Project Summary

This research project is in progress. PCORI will post the research findings on this page within 90 days after the results are final. In the meantime, results have been published in peer-reviewed journals, as listed below.

What is the research about?

More than half of nursing home residents have dementia. Dementia is a loss in mental ability and is common in older adults. People with dementia often lose the ability to care for themselves and have symptoms like restlessness or aggression.

Nursing home staff often prescribe medicine to calm patients and reduce aggressive behaviors. But these medicines don’t always work and can have negative side effects. Two proven ways to treat patients with dementia don’t use medicines:

  • In the first way, called the transdisciplinary method, all nursing home staff receive training to use a single approach with residents. Together, the staff create a care plan for each resident to respond to his or her needs.
  • In the second way, called the multidisciplinary method, individual staff members such as nurses and therapists assess and help each patient as problems arise.

In this study, the research team is comparing these two ways to provide dementia care in nursing homes. The team wants to see how well these methods help reduce the amount of medicine given to residents with dementia. Also, the team wants to know if one method improves wellness and safety for residents and staff more than the other. Finally, the team is asking residents, families, and staff about the benefits and drawbacks of each method.

Who can this research help?

Nursing home administrators can use these results when considering ways to care for residents with dementia.

What is the research team doing?

The research team is assigning 80 nursing homes by chance to use one of the two methods. The nursing homes are in 10 different locations across the United States and care for 4,800 residents with dementia. Across the nursing homes, the team is looking at medical records monthly for 18 months to see how often residents get medicine for dementia. The team is also looking at residents’ symptoms, falls, injuries, and weight loss. For staff, the team is looking at injuries related to patient care and missed work days. Finally, the team is conducting interviews with families and focus groups with nursing home staff to learn what they think of the two care methods.

Patients with dementia, caregivers, nursing home staff, and experts in dementia care help plan and conduct the study.

Research methods at a glance

Design ElementsDescription
DesignRandomized controlled trial
Population4,800 adults ages 65 and older diagnosed with Alzheimer’s disease or dementia who live in 1 of 80 nursing homes across the United States
  • Transdisciplinary approach to nursing home care
  • Multidisciplinary approach to nursing home care

Primary: receipt of one or more off-label psychotropic medications in the past 30 days

Secondary: days per month patients received off-label medicine, unexpected weight loss in the past 30 days, accidental fall events, neuropsychiatric symptoms, patient-on-patient and patient-on-staff injuries in the past 30 days, staff days out of work in the past 30 days


18-month follow-up for primary outcome

Project Information

Natalie E. Leland, PhD
University of Pittsburgh^
Optimizing Care for Patients with Dementia: A Comparison of Two Non-Pharmacological Treatment Approaches

Key Dates

August 2017
July 2024

Study Registration Information

^The University of Southern California was the original organization associated with this project. 


Has Results
Award Type
Health Conditions Health Conditions These are the broad terms we use to categorize our funded research studies; specific diseases or conditions are included within the appropriate larger category. Note: not all of our funded projects focus on a single disease or condition; some touch on multiple diseases or conditions, research methods, or broader health system interventions. Such projects won’t be listed by a primary disease/condition and so won’t appear if you use this filter tool to find them. View Glossary
Populations Populations PCORI is interested in research that seeks to better understand how different clinical and health system options work for different people. These populations are frequently studied in our portfolio or identified as being of interest by our stakeholders. View Glossary
Intervention Strategy Intervention Strategies PCORI funds comparative clinical effectiveness research (CER) studies that compare two or more options or approaches to health care, or that compare different ways of delivering or receiving care. View Glossary
State State The state where the project originates, or where the primary institution or organization is located. View Glossary
Last updated: January 17, 2024