CBD (aka Cannabidiol) is a compound derived from the Cannabis plant that has positive medicinal effects but does not make people feel high or anxious. CBD should not be confused with Marijuana and THC (Tetrahydrocannabinol) compound which is known for generating an altered feeling in users. CBD is derived from Cannabis plants, similar to how caffeine is derived from the coffee bean or aspirin from the bark of a Willow tree. CBD oil is the most common form of compound administration, with the oil contained in a gel cap or dropper bottle.
Alzheimer’s disease, Vascular Dementia, Dementia with Lewy bodies, Parkinson’s disease, Frontotemporal dementia, and Huntington’s disease are all dementia-related conditions that can be helped by CBD.
According to California’s Salk Institute researchers, their 2016 study found evidence that cannabinoids (such as CBD) could help remove dementia and increase connections between brain cells. Other laboratories validated those results. The US Food and Drug Administration has not yet approved CBD for the treatment of dementia but has approved a CBD-based drug called Epidiolex for treating epilepsy.
There are several ways CBD can work to improve the health of dementia patients. It can reduce inflammation, reduces oxygen buildup, work as a brain stimulant and neuroprotectant, and eliminate dead brain cells and the protein tangles that are believed to cause brain deterioration and dementia. From a user’s perspective, CBD may improve movement while reducing stress and anxiety. Additionally, it can reduce the decline of memory and other brain functions.
It should be noted that controversy surrounds CBD and the claims companies have made as to its positive effects. The FDA warns that CBD can cause liver injury (as shown in some animal experiments with super high doses) and affect the metabolism of other drugs. They also claim that long-term side effects remain unknown because it has not been studied for enough time. Acting on behalf of political biases that are not scientific, the FDA has not approved the use of CBD.
The health benefits continue to grow with new CBD and Alzheimer’s research. In recent studies, CBD has been shown to reduce or remove the impact of inflammation, oxygen buildup, and brain cell decline. CBD also increases levels of proteins that eliminate dead cells and plaques in brains with Alzheimer’s, improving both memory and motor function.
When the brain’s immune cells fail to clear blockages associated with Alzheimer’s disease, the result is an inflammatory response. When inflammation happens in the brain, oxygen is released as a result. The greater the inflammation, the greater the negative impact. Important brain functions such as memory are decreased as more oxygen is released in the brain’s cells. Memory loss and other brain deterioration indirectly lead to increased oxygen in the brain. CBD is an antioxidant, which helps reduce the problems associated with oxygen stress. Brain functions negatively impacted by oxygen stress can be improved by using CBD.
Alzheimer’s patient’s brain cells often show a path of rapid decline and destruction. The potential of stimulating brain tissue was recently discovered as a potential benefit of CBD. In clinical trials, CBD has shown the ability to reverse and even prevent the negative impact of Alzheimer’s. A 2011 study by Australian researchers Tim Karl and Carl Group found that CBD promotes the growth and development of brain cells, reducing the decline of memory and other brain functions.
More recently, in a study researchers were able to increase levels of proteins in the brain (called IL-33 and TREM2) that maintain cognitive functions by eliminating dead cells and helping clear beta-amyloid plaque tangles associated with the disease. After CBD was regularly injected into mice afflicted with Alzheimer’s, scientists noticed major improvements in their ability to think. Specifically, the mice could better tell the difference between old and new objects. The mice’s movement improved, as well. People with Alzheimer’s often develop stiffness that affects their ability to walk. In mice, they present similar symptoms and will continuously walk in a tight circle. After CBD treatments, that behavior stopped.
Vascular dementia is a general term. This describes problems with reasoning, planning, judgment, memory, and other thought processes caused by brain damage from impaired blood flow to one’s brain. To effectively treat vascular dementia, a 2016 study by the US National Institute of Health found that activating CB2 (cannabinoid) receptors in the brain helped stimulate better blood flow to the brain. Activating the CB2 receptors with CBD increases brain cell activity while reducing brain cell damage.
Lewy body dementia (LBD) is a disease associated with abnormal deposits of a protein called alpha-synuclein in the brain. These deposits, called Lewy bodies, affect chemicals in the brain. These changes can lead to problems with thinking, sleeping, movement, behavior, and mood. Unlike most pain, anxiety, or behavior management drugs, CBD does not block acetylcholine, the main chemical that LBD attacks. Research has shown that CBD can be an effective anti-inflammatory agent, reduce motor symptoms (tremors, rigidity, bradykinesia) and maintain sleep rhythms.
Parkinson’s is a chronic, progressive disease of the nervous system. It mostly affects middle-aged and elderly people. Parkinson’s is linked to decreased dopamine production. It is generally characterized by tremors, muscular rigidity, and slow, imprecise movements. A digestive imbalance may also play a role in the progression of Parkinson’s and the severity of symptoms. Cannabinoids such as CBD have been shown to contain effective brain protectors, antioxidants, and anti-inflammatory properties which can be beneficial for managing Parkinson’s disease. Read more about Parkinson’s and CBD.
Frontotemporal dementia or frontotemporal degeneration refers to a group of disorders caused by progressive nerve cell loss in the brain’s frontal lobes. These are the areas behind one’s forehead or its temporal lobes that are behind one’s ears and lead to symptoms of depression and psychosis. Unlike most antipsychotic drugs, CBD does not have an increased risk of death. Research has shown that CBD can be an effective anti-inflammatory agent, reduce anxiety, reduce motor symptoms (tremors, rigidity, bradykinesia) and maintain sleep rhythms.
Huntington’s disease, also known as Huntington’s chorea, is a genetic disorder that results in the death of brain cells. The earliest symptoms are often subtle problems with mood or mental abilities. A general lack of coordination and an unsteady gait often follow. According to 2016 research from the University of Madrid, due to CBD’s effectiveness as an antioxidant and its anti-inflammatory properties, CBD can be beneficial for managing Huntington’s disease. Experiments with mice have shown that another chemical called cannabigerol (or CBG) in marijuana plants can help maintain brain health for people with Huntington’s.
Another cannabinoid (a compound in cannabis) that has shown health benefits is cannabigerol, also known as CBG. Often taken as an oil, CBG is rarer than CBD and THC because there is much less of it in a plant. Whereas cannabis strains usually contain about 25% THC and 20% CBD, the compound CBG makes up only about 1% of most plants. CBG can, however, be extracted at higher volumes if the plants are harvested at the right age, meaning younger. CBG turns into CBD and THC as the plant gets older.
CBG acts as a binding agent to cannabinoid receptors in the body, strengthening the brain cells that are linked to functions like motivating us and regulating our appetites and sleep patterns. Studies have even shown that CBG protects nerve cells in the brain.
Those studies were done on the brains of mice, not humans. Specifically, mice with an experimental model of Huntington’s disease. There are actually fewer studies on CGB in humans than on other cannabinoids. While there is a strong case to be made that CGB works as a neuroprotectant that preserves nerve cells in the brain, the evidence is slimmer.
Like CBD, CGB is non-psychotropic and there is no feeling of being high. A key difference between CBD and CBG is that CBG is harder to extract and consistently more expensive.
The World Health Organization stated that “no public health problems… have been associated with the use of pure CBD,” and there has been no known association with the potential for dependence or abuse, unlike most pharmaceutical alternatives. The most commonly reported potential side effects of CBD usage were diarrhea, bloating, and nausea. About 3% of patients in studies reported liver problems and had to discontinue CBD use. In dementia patients, some reported increased tremors with high doses of CBD. As with any new treatment, patients and caregivers should monitor the effects and outcomes closely.
1) CBD is non-psychoactive and medicinal while THC is recreational, not medicinal
CBD (cannabidiol) has been shown to have antipsychotic and anti-anxiety effects in humans. This does not mean it is non-psychoactive, but rather that the psychoactive effects are often beneficial and non-intoxicating vs. the high feelings of the THC (aka Tetrahydrocannabinol) compound. THC has also shown medicinal benefits for patients, particularly those suffering from pain or inflammation, especially when combined with CBD for consumption by patients.
2) CBD is a sedative and reduces awareness or alertness
Even in high doses (600mg), CBD has not produced sedating effects in healthy humans. CBD usually makes humans feel more awake and alert without a negative impact on sleeping patterns. What is more likely happening is that cannabis strains being used by a patient that have high levels of CBD also contain a potentially sedating natural oil such as myrcene.
3) All CBD sources are the same
There are multiple sources of CBD such as hemp, medical cannabis, and isolate. Hemp-based CBD is plagued by mislabeling and recent studies have found that only 31% of 84 tested hemp-based CBD products were accurately labeled. Medical, locally sourced cannabis has consistently produced the best CBD source as it is held to stricter laboratory testing for potency and contaminants. If you’re ordering CBD online, know that mislabeling is common, and look for products that have been third-party tested. This means products that have been tested to show the stated percentages are correct.
4) CBD is legal in all 50 States
Despite CBD being sold in health food stores, tobacco shops, on Amazon, etc., and legalization by many US States, the Federal government has not legalized CBD-rich medical cannabis. Hemp-based CBD (with less than 0.3% THC) would not technically have this restriction because it is legal at the state and federal level everywhere except for South Dakota and Idaho. In these two states, CBD is only legal with zero THC. Medical-based CBD has been legalized in more than 30 states and is recreationally legal in a growing number of US locations.
CBD comes in many forms. They range in variety from being consumed orally, inhaled or absorbed into the skin. The most popular are:
-Oil (applied on the skin or under the tongue)
-Patches (like Band-Aids)
|Forms of CBD Administration|
|Form||Time Until Effects Are Felt||Duration of Effects|
|Oral: via Pill or Liquid Drops||15-90 minutes||4 hours|
|Skin: via Oil or Patches (like Band-Aids)||15-120 minutes||5 hours|
|Inhaled: via Vaporizer||2-3 minutes||1 to 2 hours|
CBD is widely available and can be found anywhere from local health food stores and tobacco shops to online retailers like Amazon. Because of this, its legality can be unclear. In 2018, the U.S. legalized CBD through the Farm Bill. That gave a national legal standard with guidelines dictating it contains less than 0.3% THC and is made from hemp (not marijuana). Because of differences between state and federal laws, each state can have its own requirements on its legality.
The table below breaks down the different requirements by state (as of Nov. 2022) for CDB’s legality.
|Legality of CBD by State (Updated Nov. 2022)|
|Conditions of Legality||States in which these Conditions Apply|
|CBD and medical cannabis is legally available to all adult users (21+)||Alaska, Arizona, California, Colorado, District of Columbia, Illinois, Maine, Massachusetts, Michigan, Nevada, New Jersey, Oregon, Vermont and Washington.|
|CBD and medical cannabis are legally available by prescription only||Alabama, Arkansas, Connecticut, Delaware, Florida, Georgia, Hawaii, Iowa, Louisiana, Maryland, Minnesota, Missouri, Montana, New Hampshire, New Mexico, New York, North Dakota, Ohio, Oklahoma, Pennsylvania, Rhode Island, Utah, Virginia, West Virginia, Wisconsin and Wyoming.|
|CBD with limited THC content (less than 0.3%) and made from hemp is legally available||Indiana, Kansas, Kentucky, Mississippi, Nebraska, South Carolina, North Carolina, Tennessee and Texas.|
|CBD with zero THC and made from hemp is legally available||South Dakota and Idaho.|
CBD can also be used legally in most states by residents of assisted living and memory care communities. Read more.
Because of the lack of federal approval for CBD, lawmakers wrote a bill that forces the FDA to do so. Introduced in early 2021, H.R.841 would make hemp and its byproducts legal and labeled as a dietary supplement under the FDA’s protection and jurisdiction.
This potential law is important for two major reasons. First, FDA approval is the key to making it more accessible to patients in all states and all care facilities. In addition, this leads to being a covered benefit by Medicare and private insurance companies. There is an industry standard that there is only coverage for FDA-approved medicines.
At this point, it is unknown if this Bill will make a difference. H.R.841 has a long time before it will be signed into law; it is estimated at two years before the FDA is forced to decide on CBD’s legality.
The most common means to obtain CBD-rich medical marijuana is from a state-licensed dispensary. These dispensaries can be found by searching on any number of dispensary directories (Leafly, Yelp, etc.) or Google Maps.
For those that have trouble with transportation, another increasingly available option includes delivery-based options. However, while convenient for senior patients, these options are not available in every city or town.
Finally, CBD can be legally purchased over the Internet and delivered to all 50 states. One reputable seller is CBDPure. One can visit their website here.
Given the lack of regulation with CBD products and their challenges of accurately reporting benefits to dementia patients, the dosage can be challenging. Even though no prescription is required to purchase CBD, many doctors are knowledgeable about the product and can provide dosage recommendations. Given that many patients with dementia take multiple medications, it is worth researching drug interactions when considering CBD. CBD dosage consultations can be arranged online with a doctor for about $60. This is a preferable approach to proceeding without professional medical input. However, it is unlikely one’s insurance would pay for these online dosage consultations.
Should one proceed in testing CBD’s impact on a loved one’s dementia, it’s best to start with the gel cap form of administration as the levels of CBD are consistent (when compared to a dropper) and the act of swallowing a pill is familiar. A further benefit is the once-daily scheduling. While many of CBD’s hypothetical benefits cannot be easily observed, loved ones should pay careful attention to behavior changes. People with dementia who appear calmer or experience less severe sundowning symptoms may be benefitting from CBD. Another area in which CBD’s impact may be observed is in reducing sleeplessness.
Finding the Right Dose
It’s a good idea to start small and slowly increase the dosage. Begin with between 1 and 2 milligrams per day for one week, and increase by 2 to 3 milligrams weekly until you notice improvements in symptoms. Base the dosage on body weight: go smaller if your loved one is particularly light, and give a slightly larger dose for a heavier person. A normal dose for an average adult is around 5 milligrams. You may not want to exceed that number. Again, consult a doctor as you would with any other new supplement or medication.
Currently, CBD has few options covered by insurance. The Food and Drug Administration would need to approve and there is only one CBD drug (Epidiolex, for epilepsy) that has this. New legislation is in congress that would force the FDA’s approval. When compared to the prices of alternative pharmaceuticals, patients and caregivers may still find that CBD-based medical marijuana is a more cost-effective and safer option.
Does Medicare cover CBD? Because of the federal prohibitions on prescribing Schedule 1 substances, there is no Medicare coverage for the purchase of medical marijuana or CBD derivatives. Any out-of-pocket costs one would incur purchasing marijuana for medical use will not count toward any deductibles under Part B or a Medicare Prescription Drug Plan. If congress will pass H.R.841 that will force the FDA to decide on CBD. In that case, coverage could potentially change to cover it.
Medicinal cannabis is not covered by Medicaid, private plans, group plans, the Veterans Administration (VA), or Obamacare plans. When the FDA approves CBD, there could be potential coverage of it.