dramatically. Marijuana is being promoted as a harmless “herbal” treatment that can be used to treat insomnia, stress, caregiver fatigue, and pain, conditions that are common among the elderly. However, there is a complete lack of data on the effects of marijuana and its active component, tetrahydrocannabinol (THC), among older adults. In trials examining the effect of THC-based pharmaceuticals among younger populations and in specific conditions, serious adverse events reported included dizziness, nausea, somnolence, vomiting, disorientation, confusion, loss of balance, and hallucination. These adverse events of THC-based pharmaceuticals provide a framework to understand the potential harms of plant-based marijuana use in older adults. We hypothesize that marijuana use in older adults is associated with fall-related injury, any injury, and hospitalization for altered mental status and mood disorders. In addition, as smoking is the predominant form of use, respiratory complications are also likely. To address the extensive gap in the literature on the potential harms of marijuana in older adults, we propose to construct a cohort of patients 65 years and older in the Veterans Health Administration (VA) using merged national VA and Medicare data. Specifically, we propose to use validated text processing methods to review medical record notes and identify mentions of marijuana use to preliminarily categorize patients into marijuana users and non-users. We will then perform an in-depth 25-minute telephone health interview with each patient to ascertain exposure history and baseline characteristics. After adjusting for the baseline differences between users and non-users using the comprehensive interview data collected and the national VA data available, we will compare the rates of events among 2250 current marijuana users and 2250 non- users during the follow-up period. Our proposal will accomplish four goals: (1): To use a prospective cohort design to examine the association between marijuana use and the primary adverse outcome of all-cause hospitalization and the secondary composite outcome of all-cause hospitalization and death. (2) To use a prospective cohort design to examine the association between marijuana and the secondary outcomes of fall-related injury, any injury, altered mental status, mood disorders, and respiratory infections. (3) To examine whether specific subgroups of older patients are more likely to experience adverse outcomes. (4) To determine whether there is a level of safe use of marijuana in older adults. Though very little is known about the physical harms of marijuana in older adults, it is likely that use of marijuana is associated with adverse effects. Given increasing use among older adults, a better understanding of the risks of marijuana use in this population is urgently needed to disseminate accurate information to the public.

老年人使用大麻的流行率急剧上升。大麻正在推广 作为一种无害的“草药”治疗，可用于治疗失眠，压力，照料者疲劳和疼痛， 较早的条件。但是，完全缺乏有关影响的数据 大麻及其活性成分四氢大麻酚（THC）在老年人中。在审判中检查 基于THC的药物在年轻人和特定条件下的影响，严重的逆境 报道的事件包括头晕，恶心，嗜睡，呕吐，迷失方向，混乱，失去平衡， 和幻觉。基于THC的药品的这些不良事件提供了一个了解的框架 老年人使用植物性大麻的潜在危害。我们假设大麻在较老的 成年人与秋天相关的伤害，任何伤害和住院治疗有关，以改变心理状况和情绪 疾病。另外，由于吸烟是主要使用形式，因此呼吸并发症也可能是可能的。 为了解决有关老年人大麻潜在危害的文献中的广泛差距，我们 提议使用退伍军人卫生管理（VA）建造65岁以上的患者队列 合并了国家弗吉尼亚州和医疗保险数据。具体来说，我们建议将经过验证的文本处理方法用于 审查病理记录说明并确定提及大麻的使用，以初步将患者分类为 大麻用户和非用户。然后，我们将与 每个患者以确定暴露病史和基线特征。调整基线后 用户和非用户之间的差异使用收集的综合访谈数据和国家 VA数据可用，我们将比较2250名当前大麻使用者的事件率和2250个非 - 在后续期间用户。 我们的建议将实现四个目标：（1）：使用潜在的队列设计来检查 大麻使用与全因住院的主要不利结果与 全因住院和死亡的次要综合结果。 （2）使用潜在的队列设计 检查大麻与跌倒相关伤害的次要结果之间的关联，任何伤害， 精神状况，情绪障碍和呼吸道感染的改变。 （3）检查特定子组是否 老年患者更有可能经历不良后果。 （4）确定是否存在 在老年人中安全使用大麻。 虽然对老年人大麻的身体伤害知之甚少，但很可能会使用 大麻与不利影响有关。考虑到老年人的使用越来越多，更好地理解 迫切需要在该人群中使用大麻的风险，以将准确的信息传播到 民众。