Falls are one of the most serious risks for people living with dementia, often leading to injury, hospitalisation, and loss of independence. According to NHS England and NICE guidance NG144, cannabis-based medicines remain unlicensed for dementia. Both organisations caution that dizziness, somnolence, and balance instability are recognised side effects in older adults. The MHRA also requires prescribers to record fall history and mobility assessments before starting CBPMs under the Human Medicines Regulations 2012.
What The Research Indicates
Evidence so far does not confirm fewer falls after cannabis initiation. A small crossover trial by van den Elsen et al. (2017) found mild dizziness and slower gait in 13 percent of dementia participants taking low-dose THC, though no serious falls occurred and symptoms improved after dose adjustment. In the 2022 Frontiers in Aging Neuroscience pilot study, one fall was recorded among 19 residents using THC: CBD oil, suggesting that sedation and unsteadiness were manageable but required monitoring.
Conversely, a 2021 Brain Sciences comparison study found slower walking speeds and poorer balance among older cannabis users than non-users. Meanwhile, the IACM European Elderly Registry (2023) reported mild dizziness in up to 12 percent of patients, with most issues resolving after four weeks. A large Canadian study published in JAMA Neurology (2025) observed a higher overall risk of falls and related injuries among older adults with cannabis-related hospitalisations, though the authors noted the findings show correlation, not causation.
Balancing Potential Benefits and Risks
Clinicians suggest that calmer mood or reduced agitation from cannabis might indirectly lessen restlessness-related falls. However, sedation, slowed reaction time, and postural sway remain significant safety concerns. NICE recommends that prescribers assess orthostatic symptoms and review walking ability at every follow-up visit.
The GMC Specialist Register requires doctors to document these risks clearly if CBPMs are used compassionately in dementia care.
Clinical Bottom Line
- Evidence does not show a consistent reduction in falls after cannabis initiation.
- Dizziness, sedation, and gait instability remain common side effects in older adults.
- NICE and NHS England advise fall-risk assessments before and during CBPM therapy.
- CBD-dominant products may carry lower motor risks than THC-rich formulas.
- Only GMC-registered specialists may prescribe CBPMs under MHRA oversight.
Role Of AlleviMed
Educational resources like AlleviMed help families understand UK medical cannabis regulations and safety considerations. They explain eligibility pathways, evidence quality, and why mobility and fall risks must be closely monitored when exploring unlicensed treatments for dementia.
Takeaway
Current research does not show that cannabis reduces falls in dementia, though some patients appear calmer or less agitated. Because sedation and dizziness can increase fall risk, national regulators urge careful monitoring. For families considering this approach, discussions with qualified specialists are essential to ensure safety and informed decision-making.
