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Long-term marijuana use associated with worse verbal memory in middle age

The JAMA Network Journals

Marijuana use over time was associated with remembering fewer words from a list but it did not appear to affect other areas of cognitive function in a study of men and women followed up over 25 years, according to an article published online by JAMA Internal Medicine.

Marijuana use is common among adolescents and young adults. It remains unclear whether there are long-term effects from low-intensity or occasional marijuana use earlier in life and whether the magnitude and persistence of impairment depends on the duration of marijuana use or the age of exposure.

The Coronary Artery Risk Development in Young Adults (CARDIA) study includes 25 years of repeated measures of marijuana exposure starting in early adulthood. In year 25, CARDIA measured cognitive performance using standardized tests of verbal memory, processing speed and executive function.

Reto Auer, M.D., M.A.S., formerly of the University of California-San Francisco and now the University of Lausanne, Switzerland, and coauthors used those measurements to study the association between cumulative years of exposure to marijuana use and cognitive performance in middle age among study participants who had marijuana exposures typical to the communities in which they live.

Of the 3,499 participants assessed at the year 25 visit, 3,385 (96.7 percent) had data on cognitive function. Among the 3,385 participants, 2,852 (84.3 percent) reported past marijuana use but only 392 (11.6 percent) continued to use marijuana into middle age.

Past exposure to marijuana was associated with worse verbal memory but does not appear to affect other domains of cognitive function. For every five years of past exposure, lower verbal memory corresponded to an average of 1 of 2 participants remembering one word fewer from a list of 15 words, according to the results.

Limitations to the study include self-reported information that is not always reliable.

"Future studies with multiple assessments of cognition, brain imaging and other functional outcomes should further explore these associations and their potential clinical and public health implications. In the meantime, with recent changes in legislation and the potential for increasing marijuana use in the United States, continuing to warn potential users about the possible harm from exposure to marijuana seems reasonable," the study concludes.


(JAMA Intern Med. Published online February 1, 2016. doi:10.1001/jamainternmed.2015.7841. Available pre-embargo to the media at

Editor's Note: The study includes funding/support disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures.

Commentary: Long-Term Marijuana Use, Cognitive Impairment in Middle Age

"The public health challenge is to find effective ways to inform young people who use, or are considering using, marijuana about the cognitive and other risks of long-term daily use. Young adults may be skeptical about advice on the putative adverse health effects of marijuana, which they may see as being overstated to justify the prohibition on its use. More research on how young people interpret evidence of harm from marijuana and other drugs would be useful in designing more effective health advice," write Wayne Hall, Ph.D., of the University of Queensland, Australia, and Michael Lynskey, Ph.D., of Kings College London, in a related commentary.

(JAMA Intern Med. Published online February 1, 2016. doi:10.1001/jamainternmed.2015.7850. Available pre-embargo to the media at

Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures.

Media Advisory: To contact study corresponding author Reto Auer, M.D., M.A.S., email To contact corresponding commentary author Wayne Hall, Ph.D., email

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