Can medicinal cannabis help with Alzheimer’s?
There is no doubt all forms of dementia take a tremendous toll on individuals and their loved ones. Medical cannabis research is fast growing in the arena of neurodegenerative diseases, including the most commonly diagnosed form of dementia – Alzheimer’s disease.
There’s been little progress made in the past decade in formulating or discovering novel treatments for Alzheimer’s.
Given the potential of cannabinoids as potent anti-inflammatory, antioxidant and neuroprotective agents, researchers are delving into the ways medical cannabis could aid those with dementia.
The endocannabinoid system and Alzheimer’s disease
The endocannabinoid system, or ECS, is an integral system managing and influencing the biological function of all humans and the large majority of animals.
Much like the nervous system, the ECS is made up of messengers and receptors that stimulate physiological actions. From your mood and food intake to your immune function and sleep cycles, the ECS has an influence over every aspect of the body.
When it comes to Alzheimer’s disease, changes in the ECS are strongly associated with symptoms and disease progression. Early research in this area suggests that ECS receptors and the availability of endocannabinoids, such as anandamide, change across the course of the disease.
Endocannabinoids and their receptors play a regulatory role in the transmission of signals and inflammation in the brain, both of which are altered or dysfunctional in the various forms of dementia.
By understanding the interaction between Alzheimer’s disease and ECS functions, researchers have identified ECS biomarkers that may assist in early diagnosis and hope to uncover ways to influence or support the ECS to improve treatments for Alzheimer’s patients.
Early research into medicinal cannabis and Alzheimer’s
Two of the hallmarks of Alzheimer’s disease are amyloid plaques and neurofibrillary tangles. The build-up of these plaques and tangles causes neuron loss resulting in the ongoing decline of memory, changes in mood and behaviours.
Research into medical cannabis and Alzheimer’s thus far has focused primarily on safety and reducing symptoms. A trial of 11 Alzheimer’s patients in Israel showed improvements in Alzheimer’s related delusions, agitation, aggression and irritability.
Despite these patients being on numerous neuropsychiatric medications, interestingly, only 3 out of 11 patients reported adverse side effects, that resolved with reducing the THC dose or weren’t associated with the medication.
Another study, investigating the effects of the synthetic cannabinoid Dronabinol in 40 people with varied types of dementia, showed significant reductions in patients resisting care, as well as aggressive and agitated behaviours.
The amounts of THC used in these studies are relatively low, 2.5mg -7.5mg twice daily, and unlikely to cause the typical psychotropic effects associated with cannabis.
Improving quality of life for Alzheimer’s patients through better sleep
A major feature of Alzheimer’s and other forms of dementia is sleep disturbances. Waking in the middle of the night, night wandering or emotional outbursts in the evening are common and difficult to manage for carers, especially in the home.
Much research has been dedicated to the benefits of medical cannabis for sleep disturbances, this study gathered data from carers.
One study observed that nurse practitioners had been hesitant about medical cannabis trials conducted on the dementia patients they care for. Yet, when providing accounts of the changes observed in their patients after treatment, the nurses noted how much more relaxed and less irritable these individuals were.
Medicinal cannabis aiding with appetite
Decreased appetite is common in older adults as metabolism and digestive capacity decreases with age. Early trials with synthetic cannabinoids and more recent studies with plant-based medical cannabis showed improvements in appetite and weight in Alzheimer’s patients with low body weight.
Improvements in appetite, food intake and body mass index with medical cannabis are well established, particularly in instances of anorexia and cachexia related to cancer treatments. More long term research into how medical cannabis can simultaneously improve food and nutrient intake while reducing negative mood and behaviours in Alzheimer’s will go a long way to supporting the quality of life of patients and their carers.
CBD for Alzheimer’s Disease
Cannabidiol, or CBD, is a non-intoxicating cannabinoid found in medical cannabis. CBD shot into the limelight for its ability to reduce seizures in epilepsy patients through its neuroprotective.
This neuroprotective action with CBD’s potential to promote the development of new brain cells is actively being explored in the context of dementia and Alzheimer’s disease.
In 2017 Australian researchers collated numerous pieces of in vitro and animal studies concluding that CBD has the capacity to reduce neuroinflammation and promote neurogenesis – the creation of new nerve cells in the brain.
Some animal research points to medical cannabis reducing the rate of memory impairment in social situations, which could mean the world to families who struggle with the loss of recognition of their partners, children or friends.
Australian trial using CBD for dementia
The dysfunction and rapid destruction of brain cells is key to the progression of Alzheimer’s symptoms. To see if CBD can reduce the decline in brain function, an upcoming Australian trial will be giving early-stage dementia patients CBD oil.
The study will assess if early treatment with CBD can slow deteriorations in mood, behaviour or cognition; and use MRI scans to assess changes in the brain compared to a placebo group. Watch this space!
Medical cannabis safety in older adults
As with any medication, medical cannabis isn’t suitable for everyone. Especially when it comes to our elders, it’s important to make sure any new medication is safe for their circumstances and in combination with any other medication they are taking.
While early research into the benefits of medical cannabis in Alzheimer’s disease is promising, long term data on the safety of cannabinoid medicines in older adults is limited.
Although there are concerns surrounding side effects in older adults, there is also data suggesting medical cannabis may help reduce the need for pain and other medications.
What the future holds
The foundations are laid for larger more comprehensive studies into the benefits of medical cannabis for Alzheimer’s.
Upcoming human trials are focused on reducing agitation if evidence from animal trials holds true in human patients, the future may see investigations into improving cognitive function and even halting memory decline.
In the present, treatments that assist in reducing caregiver burden and supporting quality of life for Alzheimer’s disease patients are a priority.
If you or your loved one have a dementia diagnosis our team at CA Clinics can offer guidance around how medical cannabis could be of benefit. Contact us at [email protected] if you’d like more information, or register here.
By Jessica Kindynis BHSC Nat