DOI: 10.1177/08919887261502978 ISSN: 0891-9887

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

Andreana Benitez, Reyna Hickey, Nathaniel Baker, Kathryn Thorn, Zoe Watson, Lisa Nunn, Aimee McRae-Clark

Introduction

We 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.

Methods

47 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.

Results

Men 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.

Conclusions

Among 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.

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