humulene and Dementia

Palliative care aims to improve the quality of life in patients with incurable illness. Medicinal cannabis (MC) has been used in the palliative care setting to address multiple symptoms in patients.. To evaluate the full scope of available literature investigating the effects and potential harms of MC on symptom management and quality of life in palliative care.. PubMed, Embase, The Cochrane Library and clinicaltrials.gov were searched for eligible articles, published between 1960 and September 9, 2021. Quality of the evidence was assessed in accordance with Grading of Recommendations, Assessment, Development and Evaluations. Risk of bias was assessed using the RoB 2 tool for randomised controlled trials and the Risk of Bias in Non-randomized Studies-of Interventions (ROBINS-I) tool for non-randomized trials.. Fifty-two studies (20 randomised; 32 non-randomised) with 4786 participants diagnosed with cancer (n = 4491), dementia (n = 43), AIDS (n = 235), spasticity (n = 16), NORSE syndrome (n = 1) were included. The quality of evidence was 'very low' or 'low' for all studies, and low for only two randomised controlled trials. Positive treatment effects (statistical significance with P < 0.05) were seen for some MC products in pain, nausea and vomiting, appetite, sleep, fatigue, chemosensory perception and paraneoplastic night sweats in patients with cancer, appetite and agitation in patients with dementia and appetite, nausea and vomiting in patients with AIDS. Meta-analysis was unable to be performed due to the wide range of cannabis products used and the heterogeneity of the study outcomes.. While positive treatment effects have been reported for some MC products in the palliative care setting, further high quality evidence is needed to support recommendations for its use in clinical practice.

Topics: Acquired Immunodeficiency Syndrome; Analgesics; Cannabis; Dementia; Humans; Medical Marijuana; Nausea; Neoplasms; Palliative Care; Quality of Life; Vomiting

Topics: Anxiety; Anxiety Disorders; Cannabis; Dementia; Humans

Cannabis use is increasing among midlife and older adults. This study tested the hypotheses that long-term cannabis use is associated with cognitive deficits and smaller hippocampal volume in midlife, which is important because midlife cognitive deficits and smaller hippocampal volume are risk factors for dementia.. Participants are members of a representative cohort of 1,037 individuals born in Dunedin, New Zealand, in 1972-1973 and followed to age 45, with 94% retention. Cannabis use and dependence were assessed at ages 18, 21, 26, 32, 38, and 45. IQ was assessed at ages 7, 9, 11, and 45. Specific neuropsychological functions and hippocampal volume were assessed at age 45.. Long-term cannabis users showed IQ decline from childhood to midlife (mean=-5.5 IQ points), poorer learning and processing speed relative to their childhood IQ, and informant-reported memory and attention problems. These deficits were specific to long-term cannabis users because they were either not present or were smaller among long-term tobacco users, long-term alcohol users, midlife recreational cannabis users, and cannabis quitters. Cognitive deficits among long-term cannabis users could not be explained by persistent tobacco, alcohol, or other illicit drug use, childhood socioeconomic status, low childhood self-control, or family history of substance dependence. Long-term cannabis users showed smaller hippocampal volume, but smaller hippocampal volume did not statistically mediate cannabis-related cognitive deficits.. Long-term cannabis users showed cognitive deficits and smaller hippocampal volume in midlife. Research is needed to ascertain whether long-term cannabis users show elevated rates of dementia in later life.

Topics: Aged; Cannabis; Child; Cognition; Cognitive Reserve; Dementia; Hippocampus; Humans; Marijuana Abuse; Middle Aged; Neuropsychological Tests

Topics: Advance Care Planning; Advance Directives; Cannabis; Centers for Medicare and Medicaid Services, U.S.; Deep Sedation; Dementia; Drugs, Investigational; Federal Government; Forecasting; Health Care Costs; Hospice Care; Humans; Legislation, Drug; Long-Term Care; Palliative Care; Phytotherapy; Quality Assurance, Health Care; State Government; Terminal Care; Terminally Ill; Treatment Refusal; United States

Topics: Ataxia; Brain; Cannabis; Crack Cocaine; Dementia; Humans; Magnetic Resonance Imaging; Male; Substance-Related Disorders; Young Adult

Topics: Adult; Cannabis; Dementia; Humans; Male; Marijuana Abuse; Psychoses, Substance-Induced; Substance Withdrawal Syndrome; Syndrome

Topics: Aged; Alzheimer Disease; Brain; Cannabis; Cognition; Dementia; Humans; Models, Biological; Propranolol; Time Perception

Topics: Adolescent; Adult; Atrophy; Brain Diseases; Cannabis; Dementia; Female; Humans; Male; Substance-Related Disorders