Dementia is a general term for the impaired ability to remember, think, or make decisions that interfere with performing everyday activities. Contrary to common belief, dementia isn’t a normal part of aging.
In the United States, approximately 5 million adults 65 or older were living with dementia in 2014. By 2060, this number might reach nearly 14 million. While dementia primarily affects older adults, it can occur in younger individuals as well.
Could CBD have a role in the treatment of dementia? With the aging population and the ever-growing interest in CBD, many people want to examine the potential benefits of CBD and dementia.
What is Dementia?
The gradual weakening of muscles and bones is normal aging, and your brain experiences some age-related changes as the arteries and vessels stiffen. Some forgetfulness is a natural part of the aging process. Dementia is a loss of cognitive functioning caused by difficulty with thinking, remembering, and reasoning, which interferes with everyday functions.
Symptoms of dementia can vary from person to person. Noticeable changes can include impaired memory, attention, communication, judgment, or problem-solving. Shifts beyond typical age-related changes may become apparent.
Changes are usually gradual, but signs that indicate dementia can include:
- Getting lost in a familiar neighborhood
- Difficulty remembering names of family and close friends
- Using unusual words to describe familiar objects
- Forgetting old memories
- Not being able to complete tasks independently
- Repeating questions
- Acting impulsively
- Losing balance or problems with movement.
Any notable reduction in abilities and skills may be a sign of dementia. By evaluating current capabilities and observing changes over time, loved ones can help distinguish typical aging issues from dementia.
With dementia, neurons in the brain are blocked from communicating with other brain cells and eventually die. The underlying causes of blockage define different forms of dementia.
Common Forms of Dementia
Alzheimer’s Disease is the most common form of dementia, accounting for up to 80% of all cases. Alzheimer’s causes specific changes in the brain, including the formation of amyloid plaques. The primary initial symptoms include forgetting recent events and conversations. A family history of Alzheimer’s is the leading risk factor.
Vascular dementia occurs when blood flow is disrupted to the brain. Risk factors like diabetes, high blood pressure, and high cholesterol can contribute to the disease. Symptoms and progression can vary based on the amount of blockage and the areas of the brain affected.
Lewy body dementia forms when specific proteins (Lewy bodies) affect the brain’s chemical messengers. In addition to memory issues, this can cause physical symptoms like movement or balance problems. Changes in daytime alertness, trouble sleeping at night, and visual hallucinations can also occur.
Frontotemporal dementias manifest in behavioral changes as proteins form in the front lobes of the brain. Early signs may include unusual or inappropriate behaviors, emotional swings, or neglecting responsibilities at work or home.
Risk Factors for Dementia
Although dementia isn’t a normal part of aging, the likelihood of dementia increases with age. Most cases affect those 65 and over. As the population in the United States continues to age, a self-reported cognitive decline study by the CDC indicates that older adults are concerned. More than 48% of adults from 45 to 64 have discussed memory issues with their doctors. Other risk factors include family genetics, race, and gender.
A family history of dementia increases its risk, although not all forms of dementia have a genetic component. A close family member with dementia may raise the risk, but having no family history of dementia does not ensure it won’t develop.
Certain groups, including African Americans, American Indians, and Alaskan Natives, have the highest rates of dementia. Women are more likely to get dementia than men, which may relate to their longer life expectancy.
Some risk factors are fixed, but lifestyle changes can help reduce risks.
Preventing Dementia
Research suggests that by adopting better habits, people can reduce the risk of developing dementia and other similarly related illnesses. These habits include:
- Being physically active
- Maintaining a healthy diet and weight
- Managing blood sugar
- Preventing and correcting hearing loss
- Avoid smoking and excess alcohol
The first step in the treatment of dementia is diagnosis. Other factors can mimic dementia, such as vitamin B-12 deficiency, drug interactions, infections, or hypothyroidism, so a medical diagnosis is necessary.
Diagnosis begins with cognitive ability testing, checking attention, memory, and problem-solving. Next, a physical exam, blood tests, and brain scans like a CT or MRI will look for an underlying cause.
Once diagnosed, prescription medications may slow the progression or ease symptoms. These are most effective in the early stages of dementia and can lose effectiveness over time. There is no cure for this progressive disease, but some interventions can improve the quality of life.
Benefits of Using CBD for Dementia
In recent years, older adults have embraced CBD edibles for anxiety reduction and neuroprotection. Interest has grown in the potential benefits of using cannabidiol (CBD) for Alzheimer’s Disease and other forms of dementia. Studies that focus on the underlying biological processes involved in the development and progression of dementia have reported encouraging news. According to current research, CBD shows promising results in addressing various aspects of this disease.
CBD for Preventing and Treating Dementia
A review of multiple studies of both THC and CBD found they play a targeted role in a myriad of brain protections and functions.
CBD activates a receptor in the brain called PPARγ, which helps protect brain cells from damage caused by harmful substances and stress. This protection is vital because it can prevent the deterioration of brain function seen in conditions like Alzheimer's disease. CBD protects cells from damage, reduces harmful molecule production, and prevents abnormal protein processes.
The CBD-activated PPARy receptor also preserves neurotransmitters essential for brain function while promoting the growth of new healthy brain cells in areas important for memory and learning.
One study found CBD beneficial for those experiencing memory loss and cognitive decline associated with dementia. Furthermore, adding THC to the treatment may improve results. A synergistic treatment that includes both THC and CBD is more effective in memory treatment than either CBD or THC alone, according to this study.1
CBD for Dementia Symptom Management
A symptom in advancing cases of dementia is agitation or aggressive behaviors that can pose a danger to the patient or caregivers. This behavior challenges family and caregivers, often leading to institutional care as the patient becomes too difficult to manage at home.
An observational study in Switzerland followed an alternative treatment for behavioral outbursts in institutionalized patients. Patients with severe dementia symptoms received a daily dosage of THC and CBD. Dosages started at a baseline of 7.6mg THC/13.2mg CBD over two weeks. After one month, the dose increased to 8.8mg THC/17.6mg CBD and 9.0mg THC/18.0mg CBD after two months. The lowest daily dosage given was 7mg THC/14mg CBD, and the highest was 13mg THC/26mg CBD.
Among the patients, they found an improvement in body rigidity, a problem in some cases of dementia. Further, behavior improved overall, allowing half of the patients to decrease or stop other psychotropic medications.2 While this is positive news, there is no FDA-approved medication to treat anxiety and agitation in patients with dementia.
A current clinical trial is studying the use of CBD as a safe and effective treatment. Preliminary results from this ongoing trial have shown that a four-week CBD treatment for patients with dementia and anxiety had a significant reduction in anxiety symptoms and improvements in mood, quality of life, and executive function.3 Since behavioral issues can cause great difficulty in care for dementia patients, studies continue to research solutions.
Other researchers ran a randomized clinical trial for men and women with dementia and behavioral disturbances. Participants received a placebo or doses of a 30:1 CBD/THC oil. Compared to pre-trial assessments, patients given the CBD oil experienced fewer sleep disturbances and less agitation and aggression, with minimal side effects.
A considerable portion of patients in the group, over 30%, reached the maximum allowable dosage of THC (10.5mg), suggesting that THC combined with CBD might contribute to the decrease in behavioral issues. Other controlled studies confirm THC alone shows no significant improvement.
Animal studies considered how CBD might affect agitation. CBD regulates neurotransmitter receptors in the brain, including serotonin, cannabinoid (CB1 and CB2), anandamide, and GABAA receptors. Researchers found ongoing administration of CBD reduced inflammation and amyloid beta plaque, contributing to lower anxiety, depression, and stress-related behaviors.
Overall, each study found CBD or a CBD/THC combination supported positive effects on challenges in dementia treatment. CBD protects brain cells and fosters the growth of new cells while reducing rigidity, agitation, anxiety, sleep disturbances, and general behavioral disturbances. In every case, CBD was well tolerated.
CBD and Dementia: Are There Any Risks?
Some ask, “Does CBD cause memory loss?” Most neurologists agree that CBD does not. In the brain, CBD reduces inflammation and offers neuroprotection. These potential benefits of CBD are encouraging for dementia patients, but like any drug, it is not risk-free.
CBD is generally safe, but adverse reactions can occur, especially in older patients. Common side effects include sleepiness, confusion, disorientation, restlessness, fear, and hallucinations. Researchers in the study of a CBD/THC combination on dementia patients expressed concern over tolerance of the administered dose of 10mg THC. Although few subjects experienced decreased memory, sleepiness, or hallucinations, THC might contribute to these side effects, even when tempered with CBD.4
Older adults often require multiple prescriptions to manage health concerns. CBD interactions with commonly prescribed medications may cause liver enzyme changes, diarrhea, fatigue, vomiting, or sleepiness.5 Most of these symptoms occur at higher doses of CBD. However, patients and caregivers should check with their doctor before adding CBD to their treatment plan.6
CBD as a Treatment for Dementia
There is no definitive evidence that CBD can replace existing treatments for dementia. CBD and dementia research is currently limited, and no solid conclusive evidence proves that CBD alone can alter the path of this disease.
There is some success in treating symptoms like mood changes and sleep difficulties with CBD, but more conclusive studies are needed.
Researchers have identified multiple benefits of using CBD against dementia challenges. This includes brain benefits like neuroprotection, reduced inflammation, and regulation of receptors. For dementia patients and their caregivers, quality of life improvement alone, such as less anxiety or agitation, can significantly enhance daily activities and care.
Since dementia requires long-term therapy, the safety of the drug is of high importance. The medication must reach the central nervous system and target the relevant cells and pathways to be clinically effective.
In clinical trials, CBD compares favorably to the drug rosiglitazone when used alone or in combination with donepezil in targeting the PPARy receptors. CBD produces the desired anti-inflammatory and neuroprotective effects and is safe to use long-term with minimal adverse side effects.7 Although more research is needed, CBD therapy for dementia holds excellent promise.
Tips for Using CBD for Dementia
Before starting any CBD treatment for dementia, speak with a doctor to assess any potential risks, like medication conflicts or underlying health conditions.
Treatment recommendations begin with a low dose, around 2.5mg to 5mg, gradually increasing by 2.5mg to 5mg as needed. The maximum recommended daily dose of CBD is at most 1,500mg.
Higher doses of THC may cause adverse effects in dementia patients. An optimal dose is the lowest amount of CBD and THC that comfortably produces the desired therapeutic benefits. Patients and caretakers should monitor the response carefully and adjust the dosage slowly to find the most effective and tolerable dose.8
Ask a Budtender: Which CBD is Best For Dementia?
Patients report that edibles are the simplest way to get the benefits from CBD. Edibles are easy to use, simple to dose, and have longer-lasting effects compared to smoking or vaping. CBD gummies for dementia may be an enjoyable way to receive adequate relief.
When selecting CBD products, opt for regulated products, especially when it comes to medical use. Dispensary products are subject to stringent quality control measures, including independent testing for safety. Product labeling confirms the cannabinoid content and concentration. Testing also ensures that no contaminants or harmful pesticides ruin the quality and that safe products are assured.9
A research team studied multiple cannabinoids, including CBN (Cannabinol), CBC (Cannabichromene), CBDV (Cannabidivarin), and CBDA (Cannabidiolic Acid). They found promising results: these cannabinoids shield brain cells from toxic amyloid proteins and actively degrade and remove them.
Further, these same cannabinoids, especially CBN, hinder oxytosis (brain cell death) caused by promoting antioxidant defenses. CBN achieves this by directly fortifying the mitochondria, the cell’s energy source, and increasing its ability to fend off oxidative stress.
In the treatment of dementia, they found equal parts of CBD and THC (1:1 ratio) more effective than using either cannabinoid alone. THC can cause unwanted cognitive changes in high doses, although CBD tempers this.10
The current evidence suggests that the most effective strategies for treating dementia could be treatments that combine multiple cannabinoids, including low doses of THC or extracts with a balanced 1:1 ratio of CBD and THC. This approach achieves therapeutic benefits while minimizing the cognitive side effects of THC.
Fortunately, products are available to help relieve symptoms of dementia, including anxiety relief, reduced agitation, improved sleep, and pain management. Which CBD is best for dementia? Here are consumer picks for the best CBD for dementia to try.
Papa & Barkley 30:1 Releaf Capsules
Dementia patients benefit from lowered stress levels. The high CBD to THC ratio found in Papa & Barkley 30:1 Releaf Capsules lessen anxiety and agitation without causing sedation. The addition of THC may contribute to the entourage effect to enhance neuroprotective properties. Capsules may provide up to 8 hours of continuous relief, ideal for daytime use yet calming for nighttime. Each vegan, gluten-free capsule contains a full spectrum of cannabinoids, terpenes, and phytonutrients without solvents. Suitable for those new to cannabis.
Papa & Barkley CBD Releaf Capsules 30mg
Reducing overall anxiety improves the well-being of dementia patients. Papa & Barkley CBD Releaf Capsules may provide anti-inflammatory and neuroprotection benefits for non-intoxicating pain management. Containing less than 0.3% THC, these capsules offer gentle relaxation without concern for cognitive distortion. Capsules may promote up to eight hours of calming and pain-relieving benefits. These vegan capsules are solventless and full spectrum.
Level Calm Tablingual
Dementia-related mood swings distress the patient and challenge caregivers. The CBG formulation of Level Calm Tablingual may address the anxiety and agitation that accompanies dementia. As a sublingual under-the-tongue tablet, calming effects may begin within 5-20 minutes, lasting 1-2 hours. CBG works without causing impairment. Microdose tablets contain 5mg of CBG and are effective for new or cannabis-sensitive patients.
Kahna 1:1:1 CBN Tranquility Sleep
Disturbed sleep contributes to cognitive decline and reduces quality of life. Kahna 1:1:1 CBN Tranquility Sleep gummies combine 5mg each of CBN, CBD, and THC, which may promote restful and restorative nights for dementia patients. The all-natural blue raspberry flavor in an easy-to-chew gummy improves medication acceptance and makes dosing easy.
References
- Kim SH, Yang JW, Kim KH, Kim JU, Yook TH. A Review on Studies of Marijuana for Alzheimer’s Disease - Focusing on CBD, THC. Journal of Pharmacopuncture. 2019;22(4):225-230. doi:https://doi.org/10.3831/KPI.2019.22.030 ↩︎
- Broers B, Patà Z, Mina A, Wampfler J, de Saussure C, Pautex S. Prescription of a THC/CBD-Based Medication to Patients with Dementia: A Pilot Study in Geneva. Medical Cannabis and Cannabinoids. 2019;2(1):56-59. doi:https://doi.org/10.1159/000498924 ↩︎
- McManus K, Ash E, Harper D, Smith R, Gruber S, Forester B. Caring for Behavioral Symptoms of Dementia (CBD): A New Investigation into Cannabidiol for the Treatment of Anxiety and Agitation in Alzheimer’s Dementia. The American Journal of Geriatric Psychiatry. 2021;29(4):S110-S111. doi:https://doi.org/10.1016/j.jagp.2021.01.107 ↩︎
- Hermush V, Ore L, Stern N, et al. Effects of rich cannabidiol oil on behavioral disturbances in patients with dementia: A placebo controlled randomized clinical trial. Frontiers in Medicine. 2022;9. doi:https://doi.org/10.3389/fmed.2022.951889 ↩︎
- Huestis MA, Solimini R, Pichini S, Pacifici R, Carlier J, Busardò FP. Cannabidiol Adverse Effects and Toxicity. Current Neuropharmacology. 2019;17(10):974-989. doi:https://doi.org/10.2174/1570159X17666190603171901 ↩︎
- Brown JD, Winterstein AG. Potential Adverse Drug Events and Drug–Drug Interactions with Medical and Consumer Cannabidiol (CBD) Use. Journal of Clinical Medicine. 2019;8(7):989. doi:https://doi.org/10.3390/jcm8070989 ↩︎
- Bhunia S, Kolishetti N, Arias AY, Vashist A, Nair M. Cannabidiol for neurodegenerative disorders: A comprehensive review. Frontiers in Pharmacology. 2022;13. doi:https://doi.org/10.3389/fphar.2022.989717 ↩︎
- MacCallum CA, Russo EB. Practical considerations in medical cannabis administration and dosing. European Journal of Internal Medicine. 2018;49(49):12-19. doi:https://doi.org/10.1016/j.ejim.2018.01.004 ↩︎
- MacCallum CA, Lo LA, Pistawka CA, Boivin M. A Clinical Framework for Evaluating Cannabis Product Quality and Safety. Cannabis Cannabinoid Res. 2023;8(3):567-574. doi:10.1089/can.2021.0137 ↩︎
- Coles M, Steiner-Lim GZ, Karl T. Therapeutic properties of multi-cannabinoid treatment strategies for Alzheimer’s disease. Frontiers in Neuroscience. 2022;16(16). doi:https://doi.org/10.3389/fnins.2022.962922 ↩︎
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