{"id":"F2019L00240","name":"Statement of Principles concerning Alzheimer disease (Reasonable Hypothesis) (No. 33 of 2019)","slug":"statement-of-principles-concerning-alzheimer-disease-reasonable-hypothesis-no-33-of-2019","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":439955,"registerId":"F2019L00240-fast-fetch-1775955776603","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning Alzheimer disease (Reasonable Hypothesis) (No. 33 of 2019)","content":"---\nmeta-content-style-type: text/css\nmeta-content-type: application/xhtml+xml; charset=utf-8\nmeta-generator: Aspose.Words for .NET 20.2\n---\n\n?xml version=\"1.0\" encoding=\"utf-8\" standalone=\"no\"?>\n\n\n\n \n\nStatement of Principles\n\nconcerning\n\nALZHEIMER DISEASE (Reasonable Hypothesis)\n\n(No. 33 of 2019\n\nThe Repatriation Medical Authority determines the following Statement of Principles under subsection 196B(2) of the Veterans' Entitlements Act 1986.\n\n \n\nDated 1 March 2019\n\n \n\n \n\n \n\n \n\n \n\n| The Common Seal of the Repatriation Medical Authority was affixed to this instrument at the direction of:
|\n| --- |\n| 
Professor Nicholas Saunders AO
Chairperson
|\n\n\n \n\n \n\n\nContents\n\n1 Name\n\n2 Commencement\n\n3 Authority\n\n4 Repeal\n\n5 Application\n\n6 Definitions\n\n7 Kind of injury, disease or death to which this Statement of Principles relates\n\n8 Basis for determining the factors\n\n9 Factors that must exist\n\n10 Relationship to service\n\n11 Factors referring to an injury or disease covered by another Statement of Principles\n\nSchedule 1 - Dictionary\n\n1 Definitions\n\n \n\n\n\n\n1 Name\n\nThis is the Statement of Principles concerning Alzheimer disease (Reasonable Hypothesis) (No. 33 of 2019).\n\n2 Commencement\n\n This instrument commences on 25 March 2019.\n\n3 Authority\n\nThis instrument is made under subsection 196B(2) of the Veterans' Entitlements Act 1986.\n\n4 Repeal\n\nThe Statement of Principles concerning Alzheimer-type dementia No. 22 of 2010 (Federal Register of Legislation No. F2017C00820) made under subsections 196B(2) and (8) of the VEA is repealed.\n\n5 Application\n\nThis instrument applies to a claim to which section 120A of the VEA or section 338 of the Military Rehabilitation and Compensation Act 2004 applies.\n\n6 Definitions\n\nThe terms defined in the Schedule 1 - Dictionary have the meaning given when used in this instrument.\n\n7 Kind of injury, disease or death to which this Statement of Principles relates\n\n(1) This Statement of Principles is about Alzheimer disease and death from Alzheimer disease.\n\nMeaning of Alzheimer disease\n\n(2) For the purposes of this Statement of Principles, Alzheimer disease means a central nervous system neurodegenerative disorder meeting the following clinical diagnostic criteria (derived from DSM-5):\n\n1. Evidence of major neurocognitive disorder or mild neurocognitive disorder.\n2. There is insidious onset and gradual progression of impairment in one or more cognitive domains. There is steady progressive, gradual decline in cognition, without extended plateaus.\n3. There is either:\n\n\n(i) evidence of a causative Alzheimer disease genetic mutation from family history or genetic testing; or\n\n(ii) clear evidence of decline in memory and learning, except where there are atypical presentations of Alzheimer disease.\n\nD. The cognitive deficits in Criteria A, B and C are not primarily due to any of the following:\n\n(i) delirium;\n\n(ii) another mental disorder (for example, major depressive disorder, schizophrenia); or\n\n(iii) cerebrovascular disease, another neurodegenerative disease (for example, neurocognitive disorder with Lewy bodies, Parkinson's disease, Huntington's chorea), brain tumour, subdural haematoma, the effects of a substance, or systemic disorder (for example, hypothyroidism, vitamin B12 or folic acid deficiency, niacin deficiency, hypercalcaemia, neurosyphilis, human immunodeficiency virus infection).\n\nNote: atypical presentations of Alzheimer disease, DSM-5, major neurocognitive disorder and mild neurocognitive disorder are defined in the Schedule 1 – Dictionary.\n\n(3) While Alzheimer disease attracts ICD‑10‑AM code G30.0, G30.1, G30.8 or G30.9, in applying this Statement of Principles the meaning of Alzheimer disease is that given in subsection (2).\n\n(4) For subsection (3), a reference to an ICD-10-AM code is a reference to the code assigned to a particular kind of injury or disease in The International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification (ICD-10-AM), Tenth Edition, effective date of 1 July 2017, copyrighted by the Independent Hospital Pricing Authority, ISBN 978-1-76007-296-4.\n\nDeath from Alzheimer disease\n\n(5) For the purposes of this Statement of Principles, Alzheimer disease, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's Alzheimer disease.\n\nNote: terminal event is defined in the Schedule 1 – Dictionary.\n\n8 Basis for determining the factors\n\nThe Repatriation Medical Authority is of the view that there is sound medical‑scientific evidence that indicates that Alzheimer disease and death from Alzheimer disease can be related to relevant service rendered by veterans, members of Peacekeeping Forces, or members of the Forces under the VEA, or members under the MRCA.\n\nNote: MRCA, relevant service and VEA are defined in the Schedule 1 – Dictionary.\n\n9 Factors that must exist\n\nAt least one of the following factors must as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting Alzheimer disease or death from Alzheimer disease with the circumstances of a person's relevant service:\n\n(1) having moderate to severe traumatic brain injury at least ten years before the clinical onset of Alzheimer disease;\n\n(2) smoking at least 20 pack-years of cigarettes, or the equivalent thereof in other tobacco products, before the clinical onset of Alzheimer disease, and where smoking has ceased, the clinical onset of Alzheimer disease has occurred within five years of cessation;\n\nNote: pack-years of cigarettes, or the equivalent thereof in other tobacco products is defined in the Schedule 1 - Dictionary. \n\n(3) undergoing a course of therapeutic radiation for cancer, where the brain was in the field of radiation, at least ten years before the clinical onset of Alzheimer disease;\n\n(4) having received a cumulative dose of at least ten microTesla-years of extremely low frequency electromagnetic field (ELF-EMF), at least ten years before the clinical onset of Alzheimer disease;\n\nNote: cumulative dose and extremely low frequency electromagnetic field (ELF-EMF) are defined in the Schedule 1 - Dictionary.\n\n(5) being obese for at least ten years before the clinical onset of Alzheimer disease;\n\nNote: being obese is defined in the Schedule 1 - Dictionary. \n\n(6) having dyslipidaemia before the age of 65 years and at least ten years before the clinical onset of Alzheimer disease;\n\nNote: dyslipidaemia is defined in the Schedule 1 - Dictionary. \n\n(7) having diabetes mellitus for at least the ten years before the clinical onset of Alzheimer disease;\n\n(8) having hypertension at least ten years before the clinical onset of Alzheimer disease;\n\n(9) having hyperhomocysteinaemia at least ten years before the clinical onset of Alzheimer disease;\n\nNote: hyperhomocysteinaemia is defined in the Schedule 1 - Dictionary. \n\n(10) having major depressive disorder at least ten years before the clinical onset of Alzheimer disease;\n\n(11) having posttraumatic stress disorder at least ten years before the clinical onset of Alzheimer disease;\n\n(12) an inability to undertake any physical activity greater than three METs for at least five years, at least ten years before the clinical onset of Alzheimer disease;\n\nNote: MET is defined in the Schedule 1 - Dictionary. \n\n(13) being treated with an anticholinergic drug from the specified list of anticholinergic drugs, at the time of the clinical worsening of Alzheimer disease;\n\nNote: specified list of anticholinergic drugs is defined in the Schedule 1 – Dictionary.\n\n(14) inability to obtain appropriate clinical management for Alzheimer disease.\n\n10 Relationship to service\n\n(1) The existence in a person of any factor referred to in section 9, must be related to the relevant service rendered by the person.\n\n(2) The factors set out in subsections 9(13) and 9(14) apply only to material contribution to, or aggravation of, Alzheimer disease where the person's Alzheimer disease was suffered or contracted before or during (but did not arise out of) the person's relevant service.\n\n11 Factors referring to an injury or disease covered by another Statement of Principles\n\nIn this Statement of Principles:\n\n(1) if a factor referred to in section 9 applies in relation to a person; and\n\n(2) that factor refers to an injury or disease in respect of which a Statement of Principles has been determined under subsection 196B(2) of the VEA;\n\nthen the factors in that Statement of Principles apply in accordance with the terms of that Statement of Principles as in force from time to time.\n\n \n\n \n\nSchedule 1 - Dictionary \n\nNote: See Section 6\n\n1 Definitions\n\nIn this instrument:\n\n Alzheimer disease—see subsection 7(2).\n\n atypical presentations of Alzheimer disease means where memory and learning impairments are not predominant (nonamnestic presentations). There are several different variants of this nonamnestic presentation including visuospatial, logopenic aphasic, visuoperceptive impairments and executive dysfunction.\n\n being obese means having a Body Mass Index (BMI) of 30 or greater.\n\nNote: BMI is also defined in the Schedule 1 - Dictionary.\n\n BMI means W/H2 where:\n\nW is the person's weight in kilograms; and\n\nH is the person's height in metres.\n\n cumulative dose means the total dose of extremely low frequency electromagnetic field (ELF-EMF) received by the body. The unit of cumulative dose is the microTesla-year. The cumulative dose is calculated from the sum of exposures to electromagnetic field flux density in microTesla multiplied by the duration of the exposure in years, excluding background exposure.\n\nNote: extremely low frequency electromagnetic field (ELF-EMF) is also defined in the Schedule 1 - Dictionary.\n\n DSM-5 means the American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington, VA, American Psychiatric Association, 2013.\n\n dyslipidaemia generally means evidence of a persistently abnormal lipid profile after the accurate evaluation of serum lipids following a 12 hour overnight fast, and estimated on a minimum of two occasions as:\n\n(a) a total cholesterol level greater than or equal to 5.5 millimoles per litre (mmol/L);\n\n(b) a triglyceride level greater than or equal to 2.0 mmol/L; or\n\n(c) a high density lipoprotein cholesterol level less than 1.0 mmol/L.\n\n extremely low frequency electromagnetic field (ELF-EMF) means electromagnetic fields generated at a frequency of 3-3000 hertz (Hz), and excludes static electromagnetic fields (for example, MRI scans) and radiofrequency electromagnetic fields (for example, radar).\n\nNote: Examples of circumstances that might lead to exposure to ELF-EMF include, but are not limited to, being in close proximity to electric power generators, electric motors, transformers, inductors, and power transmission and distribution lines.\n\n hyperhomocysteinaemia means a condition characterised by an excess of homocysteine in the blood.\n\n major neurocognitive disorder means:\n\n(a) evidence of significant cognitive decline from a previous level of performance in one or more cognitive domains (complex attention, executive function, learning and memory, language, perceptual-motor, or social cognition) based on:\n\n(i) concern of the individual, a knowledgeable informant, or the clinician that there has been a significant decline in cognitive function; and\n\n(ii) a substantial impairment in cognitive performance, documented by standardised neuropsychological testing or another qualified clinical assessment; and\n\n(b) the cognitive deficits interfere with independence in everyday activities (that is, at a minimum, requiring assistance with complex instrumental activities of daily living such as paying bills or managing medications).\n\n MET means a unit of measurement of the level of physical exertion. 1 MET = 3.5 ml of oxygen/kg of body weight per minute, 1.0 kcal/kg of body weight per hour or resting metabolic rate.\n\n mild neurocognitive disorder means evidence of modest cognitive decline from a previous level of performance in one or more cognitive domains (complex attention, executive function, learning and memory, language, perceptual-motor, or social cognition) based on:\n\n(a) concern of the individual, a knowledgeable informant, or the clinician that there has been a mild decline in cognitive function; and\n\n(b) a modest impairment in cognitive performance, documented by standardised neuropsychological testing.\n\n MRCA means the Military Rehabilitation and Compensation Act 2004.\n\n pack-years of cigarettes, or the equivalent thereof in other tobacco products means a calculation of consumption where one pack-year of cigarettes equals 20 tailor-made cigarettes per day for a period of one calendar year, or 7 300 cigarettes. One tailor-made cigarette approximates one gram of tobacco or one gram of cigar or pipe tobacco by weight. One pack-year of tailor-made cigarettes equates to 7.3 kilograms of smoking tobacco by weight. Tobacco products mean cigarettes, pipe tobacco or cigars, smoked alone or in any combination.\n\n relevant service means:\n\n(a) operational service under the VEA;\n\n(b) peacekeeping service under the VEA;\n\n(c) hazardous service under the VEA;\n\n(d) British nuclear test defence service under the VEA;\n\n(e) warlike service under the MRCA; or\n\n(f) non-warlike service under the MRCA.\n\nNote: MRCA and VEA are also defined in the Schedule 1 - Dictionary.\n\n specified list of anticholinergic drugs means:\n\n(a) antidepressants (amitriptyline, amoxapine, clomipramine, desipramine, doxepin, imipramine, nortriptyline, paroxetine, protriptyline and trimipramine);\n\n(b) antiparkinson agents (benztropine, biperiden, chlorphenoxamine, cycrimine, ethopropazine, procyclidine and trihexyphenidyl); or\n\n(c) bladder antimuscarinics (darifenacin, fesoterodine, flavoxate, oxybutynin, solifenacin, tolterodine and trospium).\n\n terminal event means the proximate or ultimate cause of death and includes the following:\n\n(a) pneumonia;\n\n(b) respiratory failure;\n\n(c) cardiac arrest;\n\n(d) circulatory failure; or\n\n(e) cessation of brain function.\n\n VEA means the Veterans' Entitlements Act 1986.\n\n \n\n \n","sortOrder":0}],"analysis":{"flash_summary":{"complexity_score":6,"scope_assessment":{"changed":true,"description":"This instrument narrows and simultaneously broadens the original 2010 instrument. It repeals the 2010 Statement and replaces it with updated diagnostic criteria and a revised, explicit list of service‑related factors (s 4, s 7, s 9). Compared with a generic ‘Alzheimer‑type dementia’ formulation, it adds several specific exposures and medical conditions (for example cumulative ELF‑EMF exposure, therapeutic brain radiation, a defined list of anticholinergic drugs, inability to obtain appropriate clinical management, and quantified metabolic/cardiovascular risk factors). It also formalises timing thresholds (commonly 10 years before clinical onset) and precise measurement rules (pack‑years, BMI, microTesla‑years). Those additions broaden the substantive bases on which a reasonable hypothesis can be raised, but the tighter DSM‑5‑based diagnostic framing and the measurement thresholds may narrow or channel how evidence is presented. Overall the scope has materially changed from the earlier instrument by altering both qualifying factors and the evidentiary mechanics used to assess claims."},"complexity_factors":["Replaces prior instrument and cross-references (repeal of 2010 Statement) increasing historical comparison complexity (s 4).","About 20 specific defined terms and measurement concepts in Schedule 1 (e.g. pack‑years, BMI, MET, cumulative ELF‑EMF, dyslipidaemia, DSM‑5 references).","Fourteen substantive factors listed in s 9 with multiple timing rules (many require exposure or condition at least 10 years before clinical onset; one requires 5 years of inactivity).","Nested conditional logic: at least one factor must exist (s 9) and must be related to relevant service (s 10); s 10(2) limits operation of s 9(13) and s 9(14).","Multiple external authority cross-references: DSM‑5 diagnostic criteria, ICD‑10‑AM codes, VEA and MRCA, and other Statements of Principles (s 7(3)–(4), s 11).","Quantitative, specialist calculations required (microTesla‑years for ELF‑EMF; pack‑years; BMI; laboratory lipid/homocysteine cut-offs), increasing evidentiary complexity (Schedule 1).","Clinical diagnostic complexity: DSM‑5 based diagnostic thresholds (major vs mild neurocognitive disorder), differential diagnosis exclusions (delirium, other neurodegenerative diseases, systemic causes) (s 7(2)(D)).","Interplay between primary causation and aggravation/contribution (special treatment of anticholinergic drugs and lack of clinical management) creating legal distinctions in adjudication (s 10(2))."],"plain_english_summary":"**What this instrument does (mechanics first)**\n\n- Replaces the earlier 2010 Statement of Principles about Alzheimer-type dementia with a new Statement of Principles about Alzheimer disease (called No. 33 of 2019). (See s 4.)\n- Declares the clinical definition of “Alzheimer disease” that must be applied when assessing certain veterans’ compensation or rehabilitation claims. That definition is drawn from DSM-5 diagnostic concepts and narrows what clinical features count as Alzheimer disease for these claims. (See s 7(2)–(4).)\n- Sets out a closed list of medical and exposure “factors” which, if at least one is present and linked to the veteran’s relevant service, are sufficient to raise a “reasonable hypothesis” that the Alzheimer disease (or death from it) is connected to service. These factors include traumatic brain injury, smoking (with a specified pack‑year threshold), therapeutic brain radiation, cumulative ELF‑EMF exposure, obesity, dyslipidaemia, diabetes, hypertension, high homocysteine, depression, PTSD, prolonged physical inactivity, certain anticholinergic drugs, and lack of appropriate clinical management. (See s 9.)\n- Requires that any factor relied on must be related to the veteran’s relevant service (for example, operational, peacekeeping, hazardous or warlike service). Two of the listed factors (treatment with listed anticholinergic drugs, and inability to obtain appropriate clinical management) only operate where the Alzheimer disease existed before or during service and the factor materially contributed to or aggravated the disease. (See s 10.)\n- Provides definitions needed to apply the Statement (for example pack‑years, BMI, ELF‑EMF cumulative dose, METs, ICD and DSM references). (See Schedule 1.)\n\n**Who this affects**\n\n- Veterans, current or former members of the Australian Defence Force, members of Peacekeeping Forces and other persons whose claims fall under the Veterans’ Entitlements Act 1986 (VEA) or the Military Rehabilitation and Compensation Act 2004 (MRCA). (See s 5 and Schedule 1: relevant service.)\n- Decision-makers at the Department of Veterans’ Affairs and the Repatriation Medical Authority who assess whether a reasonable hypothesis exists connecting Alzheimer disease to service. (See s 3, s 8, s 9, s 10.)\n- Medical practitioners and allied health professionals who must provide or interpret clinical evidence (diagnostic criteria, laboratory results, exposure histories and medication records) to support or rebut claims.\n\n**Why it matters (claimed purpose and practical implications)**\n\n- The Repatriation Medical Authority states there is sound medical‑scientific evidence that Alzheimer disease can be related to relevant service and therefore sets these factors to guide claims decisions (s 8). That is the official purpose statement.\n\n- Practical effect: if a veteran can show a qualifying factor from the list in s 9, properly related to their relevant service, then a “reasonable hypothesis” connecting the disease to service is established. That changes the legal starting point for compensation or rehabilitation decision‑making under the VEA and MRCA.\n\n**Testing the purpose against costs, incentives and implementation trade‑offs**\n\n- Who pays: increased acceptance of service‑connection for Alzheimer disease will increase the liability of the veterans’ compensation system (Department of Veterans’ Affairs), with fiscal cost borne by the federal budget. (Mechanism: more claims meeting the reasonable‑hypothesis threshold.)\n\n- Evidence and compliance burden: the Statement depends on clinical and exposure evidence that can be demanding to produce. Examples:\n - calculating cumulative ELF‑EMF exposure in microTesla‑years requires detailed occupational or environmental exposure histories and possibly expert estimation (Schedule 1: cumulative dose);\n - proving pack‑years or BMI requires documented smoking history and anthropometric records (Schedule 1: pack‑years; BMI);\n - many factors require laboratory or documented clinical history (dyslipidaemia, hyperhomocysteinaemia, diabetes, hypertension, neuropsychological testing per DSM‑5). (See s 7(2), s 9 and Schedule 1.)\n This raises administrative and medical‑evidence costs for claimants, clinicians and the decision maker.\n\n- Bureaucratic discretion: the Repatriation Medical Authority has prescribed the list and diagnostic thresholds, but decision-makers must still assess whether the factor is related to the veteran’s relevant service and whether the evidence meets the thresholds. There is judgment involved in connecting exposures or conditions to service, which can create variability and require expert opinion. (See s 10 and s 11.)\n\n- Effects on private parties and providers: the Statement may change clinical record-keeping incentives for doctors treating veterans (to document exposures, medications and management). It may also increase demand for specialist assessments (neurology, neuropsychology, occupational exposure experts), which affects private providers’ workloads and fees.\n\n- Potential for substitution or strategic behaviour: claimants may focus on evidence that matches one of the listed factors (for example documenting smoking pack‑years or prior TBI) rather than presenting broader causation arguments. Conversely, absence of listed factors makes service connection harder under this instrument.\n\n- Implementation risk and opportunity costs: the reliance on specific measurements (microTesla‑years, DSM‑5 diagnostic thresholds, biochemical cut‑offs for lipids) concentrates the decision process on measurable thresholds. That reduces some uncertainty but can exclude relevant but less‑easily‑measured influences. Producing and reviewing this evidence consumes clinical and administrative resources that could be used elsewhere.\n\n**Concrete mechanics and important limitations**\n\n- At least one of the factors in s 9 must be present and must relate to relevant service for the statement to raise a reasonable hypothesis. (s 9, s 10.)\n- Two factors (use of listed anticholinergic drugs and inability to obtain appropriate clinical management) only apply as contributors or aggravators where Alzheimer disease pre‑dated or began during service — they do not establish primary causation arising out of service. (s 10(2).)\n- The instrument defers to other Statements of Principles where a listed factor is itself an injury/disease already covered by another Statement; that other Statement’s terms then apply. (s 11.)\n\n**Sections to consult for application**\n\n- Clinical definition and exclusions: s 7 (and Schedule 1 definitions such as atypical presentations, DSM-5 references).\n- List of qualifying factors and timing rules: s 9 (and corresponding Schedule 1 definitions for pack‑years, ELF‑EMF, BMI, MET, dyslipidaemia, etc.).\n- Requirement that factors be related to relevant service and the special rule for s 9(13) and s 9(14): s 10.\n- Interaction with other Statements of Principles: s 11.\n\n**Net effect in plain terms**\n\n- This Statement tells decision‑makers and claimants exactly which medical conditions or exposures can, if tied to service, be taken as sufficient to form a reasonable hypothesis that Alzheimer disease (as narrowly defined here) is connected to military service. It also specifies evidence measures and timing rules, thereby shifting resource and evidential burdens onto claimants and clinicians to document those factors. (See s 7, s 9, Schedule 1.)"},"flash_summary_failed":{"failed":true,"reason":"A positive credit balance is required for all requests, including BYOK, so fallback providers remain available. Add credits at https://vercel.com/d?to=%2F%5Bteam%5D%2F%7E%2Fai%3Fmodal%3Dtop-up to continue.","source":"analysis-cron"},"kimi_summary":{"content_quality":"ok","complexity_score":6,"scope_assessment":{"changed":false,"description":"This instrument maintains the same scope as its predecessor (No. 22 of 2010). It is a routine update reflecting modernised medical terminology (changing from 'Alzheimer-type dementia' to 'Alzheimer disease' aligned with DSM-5 criteria) and revised evidentiary factors based on updated medical research. The fundamental purpose—establishing service connection criteria for veterans' compensation claims—remains unchanged."},"complexity_factors":["14 distinct causal factors with varying temporal requirements (most requiring 10-year latency periods, some with additional conditions like age thresholds)","Extensive cross-referencing to external medical standards: DSM-5 diagnostic criteria and ICD-10-AM coding system","19 defined terms in Schedule 1, including complex medical calculations (BMI formula, pack-year calculations, cumulative electromagnetic dose formulas)","Nested conditional logic: Factor 9(2) has a secondary condition about timing of cessation; Factor 9(13) applies only to clinical worsening, not onset","Dual application framework: Different rules apply depending on whether the claim is under VEA or MRCA, with specific exclusions for factors 9(13) and 9(14)","Incorporation by reference of other Statements of Principles through section 11, creating interdependent regulatory web","Technical medical terminology requiring specialist knowledge (METs, dyslipidaemia thresholds, ELF-EMF frequency ranges, specific drug classifications)"],"plain_english_summary":"This Statement of Principles sets the medical test for deciding whether Alzheimer’s disease (or death from it) in veterans and current/former defence members is service-related for compensation purposes. Replacing a 2010 version, it adopts DSM‑5–based criteria and identifies multiple service-linked risk factors — e.g. traumatic brain injury, heavy smoking, radiation/EMF exposure, metabolic and mental-health conditions, certain medications, and lack of treatment — that can create a \"reasonable hypothesis\" of service connection."}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-alzheimer-disease-reasonable-hypothesis-no-33-of-2019","history":"/api/acts/statement-of-principles-concerning-alzheimer-disease-reasonable-hypothesis-no-33-of-2019/history","analysis":"/api/acts/statement-of-principles-concerning-alzheimer-disease-reasonable-hypothesis-no-33-of-2019/analysis","conflicts":"/api/acts/statement-of-principles-concerning-alzheimer-disease-reasonable-hypothesis-no-33-of-2019/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-alzheimer-disease-reasonable-hypothesis-no-33-of-2019/important-cases","documents":"/api/acts/statement-of-principles-concerning-alzheimer-disease-reasonable-hypothesis-no-33-of-2019/documents"}}