Sex Differences in Stress Reactivity and Dementia Risk: A Pilot Study of Older Adults With Problematic or Frequent Cannabis Use

IntroductionWe conducted a pilot study of older cannabis users with problematic or frequent (i.e. ≥4/7 days/week) use as a preliminary test of the hypothesis that compared to men, women would demonstrate greater stress reactivity and dementia risk.Methods47 participants ages 50-75 (55.3% male, 68% with cannabis use disorder) completed the Trier Social Stress Test, neuropsychological testing, 3T brain MRI, and blood draw.ResultsMen demonstrated: greater salivary cortisol, systolic blood pressure, and craving post-stress induction; worse memory and executive function; greater risk of heart disease or stroke and white matter hyperintensity volumes. There were no sex differences in Alzheimer's disease plasma biomarkers.ConclusionsAmong non-treatment-seeking older adults with problematic or frequent cannabis use, men may have greater risk for dementia due to stress reactivity and vascular risk factors. Future work must replicate and verify this unexpected sex difference and the specificity of these effects to cannabis use.