408The following rules apply to scoring:

408     The following rules apply to scoring:

a)      if at least three secondary categories are given the same numeric score as memory, then the clinical dementia rating equals the memory score (CDR=M);

b)      if three or more of the secondary categories are given a score greater than or less than that for memory, then CDR is increased or decreased from M by one level as applicable;

c)       however, if three secondary categories are scored one side of M, and two are scored on the other side of M, then CDR=M.

409     Find the row in Table 12.2: Impairment of memory, learning, abstract reasoning and problem-solving ability that exactly matches the respective scores for CDR and memory. The WPI rating is shown in the first column of that row.

Table 12.2: Impairment of memory, learning, abstract reasoning and problem solving ability

| %WPI | CDR Score | Memory Score | | 0 | 0 | 0 | | 3 | 0.5 | 0 | | 7 | 0.5 | 0.5 | | 10 | 0.5 | 1.0 | | 15 | 1.0 | 0.5 | | 20 | 1.0 | 1.0 | | 25 | 1.0 | 2.0 | | 30 | 2.0 | 1.0 | | 40 | 2.0 | 2.0 | | 45 | 2.0 | 3.0 | | 55 | 3.0 | 2.0 | | 70 | 3.0 | 3.0 |

Figure 12-B: Clinical dementia rating (CDR)

From the AMA5.

• Impairment level and CDR score(most of the criteria for a particular WPI rating should be present)
• Category None 0 Questionable 0.5 Mild 1.0 Moderate 2.0 Severe 3.0
• Memory (M) No memory loss or slight inconsistent forgetfulness. Consistent slight forgetfulness; partial recollection of events; ‘benign’ forgetfulness. Moderate memory loss; more marked for recent events; defect interferes with everyday activities. Severe memory loss; only highly learned material retained; new material rapidly lost. Severe memory loss; only fragments remain.
• Orientation (O) Fully oriented. Fully oriented, except for slight difficulty with time relationships. Moderate difficulty with time relationships; oriented for place at examination; may have geographic disorientation elsewhere. Severe difficulty with time relationships; usually disoriented to time, often to place. Oriented to person only.
• Judgement and problem solving (JPS) Solves everyday problems and handles business and financial affairs well; judgement good in relation to past performance. Slight impairment in solving problems, similarities and differences. Moderate difficulty in handling problems, similarities and differences; social judgement usually maintained. Severely impaired in handling problems, similarities and differences; social judgement usually impaired. Unable to make judgements or solve problems.
• Community affairs(CA) Independent function at usual level in job, shopping, volunteer and social groups. Slight impairment in these activities. Unable to function independently at these activities although may still be engaged in some; appears normal to casual inspection. No pretence of independent function outside home; appears well enough to be taken to functions outside a family home. No pretence of independent function outside home; appears too ill to be taken to functions outside the employee’s family home.