WHY IT MATTERS: Older adults who use cannabis for pain, sleep, or anxiety can share this research with their physicians to support more informed, evidence-based conversations about risk rather than assumption-based discouragement. CLINICAL OVERVIEW: Concerns about cannabis use accelerating cognitive decline or contributing to dementia risk in older adults have long influenced clinical conversations, but emerging research is beginning to challenge those assumptions. The biological reality is complex, given that the endocannabinoid system plays a regulatory role in neuroinflammation and neuroprotection, and that older adults are using cannabis for legitimate symptom management at increasing rates.