COPS investigators have conducted several studies concerning cannabis use among older adults.

In 2015, we interviewed 128 persons over age 60 about cannabis use at senior centers and medical dispensaries across nine states that varied in cannabis legalization. Since then, we have secured competitive research funding and conducted mixed-method studies in Colorado, Illinois, Iowa and California.

In Colorado, we surveyed 139 adults aged 60 and over and conducted 17 focus groups. Findings indicated that older Coloradans who used cannabis were more likely to be primary Informal Care Partners (ICPs) than those who did not use cannabis. The ICPs who used cannabis were more likely to report improved sleep and quality of life than ICPs who did not use cannabis. In this study we also validated the reliability of two scales used to measure attitudes about cannabis.

In Illinois, we collected cross-sectional survey data from 4,135 older persons enrolled in the state medical cannabis program prior to recreational cannabis legalization. Of the respondents, 274 persons reported being ICPs who purchased cannabis for a care recipient. Relying on the proximal/distal framework, we separated the health impacts into two categories - whether the ICPs reported if the care recipients experienced an immediate effect (such as pain relief or improved sleep) or a more distal effect such as changes in overall wellbeing or memory. One ICP reported that cannabis made the care recipient’s memory decline. We know of no other research that has considered the health impacts of cannabis use in such a comprehensive manner.

In Iowa, we surveyed more than 500 physicians about recommending medical cannabis, and demonstrated how attitudes, knowledge and preferences varied extensively.  We also determined that individuals over the of age of 60 have accounted for nearly 25% of program participants while persons under the age of 30 make up less than 10%. The most common diagnosable medical conditions experienced by older program participants include cancer, glaucoma, cachexia, pain, and nausea—conditions that all are considered amendable to medical cannabis. The IDPH  also reported that cancer and fibromyalgia are among the most common reasons individuals are qualified for the cannabis program.    

In California, we conducted six focus groups with 26 informal care partners (ICPs) of People Living with Dementia (PLwD) recruited from the University of Southern California Rancho Los Amigos California Alzheimer’s Disease Center in Los Angeles. Findings revealed higher rates of cannabis use by PLwD and ICPs compared to what was reported in nationally representative samples. Our data indicated that more than 10.0% of PLwD received cannabis from their ICPs to manage BPSD, pain and sleep disturbances, and nearly 20.0% of ICPs used cannabis to reduce burden and stress and improve sleep.

Altogether, the COPS have developed several interview questions, constructed and fielded four separate surveys concerning cannabis use and older adults. We also have written questions included in special modules featured in the Health and Retirement Study and the Framingham Studies.

COPS investigators also have extensive experience in analyzing large secondary datasets.

We analyzed data from the Behavioral Risk Factor Surveillance System (BRFSS) collected from 2016-2020 in 10 states that administered supplemental surveys to evaluate memory loss and cannabis use. Respondents aged 65 years and older who reported experiencing confusion or memory loss in the past year were twice as likely to report using cannabis in the last 30 days compared to those who did not report confusion or memory problems. We also linked BRFSS modules on informal caregiving and cannabis use and found that among younger individuals (18-49 years), informal caregiving was associated with higher odds of cannabis use, and in this group, higher prevalence of cannabis use was associated with more intensive care.

With data from the 2018 Health and Retirement Study Cannabis module completed by 1,372 respondents aged 50 years and older, we distinguished current cannabis users from those who have never used and those who have some prior use. We then linked with 2018 and 2016 core data from the Health and Retirement Study and used multinomial regressions to identify associations among current cannabis use, attitudes about cannabis, place of residence, as well as current (2018) and past (2016) medical conditions, pain and sleep issues. We also examined associations among cannabis use, inpatient hospital stays and outpatient medical visits.

Our current analysis of the 2019 and 2021 California Health Interview Surveys has revealed that ICPs were more likely to use cannabis than non-care partners and as many as one of every four ICPs indicated they provided care for PLwD.