The LiBBY trial studied hospice-eligible people with advanced Alzheimer's disease or other dementia who had major cognitive loss and significant agitation, not people with mild cognitive impairment (MCI), which means early memory or thinking change that does not yet meet dementia criteria. MCI falls outside both the diagnosis and the end-of-life stage LiBBY required. LiBBY, short for Life's End Benefits of cannaBidiol and tetrahYdrocannabinol, tested a purified oral capsule with 2 mg THC plus 100 mg CBD against placebo for 12 weeks. The Alzheimer's Association reported at AAIC 2026 in London that the design was randomized, double-blind, and placebo-controlled the AAIC 2026 trial announcement.
Medical information disclaimer: This article is for general educational purposes only and does not provide medical advice, diagnosis, or treatment. Always consult a physician or other qualified health professional about symptoms, medications, tests, or treatment decisions.
Table of Contents
- Who took part in LiBBY?
- Why was MCI not included?
- What did treatment change?
- What does this mean for MCI families?
Who took part in LiBBY?
Participants averaged about age 80, and 55% were women. The study enrolled 120 people across 10 U.S. sites, with home-based visits while usual care continued.
All participants had Alzheimer's disease or another dementia at a very late stage. They needed DSM-5 Major Neurocognitive Disorder, the medical term for dementia, plus clinically significant agitation. Eligibility also required at least one end-of-life marker, according to the NIH/USC trial record the NIH/USC trial record:.
- hospice enrollment
- FAST stage 6d, meaning extensive help needed for dressing, bathing, and toileting
- ADEPT score 12 or higher, meaning high predicted short-term mortality
Why was MCI not included?
MCI is DSM-5 Mild Neurocognitive Disorder, not Major Neurocognitive Disorder. That diagnostic difference alone placed MCI outside LiBBY. The prognostic gap was also wide.
People with MCI would not meet hospice enrollment, FAST stage 6d, or the ADEPT threshold used to define this frail population. Agitation criteria added another barrier. LiBBY required a score of 4 or higher on the agitation part of the Neuropsychiatric Inventory, which measures distressing behaviors in dementia.
What did treatment change?
Agitation scores fell faster and further on THC/CBD. The active group dropped 10.61 points on the Cohen-Mansfield Agitation Inventory at week 2, versus 4.35 points on placebo, with separation sustained through week 12. Clinician ratings showed a similar pattern.
Global improvement reached 83.9% versus 30.5% at week 2, then 87.2% versus 23.6% at week 12 in this advanced group. These results describe supervised late-stage dementia care. They do not show prevention of decline, better memory, or safer daily function in MCI.
What does this mean for MCI families?
Do not use LiBBY to support THC/CBD for early memory concerns or store-bought cannabis products. The trial used a purified formulation and dosing system, given under supervision with caregiver support in frail end-of-life dementia. Safety also limits any broader use.
NeurologyLive reported more serious adverse events with active treatment than placebo, 23.3% versus 11.9%, driven by serious infections, with more deaths, 13.1% versus 5.1%, while overall adverse-event rates were similar the NeurologyLive trial report. A practical step is to bring new agitation, sleep change, anxiety, or safety concerns to the regular clinician. Ask about hearing, vision, medicines, pain, mood, sleep apnea, and follow-up testing before considering any cannabis product.
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