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Release: April 11, 2000

UI researcher receives $1.2 million National Institute on Aging grant

IOWA CITY, Iowa -- Kennith Culp, Ph.D., assistant professor in the University of Iowa College of Nursing, has received a $1.2 million, four-year grant from the National Institute on Aging to investigate the prevalence of delirium among elderly patients in rural long-term care facilities. Delirium, which Culp described as a reversible cognitive disturbance in the elderly, is often missed as a diagnosis in these communities, which can mean inadequate care for these patients, he said.

"In long-term care facilities, clinicians often use different terms of diagnosis to label this condition, and elders may be placed in nursing homes simply because they are confused and presumed to be 'demented,' " Culp said. "In rural communities, detection of delirium is even more difficult because the primary care provider is generally not immediately available in the facility to conduct an assessment. This makes delirium potentially a catastrophic illness.

"Care providers, including nursing home staff, often fail to diagnose this illness," he continued. "As a result, elders with delirium in long term care receive inadequate care and treatment."

Culp said his study is one of the first to look at delirium in rural nursing home settings. The investigation will estimate the prevalence of delirium among long-term care patients and identify its natural history, such as onset, duration and resolution of the delirium. The study also will identify the risk factors for the illness.

The ultimate goal, Culp said, is to develop effective delirium intervention strategies specifically designed for long-term care patients. Culp's co-investigator on the study is Bonnie Wakefield, Ph.D., a research scientist at the Iowa City Veteran Affairs Medical Center and adjunct assistant professor in the UI College of Nursing.