Alzheimer’s disease is a progressive neurodegenerative condition that affects the nerve cells in the brain and spinal cord. It is the leading cause of dementia worldwide.
Over time, Alzheimer’s disease impairs memory, thinking, and decision-making abilities.
Emerging research suggests that cannabis and its main compounds, tetrahydrocannabinol (THC) and cannabidiol (CBD), may improve quality of life in people with Alzheimer’s because of their neuroprotective and mood-regulating effects.
Research on cannabis for Alzheimer’s disease
While research is limited on cannabis for Alzheimer’s disease, some evidence suggests it may help manage symptoms.
In one review of studies, researchers found that cannabinoids significantly improved the following Alzheimer’s symptoms with no adverse side effects reported:
- Agitation
- Aggression
- Food refusal
- Sundowning (late-day confusion)
Other research suggests that medical cannabis and its compounds, including cannabinoids, terpenes, and flavonoids, can help manage Alzheimer’s symptoms, including:
- Anxiety
- Depression
- Inflammation
Preclinical studies have also found that certain cannabinoids, including THC and CBD, may reduce the buildup of amyloid beta. Amyloid beta is a protein fragment that forms plaques in the brain, which are a clear sign of Alzheimer’s progression.
However, the link between THC and dementia is more complicated, considering THC’s potential negative effects on short-term memory.
Overall, clinical trials are limited, and more human studies are needed to understand cannabis’ effectiveness and safety for Alzheimer’s. Still, early results are promising, and cannabinoids might be an alternative option for people who don’t respond to traditional medications.
Using cannabis for Alzheimer’s disease
There’s currently not enough evidence to support cannabis as a treatment for Alzheimer’s disease, but it might be able to help with mood and behavior-related symptoms.
These potential benefits of cannabis may be especially helpful for caregivers and loved ones, who are often significantly impacted by the challenging mental effects of Alzheimer’s.
Benefits
Some benefits of using cannabis for dementia include:
- Reduces agitation and aggression: There’s some evidence supporting medical cannabis in managing Alzheimer’s symptoms like aggression and agitation.
- Supports nutrition and weight management: One small study of 11 patients with Alzheimer’s found that dronabinol, a synthetic form of THC, reduced food refusal and increased body weight.
- Lowers inflammation: CBD has anti-inflammatory and neuroprotective properties, which might help reduce Alzheimer’s progression, as shown in early animal studies. More human studies are needed.
- Reduces plaque buildup: Cannabinoids like THC and CBD may support brain cell growth and reduce amyloid-beta plaque buildup.
Risks and side effects
As with any medication, medical cannabis has potential risks and side effects. These include:
- Affects memory when taken in high amounts: High doses of THC could make memory issues worse. Terpenes like pinene may help with memory impairment, with one study suggesting that it may prevent memory loss associated with THC.
- Reduces balance and coordination: THC can impair motor skills, increasing the risk of falls, which is a concern in older adults and people with Alzheimer’s.
- Affects mental processes (cognition): Cannabinoids may change perception and thinking and require careful dose management.
Is it legal?
You can legally access medical marijuana for dementia with a medical card.
While cannabis is still illegal at the federal level in the United States, Alzheimer’s disease is a qualifying condition under many medical marijuana programs. You’ll need to check the details of your state’s program to be sure it’s accepted.
In some cases, Alzheimer’s disease may not be listed as a qualifying condition, but a symptom of Alzheimer’s will be. This means that it’s still possible to qualify for medical cannabis if you or your loved one lives with Alzheimer’s and has another qualifying condition or symptom, such as anxiety.
Best strains and products for Alzheimer’s disease
Choosing a product or strain of cannabis for Alzheimer’s disease should be based on your personal preferences. There is little data or research when it comes to specific cannabis types for Alzheimer’s.
Because of the lack of research, recommendations for specific products are usually based on anecdotal evidence, or collective personal experiences, rather than scientific studies.
For a condition like Alzheimer’s, where symptoms are present throughout the day, long-term, consistent relief is generally needed. Therefore, CBD oil or edibles, tinctures, and transdermal patches with balanced THC and CBD content may be most beneficial for those with Alzheimer’s.
For more sudden flare-ups of a symptom, such as anxiety, vaporizing flower that’s rich in CBD with low or moderate THC content could be helpful.
However, a product that works for one person may not work for another. Finding what works best for you or your loved one may take some trial and error.
When first using medical cannabis or trying a new product, it’s essential to start with the lowest recommended dose and build up slowly over time. This is especially important when using THC-rich products.
Strains (aka cultivars)
In the case of Alzheimer’s disease, cannabis strains and products with balanced THC:CBD ratios and terpenes like pinene, linalool, limonene, and beta-caryophyllene may be ideal.
Consider the following strains of cannabis for dementia symptoms:
- Blue Dream: A moderate THC content strain with terpenes like myrcene, pinene, and beta-caryophyllene to help with appetite loss and insomnia
- Cannatonic: Fairly balanced in THC and CBD content and contains myrcene, pinene, and beta-caryophyllene to help with agitation and irritability
- Cotton Candy Kus, aka Purple Cotton Candy: A variety with plenty of myrcene, pinene, and limonene, which could help with stress, anxiety, and depression
- Harlequin: Low THC, high CBD, and abundant in myrcene, pinene, and beta-caryophyllene for chronic pain, stress, and anxiety
- Quin-N-Tonic: A CBD-rich strain with beta-caryophyllene, ideal for chronic pain and anxiety
- Remedy: Another CBD- and myrcene-rich variety, reported as being useful for stress and anxiety
- Xena: Rich in linalool, a terpene that may help reverse memory and behavioral impairments, and high in THC, which could be helpful for insomnia and appetite loss
Cannabinoid ratios
There are various CBD:THC ratios that could be useful for Alzheimer’s disease.
- CBD:THC 20:1: A high amount of CBD for inflammation and neuroprotection
- CBD:THC 3:1: A balanced ratio for mild symptom relief
- CBD:THC 1:2: A balanced ratio for general symptom relief, with greater emphasis on THC
- CBD:THC 1:1: Equal parts THC and CBD for comprehensive benefits, including pain management
- CBD:THC 1:2: Higher in THC for dementia agitation, chronic pain, and anxiety management
Terpenes
Terpenes are chemicals in cannabis that give it its unique smell. They also have their own therapeutic effects.
- Limonene and pinene: May help with brain fog and memory issues
- Beta-caryophyllene: Anti-inflammatory and useful for managing neuroinflammation
- Linalool: May restore emotional and cognitive function
Flavonoids
Flavonoids are natural compounds found in fruit, vegetables, and plants, including cannabis.
Flavonoid-rich diets have been shown to slow age-related cognitive decline and reduce the risk of dementia.
These flavonoids in cannabis may be helpful for their anti-inflammatory, neuroprotective, and antioxidant properties:
More about Alzheimer’s disease
Alzheimer’s is a type of dementia caused by a buildup of amyloid-beta plaques and tau protein tangles in the brain. These plaques and proteins build up and disrupt communication between nerve cells, causing inflammation.
Alzheimer’s disease accounts for 60% to 80% of dementia cases, affecting over 55 million people globally.
Risk factors for Alzheimer’s include aging, genetics, head injuries, high blood pressure, and depression.
Symptoms include:
- Memory loss
- Mood swings
- Language difficulties
- Decline in problem-solving and reasoning abilities
Other treatments for Alzheimer’s disease
There are several therapies that help slow the progression of Alzheimer’s and manage some of its symptoms.
Donanemab (Kinsula) is a drug designed to reduce beta-amyloid plaques, the main sign of Alzheimer’s. However, donanemab is usually only prescribed for the early stages of Alzheimer’s and dementia, meaning that other treatments are needed for later Alzheimer’s stages and those who don’t respond to traditional medications.
Traditional therapies
- Medications: Aducanumab (Aduhelm), donepezil (Aricept), galantamine (Razadyne), and rivastigmine (Exelon)
- Non-drug therapies: Memory exercises, art and music therapy, aromatherapy, and animal-assisted therapy
Natural and alternative therapies
- Dietary changes: Antioxidant-rich foods like fruits, vegetables, and tea
- Supplements: Omega-3 fatty acids, flavonoids, and vitamins
Cannabis as part of your treatment plan for Alzheimer’s disease
Using medical cannabis in an Alzheimer’s treatment plan requires close collaboration with your healthcare team.
You may want to explore using THC and CBD for dementia symptoms, including agitation, food refusal, and anxiety. There is some early research to support these uses, but more robust studies are needed.
People with Alzheimer’s disease might benefit most from products and strains with high CBD content and low to moderate THC content. This is to reduce possible side effects of THC overconsumption, like an increase in anxiety or memory issues.
Frequently asked questions
Get answers to your FAQs about medical cannabis for Alzheimer’s disease.
What type of CBD is best for dementia?
There is no best type of CBD for dementia, and scientific evidence is limited. Some research suggests that CBD-rich products may be ideal for agitation and anxiety associated with Alzheimer’s and dementia.
Does CBD help with sundowning?
People with Alzheimer’s or dementia can experience an increase in agitation or anxiety when the evening approaches, sometimes referred to as sundowning. Some research suggests that moderate or high doses of CBD may help manage anxiety, agitation, and irritability in people with dementia.
Does CBD affect memory?
Although THC-rich cannabis has been associated with memory problems when used over long periods, there’s no such evidence when it comes to CBD. In fact, there’s some evidence that CBD could help improve learning, memory, and brain plasticity. More research is needed to confirm these potential effects.
Is cannabis safe for older adults?
With proper dosing and medical supervision, cannabis can be safe and effective for older adults.
Resources
- 2024 Alzheimer’s disease facts and figures. https://alz-journals.onlinelibrary.wiley.com/doi/10.1002/alz.13809
- Alzheimer’s disease; taking the edge off with cannabinoids? https://pmc.ncbi.nlm.nih.gov/articles/PMC2190031/
- A review of the potential use of pinene and linalool as terpene-based medicines for brain health: Discovering novel therapeutics in the flavours and fragrances of cannabis. https://pmc.ncbi.nlm.nih.gov/articles/PMC8426550/
- Alpha-pinene moderates memory impairment induced by kainic acid via improving the BDNF/TrkB/CREB signaling pathway in rat hippocampus. https://pmc.ncbi.nlm.nih.gov/articles/PMC10347414/
- Cannabidiol and (−)Δ9-tetrahydrocannabinol are neuroprotective antioxidants. https://www.pnas.org/doi/10.1073/pnas.95.14.8268
- Cannabinoids and neurogenesis: The promised solution for neurodegeneration? https://pmc.ncbi.nlm.nih.gov/articles/PMC8541184/
- Cannabinoids for agitation in Alzheimer’s disease. https://pmc.ncbi.nlm.nih.gov/articles/PMC8313629/
- Cannabinoids for behavioral symptoms in severe dementia: Safety and feasibility in a long-term pilot observational study in nineteen patients. https://www.frontiersin.org/journals/aging-neuroscience/articles/10.3389/fnagi.2022.957665/full
- Cannabinoids for the neuropsychiatric symptoms of dementia: A systematic review and meta-analysis. https://journals.sagepub.com/doi/full/10.1177/0706743719892717
- Cannabinoids for the treatment of dementia. https://pubmed.ncbi.nlm.nih.gov/34532852/
- Characterizing cannabis-prevalent terpenes for neuroprotection reveal a role for α and β-pinenes in mitigating amyloid β-evoked neurotoxicity and aggregation In Vitro. https://www.sciencedirect.com/science/article/pii/S0161813X23001699
- Chronic treatment with 50 mg/kg cannabidiol improves cognition and moderately reduces Aβ40 levels in 12-month-old male AβPPswe/PS1ΔE9 transgenic mice. https://pubmed.ncbi.nlm.nih.gov/32116258/
- Dementia statistics, Alzheimer’s Disease International. https://www.alzint.org/about/dementia-facts-figures/dementia-statistics
- Dementia, World Health Organization (WHO). https://www.who.int/news-room/fact-sheets/detail/dementia
- Donanemab in early symptomatic Alzheimer disease: The TRAILBLAZER-ALZ 2 randomized clinical trial. https://pubmed.ncbi.nlm.nih.gov/37459141/
- Effects of dronabinol on anorexia and disturbed behavior in patients with Alzheimer’s disease. https://pubmed.ncbi.nlm.nih.gov/9309469/
- Flavonoid-rich foods, dementia risk, and interactions with genetic risk, hypertension, and depression. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2823676
- Flavonoid-rich fruit intake in midlife and late-life and associations with risk of dementia: The Framingham Heart Study. https://link.springer.com/article/10.14283/jpad.2024.116
- Flavonoids as prospective neuroprotectants and their therapeutic propensity in aging associated neurological disorders: https://www.frontiersin.org/journals/aging-neuroscience/articles/10.3389/fnagi.2019.00155/full
- Impact of cannabis-based medicine on Alzheimer’s disease by focusing on the amyloid β-modifications: A systematic study. https://pubmed.ncbi.nlm.nih.gov/32640965/
- Linalool reverses neuropathological and behavioral impairments in old triple transgenic Alzheimer’s mice. https://pmc.ncbi.nlm.nih.gov/articles/PMC4698173/
- Prescription of a THC/CBD-based medication to patients with dementia: A pilot study in Geneva. https://karger.com/mca/article/2/1/56/188630/Prescription-of-a-THC-CBD-Based-Medication-to
- Review of the neurological benefits of phytocannabinoids. https://pmc.ncbi.nlm.nih.gov/articles/PMC5938896/
- Taming THC: Potential cannabis synergy and phytocannabinoid-terpenoid entourage effects. https://bpspubs.onlinelibrary.wiley.com/doi/10.1111/j.1476-5381.2011.01238.x
- Terpenoids as potential anti-Alzheimer’s disease therapeutics. https://pmc.ncbi.nlm.nih.gov/articles/PMC6268347/
- THC for neuropsychiatric symptoms of dementia. https://psychiatry.uchicago.edu/news/thc-neuropsychiatric-symptoms-dementia
- The neuroprotective potentiality of flavonoids on Alzheimer’s disease. https://pmc.ncbi.nlm.nih.gov/articles/PMC9736131/
- Therapeutic potential of α- and β-Pinene: A miracle gift of nature. https://www.mdpi.com/2218-273X/9/11/738
- Use of cannabinoid-based medicine among older residential care recipients diagnosed with dementia: Study protocol for a double-blind randomised crossover trial. https://trialsjournal.biomedcentral.com/articles/10.1186/s13063-020-4085-x