Supplementary Material for: History of cannabis smoking and subjective cognitive complaints in older women

Introduction: Cannabis use has been increasing in the United States (U.S.), yet its potential long-term effects on neurocognitive outcomes remain unknown. We aimed to examine the association of the history of cannabis smoking with subjective cognitive complaints (SCC) in older women. Methods: This prospective cohort analysis included 15,378 older women (age ≥ 65 years) of the U.S. National Institute of Environmental Health Sciences’ Sister Study. Participants reported their history of cannabis smoking at enrollment (2003–2009) and completed the Eight-item Interview to Differentiate Aging and Dementia (AD8) as an SCC screener at the cohort’s 2nd (2011–2014), 3rd (2014–2016), and 4th (2017–2019) follow-ups. We used multivariable joint models to assess the association. Results: 3,973 (25.8%) women reported ever smoking cannabis, mostly in their early adulthood. Compared with never cannabis smokers, the multivariable odds ratios (ORs) for ever smokers were 1.27 (95% confidence interval (CI): 1.13, 1.43) at the 2nd follow-up, 1.28 (95% CI: 1.14, 1.44) at the 3rd follow-up, and 1.30 (95% CI: 1.11, 1.52) at the 4th follow-up. Associations were stronger for regular than occasional cannabis smokers. For example, at the 2nd follow-up, the OR was 1.61 (95% CI: 1.31, 1.98) for regular smokers and 1.19 (95% CI: 1.04, 1.35) for occasional smokers. Results were overall consistent in subgroup and sensitivity analyses. Conclusions: This study suggests a potential association between a history of cannabis smoking and SCC in older women, calling for further research on cannabis use and cognitive outcomes in the context of aging.