Cognitive Difficulty Concentrating, Remembering, or Making Decisions According to Chronic Medical Conditions and...

Cannabis use and chronic diseases have both been associated with impaired cognitive ability. The current study will explore their independent and co-occurring effects on cognitive difficulty concentrating, remembering, or making decisions on the population level.

This study used a probability sample of United States (US) adults aged 18 years or older from the 2022 Behavioral Risk Factor Surveillance System (BRFSS), a telephone-administered survey. The cross-sectional survey collects data from a representative sample regarding health-related risk behaviors, chronic health conditions, and use of preventive services.

The study sample consisted of 94,918 participants in the BRFSS survey that completed the optional module on cannabis use. The prevalence of having difficulty concentrating, remembering, or making decisions was 12.7 percent (standard error [SE]: 0.21%), prevalence of monthly cannabis use was 14.9 percent (SE: 0.24%), that of daily cannabis use was 7.4 percent (SE: 0.18%), and prevalence of any chronic medical condition was 59.2 percent (SE: 0.32%). The prevalence of having difficulty concentrating, remembering, or making decisions was higher for those with a chronic medical condition (17.6% [SE: 0.31%] vs. 5.7% [SE: 0.25%], Rao-Scott p<0.0001). Such difficulty was also higher for those who used cannabis monthly (24.4% [SE: 0.731%] vs. 10.7% [SE: 0.21%], Rao-Scott p<0.0001) or daily (29.1% [SE: 1.12%] vs. 11.4% [SE: 0.21%], Rao-Scott p<0.0001). Greater cognitive difficulty for those with a chronic medical condition was accentuated by cannabis use; daily cannabis (vs. nonuse) was associated with 145-percent higher prevalence of cognitive difficulty and monthly cannabis use (vs. nonuse) was associated with 76-percent higher prevalence of cognitive difficulty. For those without a chronic medical condition, the prevalence of cognitive difficulty was 183- and 97-percent higher in daily and monthly cannabis users (vs. nonusers), respectively.

In the general population, having a chronic medical condition significantly increased cognitive difficulty concentrating, remembering, or making decisions. Cannabis use (particularly daily use) significantly increased cognitive difficulty for people with each chronic condition included in this study. The greater cognitive difficulty with cannabis use was less pronounced in individuals with chronic conditions with higher difficulty at the outset, such as depression.