UNC-CH wins $3.4M grant to study overuse of antipsychotic drugs among older people

Older Americans in assisted living centers often receive inappropriate and excessive amounts of anti-psychotic drugs to control their behavior, say researchers at UNC-Chapel Hill who on Monday announced they’ve received a $3.4 million National Institute on Aging grant to study the issue.

A recent first-time national study of residential care found that as many as 70 percent of people in assisted living have cognitive impairment, such as dementia, at levels that keep them from easily performing life tasks such as bathing, eating and dressing. And nearly 70 percent of assisted living facilities prescribe antipsychotic drugs to keep residents under control, said Sheryl Zimmerman, principal investigator for the project and a Kenan Distinguished Professor in Carolina’s School of Social Work.

“Many of these drugs have serious side effects, and there’s little evidence that they help people with dementia,” Zimmerman said in a statement.

The five-year grant will allow investigators to study 280 assisted living communities with 12,000 residents in states from New York to Texas. Areas of investigation include identifying the reasons that centers use antipsychotic drugs and exploring methods – such as diversion and calming environments – through which staff could cut back on the practice.

“It’s a major problem in assisted living, where often the resident’s problem is not physical impairment, it’s the cognitive impairment – agitation and those kinds of things,” said Triangle activist Bill Lamb, outgoing president of the National Consumer Voice for Quality Long-Term Care and a retired state social worker who is not associated with the new research.

“We’ve gotten away from physical restraints, finding that they are harmful, so the next choice is chemical restraints for exactly the same purpose,” Lamb said.

In 2005, the Food and Drug Administration started requiring makers to put warning labels on some antipsychotic drugs, such as risperidone, that were linked with increased mortality when used to deal with behavior disorders in older people who had dementia. During the past four years, an effort by the federal Centers for Medicare and Medicaid has lowered by about 25 percent the rate of residents receiving antipsychotics in more medically intensive nursing homes, the researchers noted.

“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.

Additional collaborators on the research include Philip Sloane, a professor at UNC Family Medicine; Daniel Kaufer, a neurologist and director of the UNC-Chapel Hill Memory Disorders Program; and John Preisser, a biostatistics research professor at Carolina’s Gillings School of Global Public Health.

This story was originally published November 2, 2015 at 6:03 PM with the headline "UNC-CH wins $3.4M grant to study overuse of antipsychotic drugs among older people."