Cannabis use linked to increased dementia risk after emergency care

Individuals with an emergency department (ED) visit or hospitalization due to cannabis were at 23% and 72% greater risk of a new dementia diagnosis within five years compared to individuals with an ED visit or hospitalization for any other reason or the general population, according to a new study published in JAMA Neurology. 

Long-term and heavy cannabis use has been associated with memory problems in midlife along with changes in brain structure associated with dementia. We set out to estimate the risk of being diagnosed with dementia in a group of people whose cannabis use resulted in a visit to the emergency room or required a hospitalization for treatment." 

Dr. Daniel Myran, Canada Research Chair in Social Accountability, University of Ottawa, ICES Adjunct Scientist, Investigator at the Bruyère Health Research Institute, and Associate Scientist, The Ottawa Hospital

The study included 6 million adults aged 45 years or older from Ontario, Canada, who had no history of dementia when they entered the study cohort between 2008 and 2021. The individuals were followed until 2022. 

Health data held at ICES were used to compare new diagnoses of dementia for individuals with patterns of cannabis use that required acute care, defined as a visit to the emergency department (ED) or hospitalization. They were compared to three groups: 1) individuals with an all-cause acute care visit; 2) the general population; and 3) individuals with acute care due to alcohol use. 

Key findings: 

• Over the study 16,275 (0.3%) individuals aged 45 years or older had acute care due to cannabis, and 60% were male. 

• The annual rate of people over 45 with a first-time acute care visit for cannabis use increased over five-fold over the study period from 353 (6.9 per 100,000 individuals) in 2008 to 2,508 (37.6 per 100,000 individuals) in 2021. Increases were even larger in individuals 65+ years (26.7-fold increase). 

• 5% and 19% of individuals aged 45 years or older with treatment for cannabis in acute care were diagnosed with dementia within 5 and 10 years, respectively, compared to 3.6% and 14.8% in individuals with acute care for another reason and 1.3% and 5.5% in the general population. 

• After considering differences in social factors, other mental health diagnoses, and chronic conditions, individuals with acute care due to cannabis were at 1.23 and 1.72-fold higher risk than individuals with all-cause acute care and the general population, respectively. 

• The risk of dementia in individuals with acute care for cannabis was moderately lower than comparable individuals who required acute care for alcohol 

The authors make two cautions about the study findings. First, while they observed an association between patterns of cannabis use severe enough to lead to an acute healthcare visit they did not examine patterns of cannabis use that did not require acute medical care. Second, the findings do not show that cannabis use causes dementia. 

While evidence on the association between cannabis use and dementia continues to increase, the authors highlight potential mechanisms through which cannabis might result in dementia. 

"Regular cannabis use might directly increase the risk of dementia through changes in brain structure. It's also possible that regular cannabis use increases the risk of other established risk factors for dementia, including high blood pressure, head trauma and other injuries, and a higher risk for depression and social isolation," says co-author Dr. Colleen Webber, Scientist at the Bruyère Health Research Institute. 

 "While we collectively need more research to better understand potential risks of regular cannabis use on cognition and dementia, we hope these findings can inform discussion between patients and healthcare providers," says Myran.