Cannabidiol Medication Intervention Trial

Inclusion Criteria:

1. Males or females ≥55 years of age; female must be post-menopausal or must agree tocomply with contraception requirements. Males should also abide by contraceptiverequirements when the partner is a woman of childbearing potential. Acceptablemethods of contraception include: combined (estrogen and progestogen containing)hormonal contraception associated with inhibition of ovulation, which may be oral,intravaginal, or transdermal; progestogen-only hormonal contraception associatedwith inhibition of ovulation, which may be oral, injectable, or implantable;intrauterine device or intrauterine hormone-releasing system; vasectomy of a femalesubject's male partner (with medical assessment and confirmation of vasectomysurgical success); bilateral tubal occlusion

2. Diagnostic and Statistical Manual of Mental Disorders-5 (DSM 5) criteria for MajorNeurocognitive Disorder due to possible AD. Patients with Major NeurocognitiveDisorder due to multiple etiologies (AD and vascular) will be included

3. sMMSE ≤24

4. Presence of clinically significant agitation based on the IPA definition at bothscreening and baseline

5. If treated with cognitive-enhancing medications (cholinesterase inhibitors and/ormemantine), dosage must be stable for at least 3 months prior to study randomization

6. Availability of a primary caregiver to accompany the participant to study visits andto participate in the study. The primary caregiver must be sufficiently proficientin English to complete the required study assessments, as per investigator judgementand should spend at least 10 hours a week with the participant

7. Willing and able to provide informed consent and/or have a Substitute Decision Maker (SDM) provide informed consent on behalf of the participant

Exclusion Criteria:

1. Change in psychotropic medications less than the duration of 5 half-lives of themedication in question prior to screening (e.g., concomitant antidepressants oratypical antipsychotics) and any changes during study participation

2. Administration of strong inducers of CYP3A4 ≤ 14 days prior to first doses of studyintervention or have ongoing requirements for these medications

3. Use of anticonvulsant medications

4. Contraindications to CBs, e.g. allergies to cannabis and cannabis products,potential clinically important drug-drug interactions

5. Any type of arterial vascular disease, cerebrovascular disease and currentuncontrolled cardiovascular disease (e.g. uncontrolled hypertension, ischemic heartdisease, arrhythmia and severe heart failure), as per investigator assessment

6. Patients with Cardiovascular Accident in the 3 months prior to Screening (V1)

7. Impaired hepatic function, as reflected by serum alanine aminotransferase oraspartate aminotransferase > 2 × upper limit of normal (ULN), or total bilirubin > 1.5

× ULN; the Investigator may decide to repeat the assessment to confirm criterion prior to screen failing the participant

8. Presence of clinically significant impaired renal function at screening, asevidenced by an estimated creatinine clearance < 30 mL/min/1.73 m2 (as calculated bythe glomerular filtration rate using the Modification of Diet in Renal Disease studyequation)

9. Presence or history of other psychiatric disorders or neurological conditions (e.g.

psychotic disorders, schizophrenia, stroke, epilepsy) and known or suspected psychotic disorder in a first degree relative

10. Participants currently meeting DSM 5 criteria for Major Depressive Episode

11. Current substance dependence (excluding caffeine and nicotine)

12. Clinically significant delusions and/or hallucinations (e.g. NPI-NHdelusion/hallucinations subscore ≥4 or judgement of QI)

13. Reported use of marijuana or cannabinoid-based medications, products or supplements (botanical or synthetic) within 1 week prior to randomization

14. Systolic blood pressure (SBP) < 90 mmHg or > 150 mmHg or diastolic blood pressure (DBP) < 50mmHg or > 105 mmHg at screening or baseline (prior to randomization) or apostural drop in SBP ≥ 20 mmHg or DBP ≥ 10 mmHg at screening