Dementia is a progressive loss of previously acquired mental function. Often this is seen in those who suffer from diabetes, alcoholism, head trauma, or strokes. Alzheimer’s is a type of dementia associated abnormal protein deposits that build up in the brain, associated with inflammation, and cell death. Hemp gives hope for improving quality of life, by reducing anxiety and pain in loved ones and caretakers. Now that cannabis is gaining acceptance, larger human studies are coming along to back the anecdotal evidence. This article discusses the types of dementia, causes, risk factors, symptoms, staging, benefits found in cannabis research, caretaker reports and resources, along with a few ideas for prevention.

Types of dementia and primary cause:
• Alzheimer’s Disease – Amyloid plaque and neurofibrillary tangles
• Dementia with Lewy Bodies – Protein deposits called Lewy bodies linked to visual hallucinations, aggression, and tremors
• Vascular Dementia – Associated with strokes that cut off blood supply to areas of the brain
• Frontotemporal Dementia – Tau protein deposits associated with behavior/personality change, and difficulty with problem solving.

Risk factors:

• Genetics/family history
• Cardiovascular disease
• Diabetes
• Head trauma

Other causes of dementia (reversible, not a true dementia):

• Medication toxicity
• Alcoholism
• B12 deficiency
• Infection (urinary tract infection can mimic or worsen dementia symptoms)

Symptoms of dementia:

• Short term memory loss
• Difficulty retrieving words
• Confusion
• Agitation
• Inappropriate behavior or speech
• Sleep problems
• Repeating behaviors or questions
• Wandering
• Altered levels of consciousness
• Hallucinations
• Loss of control of bodily function and need for assistance.

Prevalence:

1. Age over 65 years: 10%
2. Age over 90 years: 37-50%

Stages of dementia:

Note mental age change and increased need for assistance as time goes on.

Cannabis research:

• 2006: Neuroprotective mechanism of cannabidiol was highlighted and the importance of this compound to inhibit β-amyloid plaque induced neurodegeneration with low toxicity in humans (1).
• 2009: Study found CBD to help with improvement of Parkinson symptoms, such as psychosis and reduced tremors without notable side effects (2).
• 2013: Findings highlighted the anti-inflammatory effects of CBD and demonstrated significant therapeutic potential for the treatment of inflammatory pathologies. (3)
• 2014: Studies of older subjects (>65 years old) found cannabinoids to be a valid treatment for behavior problems associated with dementia. Sedation like symptoms were most frequently reported during cannabidiol treatment. (4)
• 2017: Cannabidiol (CBD) protects hippocampal neurons from oxidative stress, enhances mitochondrial bioenergetics, and optimizes glucose metabolism. The hippocampus is an area where neurons are generated. (6)
• 2019: This animal study gave indication of reduced: neuroinflammation, neurodegeneration, and spatial memory impairment. (7)
• 2019: CBD was found to promote both a rapid and sustained antidepressant effect in animal models. CBD interacts with multiple neurotransmitter systems involved in depression, including the serotonergic, glutamatergic, and endocannabinoid systems. CBD induces rapid cellular and molecular changes in limbic brain regions (associated with instinct and mood), it promotes the formation of synapse between nerve cells in the medial prefrontal cortex (the area of the brain associated with cognition, behavior and decision making). CBD has been found to increase the levels of Brain Derived Neurotrophic Factor (BDNF) that promote survival of neurons. (8)
• 2019: Inflammation and blood-brain barrier disturbances are found in diabetes-associated dementia. Cannabinoids exert anti-inflammatory and vascular protective effects. (9).

Reports of what caretakers are saying about the use of CBD with loved ones (9):

• “CBD oil has been very helpful for agitation!”
• “Hemp gummy bears have changed her attitude.”
• “CBD oil has been fantastic, it does take off the edge and made hubby sleep better.”
• “Grandma has it in tea, she loves it, and is calmer now than before.”
• “CBD oil tincture without THC works great.”
• “Using it for my Mom’s anxiety. She has dementia and was having severe panic attacks–so bad that my normally sweet dispositioned mother would become combative. The CBD oil has completely resolved the issue. And I know it’s the oil because in the beginning I missed a dose a couple of times and the attacks started right back up both times. Her chronic depression has also lifted.”
• “It helped to chill my mom out when she was anxious. She would be a sleep in an hour. It was the best ever!!!”
• “I really cannot explain in words the benefit that we got from using CBD oil with my mom. She gets clearer of mind, it takes away her anxiety, it helps her sleep, it takes away her nightmares, it gave her back her appetite, and has stopped the memory loss from progressing.”

Caretaker Resources:

• Facebook Groups:
  • Dementia caregivers support group – This is a great place to share experiences, vent, and know that you are not alone. It is also a great place to pose questions to others who have gone through the process.
  • MisUnderstanding Dementia – Dr Mike Chua, helps people to understand dementia and the stages that a loved one goes through, he provides suggestions and inspiration on how to care for a loved one who has dementia.
• Teppa Snow (teepasnow.com) is an occupational therapist who has made it her mission to help families and professionals to understand how it feels to be living with the challenges of coping with the stages of dementia. She provides suggestions on how to take a positive care approach. She provides free videos, along with consultations and certifications.
• Alzheimer’s Association – This association provides information about resource to help loved ones suffering with dementia and provides information about the importance of caretaker self-care. https://www.alz.org/help-support/caregiving/caregiver-health/caregiver-stress

Prevention:

Dr Ethan Russo is a neurologist and cannabis researcher.  He was recently interviewed about the use of CBD for Alzheimer’s (AD) and Parkinson’s (PD) Disease patients and discussed other preventative approaches.  Here are a few quotes from his recent interview:

“CBD has been shown to interfere with the production of abnormal toxic matter in the brain of such patients. This is quite exciting, in as much as synthetic drugs designed for similar purposes have yet to advance in the clinic. CBD holds the potential to slow or perhaps even halt the degenerative process.”

“Fascinating epidemiological studies have linked diet to degenerative diseases, especially AD. Diabetes and obesity, which are rampant in the USA, as well as trans-fats (hydrogenated oils), all increase AD risk.”

“The best current approaches to AD and PD beyond what the conventional pharmacopoeia offers include: aerobic activity, daily mental exercise, Mediterranean diets with use of anti-inflammatory fruits and berries, probiotics and prebiotics. From cannabis, THC, THCA, CBD, beta-pinene, caryophyllene, linalool and limonene may all have important contributions to treatment of these disorders.” (11)

Dr Jones final thoughts:

We know cannabinoids reduce inflammation and pain, while improving neuroplasticity (flexibility of the brain), and mood.  Here are a few more things to keep in mind about prevention:

• Older people suffering from dementia have increased risk of malnutrition. Nutritional care and support should be an integral part of dementia management and is dependent on prognosis and will. (5)
• Many elders suffer with depression. For some, eating excess sugar is a way to bring sweetness into life. Sadly, this can result in the development of type 2 diabetes and cardiovascular disease. Good prevention involves supporting brain health and stabilizing blood sugar while satiating ourselves with essential fats, proteins, and nutrient dense carbohydrates. Nutrient dense carbohydrates include mineral rich, colorful vegetables, and antioxidant rich fruits, such as dark berries.
• Keep in mind that the brain is 60% fat, adequate essential fat consumption helps to optimize brain function. Great sources of essential anti-inflammatory fats include chia, flax, hemp hearts, walnuts, pumpkins seeds, avocado, and fish oil. If using fish oil, make sure to purchase quality products from companies that sustainably catch fish, and remove heavy metals. These essential fats are also building blocks of endocannabinoids or “bliss molecules” made in our bodies.
• Turmeric (Curcumin) has been found to have various mechanisms of action that support brain health. It is a source of antioxidant’s, reduces inflammation, and decreases amyloid plaque and tau proteins. Turmeric is best absorbed when combined with a fat. Including turmeric extracts was found to improve memory in patients with AD. (12)
• Craniosacral therapy is a physical medicine modality that helps to improve circulation, reduce tension and restrictions in the body, while providing time for relaxation. One study, that involved military personal and veterans, resulted in statistically greater improvements in pain intensity, range of motion, memory, cognition, and sleep in those who have suffered concussions/traumatic brain injuries. (13)

All of the preventative measures above, including craniosacral therapy and adrenal support, are beneficial for caretakers coping with stress.  Caretaking can very much take a toll on one’s health while watching a loved one progressively decline.  Many additional responsibilities are taken on, such as managing finances, taking loved ones to appointments, shopping, and preventing harm.  Unfortunately, there are often struggles that come with taking away rights and privileges as loved ones become confused, combative, obsessive, and paranoid at times. When a loved one’s mentality reverses to a younger age, more support is needed. Hemp gives hope in that it helps to relieve anxiety and pain for loved ones and caretakers as they go through this phase in life.

Wishing you and yours the best of health. 

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Sources:

1. Giuseppe, Esposito, et al. Cannabidiol inhibits inducible nitric oxide synthase protein expression and nitric oxide production in β-amyloid stimulated PC12 neurons through p38 MAP kinase and NF-κB involvement. Neuroscience Letters. Volume 399, Issues 1–2, 15 May 2006, Pages 91-95.
2. Zuardi, A., Crippa, J., Hallak, J., Pinto, J., Chagas, M., Rodrigues, G., Tumas, V. (2009). Cannabidiol for the treatment of psychosis in Parkinson’s disease. Journal of Psychopharmacology, 23(8), 979–983.
3. Mecha, M, et al. Cannabidiol provides long-lasting protection against the deleterious effects of inflammation in a viral model of multiple sclerosis: A role for A2A receptors. Neurobiology of Disease. Volume 59, November 2013, Pages 141-150
4. Van den Elsen, G. et al. Efficacy and safety of medical cannabinoidsin older subjects: A systematic review. Ageing Research Reviews, Volume 14, March 2014, Pages 56-64
5. Volket, D et al. ESPEN guidelines on nutrition in dementia. Clinical Nutrition, Volume 34, Issue 6, December 2015, Pages 1052-1073
6. Shanshan, Suna, et al. Cannabidiol attenuates OGD/R-induced damage by enhancing mitochondrial bioenergetics and modulating glucose metabolism via pentose-phosphate pathway in hippocampal neurons. Redox Biology. Volume 11, April 2017, Pages 577-585. https://doi.org/10.1016/j.redox.2016.12.029
7. Murat, Çakıra et al. Cannabinoid type 2 receptor agonist JWH-133, attenuates Okadaic acid induced spatial memory impairment and neurodegeneration in rats. Life Sciences Volume 217, 15 January 2019, Pages 25-33
8. Silote, Gabriela, et al. Emerging evidence for the antidepressant effect of cannabidiol and potential underlying molecular mechanisms. Journal of Chemical Neuroanatomy, 2019
9. Brook, Emily, et al. Blood-brain barrier disturbances in diabetes-associated dementia: Therapeutic potential for cannabinoids. Pharmacological Research Volume 141, March 2019, Pages 291-297. https://doi.org/10.1016/j.phrs.2019.01.009
10. Facebook Dementia Caregivers Support Group. Caretaker response to use of CBD with loved ones suffering from dementia. (Feb 28, 2019)
11. Rosner, Abbie. Cannabis for Parkinson’s and Alzheimer’s Diseases – An Interview With Dr. Ethan Russo. Feb 26, 2019, 07:00am https://www.forbes.com/sites/abbierosner/2019/02/26/cannabis-for-parkinsons-and-alzheimers-diseases-an-interview-with-dr-ethan-russo/
12. Siahaan AMP, Japardi I, Rambe AS, Indharty RS, Ichwan M. Turmeric Extract Supplementation Reduces Tau Protein Level in Repetitive Traumatic Brain Injury Model. Open Access Maced J Med Sci. 2018;6(11):1953–1958. Published 2018 Nov 8. doi:10.3889/oamjms.2018.440Mishra S, Palanivelu K. The effect of curcumin (turmeric) on Alzheimer’s disease: An overview. Ann Indian Acad Neurol. 2008;11(1):13–19. doi:10.4103/0972-2327.40220
13. Wetzler G, Roland M, Fryer-Dietz S, Dettmann-Ahern D. CranioSacral Therapy and Visceral Manipulation: A New Treatment Intervention for Concussion Recovery. Med Acupunct. 2017;29(4):239–248. doi:10.1089/acu.2017.1222

*These statements have not been evaluated by the FDA. The information provided or use of these products is not intended to diagnose, treat, cure, or prevent any disease.