Exploring Nabilone and THC/CBD Oil for the Management of Behavioural and Psychological Symptoms of Dementia: A Multiple Methods Study
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Authors
Carragher, Rianne
Date
2025-08-25
Type
thesis
Language
eng
Keyword
dementia , behavioural and psychological symptoms of dementia , cannabinoids , cannabis , long-term care , gerontology , older adults , dementia behaviours
Alternative Title
Abstract
Background: Major neurocognitive disorder, commonly referred to as dementia, is a significant global health challenge. Up to 97% of individuals with dementia experience at least one behavioural and psychological symptom of dementia (BPSD), which can impair quality of life and increase caregiver distress. Management of BPSD is complex, often requiring both non-pharmacological and pharmacological approaches. Despite these, symptoms frequently persist, and psychotropic medications are often prescribed off-label. Cannabis-based medicines have emerged as potential adjunctive or alternative options.
Objectives: The aim of this dissertation was to explore the use of nabilone and THC/CBD oil, independently, in the management of BPSD. Secondary aims were to examine the perceptions and acceptance of nabilone and THC/CBD oil by most responsible providers (MRPs) and substitute decision makers (SDMs) for residents living with dementia in long-term care (LTC).
Methods: A multiple methods approach was used, consisting of three components: (1) a scoping review of evidence on nabilone for BPSD; (2) a retrospective observational case series with a single point-in-time assessment of LTC residents with dementia prescribed nabilone by their MRP; and (3) two cross-sectional surveys of MRP and SDM perspectives. Outcome measures included the safety and effectiveness of nabilone, titration schedules, and perceptions of nabilone and THC/CBD oil.
Results: Nabilone was administered safely and effectively for BPSD in four LTC residents over 2 to 5 years. Maximum cumulative daily doses ranged from 4 mg to 11 mg, with improvements noted in agitation, aggression, and sexually disinhibited behaviours. Survey findings revealed MRPs reported limited knowledge and confidence regarding cannabinoid use. SDMs were more likely to consider nabilone or THC/CBD oil when BPSD symptoms became severe.
Conclusion: This dissertation highlights the potential role of cannabinoids, particularly nabilone and THC/CBD oil, in BPSD management. Future research should focus on cannabis formulations and outcomes in vulnerable populations. Improving quality of life for older adults and reducing caregiver burden remain key priorities. Targeted education on the clinical use of medical cannabis is essential for healthcare professionals and students working with older adults.
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Intellectual Property Guidelines at Queen's University
Copying and Preserving Your Thesis
This publication is made available by the authority of the copyright owner solely for the purpose of private study and research and may not be copied or reproduced except as permitted by the copyright laws without written authority from the copyright owner.
Attribution-NoDerivatives 4.0 International