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Marijuana Alzheimer’s Disease Treatments

by in Written by Dr. Daniel May 15, 2020

A common question of many adults with aging parents is: Does CBD or THC found in marijuana help Alzheimer’s patients? Please read along as we look at the potential benefits of medical marijuana for Alzheimer’s disease.

Alzheimer’s and Marijuana?

According to the Mayo Clinic, “Alzheimer’s disease is a progressive disorder that causes brain cells to waste away (degenerate) and die. Alzheimer’s disease is the most common cause of dementia — a continuous decline in thinking, behavioral and social skills that disrupts a person’s ability to function independently.” Alzheimer’s Disease not only impacts the patient, but also those around them. Elderly Alzheimer’s patients may benefit from marijuana and reduce the challenges experienced by everyone involved.

At Ozark MMJ Cards, some of our patients are in the early stages of this disorder. These elderly marijuana users and their providers often have questions. We wanted to lay the groundwork for how the intrinsic pharmacology of cannabis medicines counteract the neuroinflammatory process characterizing Alzheimer’s Disease (AD). Starting with a brief history, we delve into the science behind the disease process and how cannabis may hold immense promise AD patients. This installment closes up with guidelines on dosing, methods of ingestion, and which cannabis strains may be most helpful in dealing with symptoms associated with AD. We hope that this writeup helps you to understand the benefits of medical marijuana for Alzheimer’s patients.

History of Cannabis and Alzheimer’s

Abstract Representation of Alzheimer’s

As far back as 1890, Sir John Russell Reynolds, MD, Physician to Queen Victoria, published his findings on cannabinoid treatment on dementia patients. He describes patients wandering and fidgety at night or what Sir Reynolds referred to as sundowning – that is until they were given a small dose of Cannabis Indica at bedtime. Through Sir Reynold’s research and testing, he determined that cannabis decreased the effect of sun-downing. Sir John Russell Reynolds, MD, recognized the benefits of medical marijuana for Alzheimer’s patients, which we are still exploring today.

“I have found nothing comparable in utility to a moderate dose of Indian hemp given at bedtime. It has been absolutely effective for months and indeed years, without any increase in the dose.” – Sir Reynolds

Pathophysiology of Alzheimer’s Disease

Image representation of Pathophysiology of Alzheimer’s Disease

To understand the benefits of marijuana for Alzheimer’s sufferers, understanding the way the disease works is helpful. Alzheimer’s disease usually begins by attacking the brain’s hippocampus, a critical brain region for memory processing. The three hallmark characteristics of the Alzheimer’s brain include:

  • The buildup of amyloid-ß (Aß) plaques
  • Tangles of fibers inside brain cells called neurofibrillary tangles
  • The activation of support cells in the brain called microglia

Over time, neurofibrillary tangles from degenerated axons (the long projections from nerves that transmit electrical impulses) form webs. These dense misfolded webs form at the junction of nerves called synapses, thus preventing communication from one nerve to another. In this manner, there is a functional decrease in the amount of available Acetylcholine, the neurotransmitter that is chronically deficient in Alzheimer’s dementia. The lack of acetylcholine is the primary cause of the symptoms of Alzheimer’s that medical marijuana can reduce.

The lack of acetylcholine forms the basis of nerve degeneration driving the clinically observable manifestations seen in Alzheimer’s dementia. These observed manifestations include recent memory dysfunction, executive dysfunction, disruption in sleep/wake patterns, personality changes, depression, and irritability. These are common symptoms in the elderly who have Alzheimer’s marijuana can help treat.

The Science Behind Cannabis on Alzheimer’s Patients

The increase in endocannabinoid tone in Alzheimer’s patients reflects the adaptive homeostatic response to nerve inflammation. The increase in endocannabinoids leads to improvements in neuroinflammation, oxidative stress, neurogenesis, and cerebral blood flow. Cannabinoids exert a multiplicity of actions to modulate neuronal dysfunction.

Central to this adaptive process is the critical presence of CB2 receptors on microglia. These vital support cells act as scavengers for the nervous system and clear out inflammatory debris. CB2 receptor activation on microglial cells initiates a cascade of events that potentiates beta-amyloid removal and reduces nerve inflammation. Such a cascade of benefits might be achievable through marijuana for the elderly among us.

Please note carefully the concept of cannabis medicines restoring cellular balance by mitigating oxidative stress will be revisited, ad nauseum, as this mechanism is central to the idea of cannabinoid rescue.

Activated CB1 receptors on the surface of microglial cells decrease harmful inflammatory glutamate release from nerve cells. This is the mechanism underlying marijuana’s beneficial effect on Alzheimer’s dementia.

CB1 receptor activation also inhibits acetylcholinesterase, the enzyme responsible for the breakdown of acetylcholine. Inactivation of this degrading enzyme increases the amount of Acetylcholine available at the nerve endings (synapses). Ironically, the same mechanism is employed by pharmaceutical drugs used to increase acetylcholine concentration in the nerve terminals of the central nervous system of Alzheimer’s patients.

Anandamide and 2-Acyl glycerol (2-AG) are increased in affected areas of the brain, as well as their metabolizing enzymes – Fatty acid amino hydrolase (FAAH) and monoacylglycerol lipase (MAGL).

With this information in mind, we can turn to specifics on how medical marijuana Alzheimer’s treatment benefits elderly patients.

Cannabis and Alzheimer's Patients

Alzheimer’s Patient MRI Scan

So, what help for Alzheimer’s can marijuana provide? Is it the marijuana or something in it, like CBD? Does CBD and marijuana help Alzheimer’s patients?

The pathophysiology and science of Alzheimer’s lead to devastating effects on patients’ orientation, including person, place, and time. As a result, they are easily confused by familiar places and even distrust family members close to them. Caregivers also suffer miserably with combative patients who often have other comorbid conditions (one or more diseases or conditions that occur with another condition in the same person at the same time) that complicate management. Visual and hearing loss also contribute to disorientation and resultant mood disorders. This is where marijuana can benefit the elderly in reducing these devastating symptoms.

In addition, sundowning can be particularly frightening for patients. Because there are deficits in recent memory once the sun goes down, patients can’t discern whether the day has just finished or is just beginning:

Imagine your anger when being denied morning coffee by a stranger claiming to be your grown child
You go to grab your car keys but are told you don’t drive
You want to take your dog for a walk but are told you don’t have a dog
Everyone telling you what to do is just annoying and undignifying

The disconnect lies in that Alzheimer’s patients have a conscious awareness that memories exist; they just can’t access them. This maddening scenario for the patient and caregivers spins into a vicious cycle of constant apprehension and confusion. Medical marijuana helps Alzheimer’s patients with these symptoms. To alleviate some of these feelings, there are Alzheimer’s symptoms that may respond to low-dose cannabis, including sleep problems, paranoia, anxiety, pain, poor appetite, and weight loss. It is here where we begin to answer the question: Does cannabis help Alzheimer’s patients? As you have seen so far, there is evidence that medical marijuana Alzheimer’s treatment has benefits for the elderly.

Cannabis for Alzheimer’s Patients: Studies, Dosing, and Strains

Elderly Man Smoking Marijuana
  • A 2016 study published in the Journal of Alzheimer’s Disease looked at nursing home patients with Alzheimer’s dementia who had THC oil added to their current meds [1,2]. All patients reported improvements in sleep, agitation, irritability, and caregiver distress as a result of a medical marijuana Alzheimer’s treatment.
  • Check out this YouTube video on cannabis and an Alzheimer’s patient – the video is taken by a son of his mom before and after cannabis dosing. You can see the effect of marijuana on Alzheimer’s patients.
  • Preliminary studies in rodents show the ideal response at a one-to-one (1:1) THC to CBD ratio in terms of reducing harmful Alzheimer’s amyloid plaque. THC and CBD are beneficial chemicals in marijuana for Alzheimer’s patients.
  • Maximal dampening of neuroinflammation is achieved with the following dosing schedule of medical marijuana for Alzheimer’s patients:
    • 2.5 milligrams THC at bedtime and 1.5 milligrams at breakfast and lunch
    • The target dose is 5 milligrams of THC two to three times daily
    • Balloon vaporizers are the favored delivery method for elderly Alzheimer’s patients. Smoking is not recommended for these patients due to fire hazards – Vaporizing balloons are a better option
  • Great care must be exercised with the administration to the demented elderly. They are at greater risk for injury with falls. Oral forms are excellent for these patients, but attention must be paid to make cannabis inaccessible so they don’t mistake it as a snack.

This clinic suggests that patients or caregivers look for cannabis strains with high myrcene and linalool content for their sedative properties and THC synergy. Myrcene enables the cannabinoids to transfer from the blood to the brain more quickly, and linalool promotes relaxation. The emphasis on high myrcene and linalool content in marijuana is for the benefit of elderly Alzheimer’s patients. These strains include high CBD varieties like ACDC and are great options for neuroprotective properties. Other viable cannabis options are Purple Urkle, Granddaddy Purple, and Bubba Kush. 

Cannabis Alzheimer’s treatment can help patients with symptoms, but results are dependent on the patient and their body. If you need help determining if cannabis may be right for you or a family member, please visit For those of you located in Oklahoma, Alzheimer’s is now considered a qualifying condition for a medical marijuana card in the state. You can apply here.

Additional References:

1.) Shelef, A., Barak, Y., Berger, U., Paleacu, D., Tadger, S., Plopsky, I., & Baruch, Y. (2016). Safety and Efficacy of Medical Cannabis Oil for Behavioral and Psychological Symptoms of Dementia: An-Open Label, Add-On, Pilot Study. Journal of Alzheimers Disease, 51(1), 15–19. doi: 10.3233/jad-150915

2.) Woodward, M. R., Harper, D. G., Stolyar, A., Forester, B. P., & Ellison, J. M. (2014). Dronabinol for the Treatment of Agitation and Aggressive Behavior in Acutely Hospitalized Severely Demented Patients with Noncognitive Behavioral Symptoms. The American Journal of Geriatric Psychiatry, 22(4), 415–419. doi: 10.1016/j.jagp.2012.11.022

One Comment
  1. So glad I read this!! I fear dementia, my grandfather passed away of it and my father as well. I was my fathers’ caregiver 2009-2010, he was up in the middle of the night “working on” the stove, the washer, etc. Then 2am one night I decided to smoke, maybe he’ll get a contact high and go to bed….instead he sat down and reached over for it nodding his head. We had conversation, in whatever time he was “living” in, then he’d go to bed and would tell ME, his daughter..Goodnite Dee….I’m hoping to slow down the early onset by taking care of my body and mind. Thanks Dr. Daniel for your wonderful blog!

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