A $3.4 million, five-year federal study will examine the off-label use of antipsychotic medications in residents with dementia living in assisted living communities. Researchers at the University of North Carolina at Chapel Hill will use funds from the National Institute on Aging to focus on the reasons for the use as well as potential alternatives.

“Many of these drugs have serious side effects, and there’s little evidence that they help people with dementia,” said the study’s principal investigator, Sheryl Zimmerman, Ph.D., a social work professor. Her collaborators in the study are family medicine faculty member Philip Sloane, M.D., M.P.H., Alzheimer’s specialist Daniel Kaufer, M.D., and biostatistics research professor John Preisser, Ph.D.

The study will focus on 280 assisted living communities, home to nearly 12,000 residents, across seven states: Arkansas, Louisiana, New Jersey, New York, Oklahoma, Pennsylvania and Texas. As part of their research, Zimmerman and her colleagues hope to learn more about non-pharmacologic solutions that study communities have tried and why others might be quick to prescribe the medications to manage behaviors.

“The fact is, you don’t consider drugs as a first choice for stopping a child’s crying without investigating what else may be going on,” she said. “We need staff in assisted living communities to be just as sensitive to residents with dementia and to be aware of alternative practices.”

Much as similar research led to changes in skilled nursing centers, the UNC researchers are optimistic that their study will prompt conversations about limiting the drugs’ use in assisted living residences, largely because they will be working closely with leaders from across the country from numerous organizations involved in providing care and oversight.

“All of the things that we used to talk about in nursing homes are the things that we should be talking about in assisted living today,” Zimmerman said. “Ultimately, older adults, especially older adults with dementia, deserve the best care, and our hope is that over the next five years, our work will lead to changes that improve their chances of having the best quality of life.”