Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Job Classification

In most duration tables, five job classifications are displayed. These job classifications are based on the amount of physical effort required to perform the work. The classifications correspond to the Strength Factor classifications described in the United States Department of Labor's Dictionary of Occupational Titles. The following definitions are quoted directly from that publication.

Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Dementia


Related Terms

  • Alzheimer's-type Dementia
  • Chronic Organic Brain Syndrome
  • Multiple Cognitive Deficits
  • Senile Dementia
  • Senile Dementia of the Alzheimer Type
  • Vascular Dementia

Differential Diagnoses

  • Alcohol/substance abuse
  • Amnestic disorders
  • Delirium
  • Depressive disorder (pseudodementia)
  • Focal brain syndromes
  • Malingering
  • Normal aging

Specialists

  • Clinical Psychologist
  • Internal Medicine Physician
  • Neurologist
  • Occupational Therapist
  • Physical Therapist
  • Psychiatrist

Comorbid Conditions

  • Alcohol/substance abuse and sequelae
  • Depressive disorders
  • Infections
  • Other psychiatric disorders
  • Vascular disorders

Factors Influencing Duration

Diagnosis and treatment of a treatable dementia may lead to restored mental function. The severity of dementia and extent of available social supports can influence disability. Most forms of dementia are incompatible with gainful employment.

Medical Codes

ICD-9-CM:
290 - Senile and Presenile Organic Psychotic Conditions
290.0 - Senile Dementia, Uncomplicated, NOS, Simple Type
290.1 - Dementia, Presenile; Brain Syndrome with Presenile Brain Disease
290.10 - Presenile Dementia, Uncomplicated, NOS, Simple Type
290.11 - Presenile Dementia with Delirium; Presenile Dementia with Acute Confusional State
290.12 - Presenile Dementia with Delusional Features; Presenile Dementia, Paranoid Type
290.13 - Presenile Dementia with Depressive Features; Presenile Dementia, Depressed Type
290.2 - Senile Dementia with Delusional or Depressive Features
290.20 - Senile Dementia with Delusional Features; Senile Dementia, Paranoid Type; Senile Psychosis NOS
290.21 - Senile Dementia with Depressive Features
290.3 - Senile Dementia with Delirium; Senile Dementia with Acute Confusional State
290.4 - Dementia, Arteriosclerotic
290.40 - Vascular Dementia, Uncomplicated; Arteriosclerotic Dementia NOS, Simple Type
290.41 - Vascular Dementia with Delirium; Arteriosclerotic Dementia with Acute Confusional State
290.42 - Vascular Dementia with Delusions; Arteriosclerotic Dementia, Paranoid Type
290.43 - Vascular Dementia with Depressed Mood; Arteriosclerotic Dementia, Depressed Type
290.9 - Senile Psychotic Condition, Unspecified
291 - Alcoholic Psychoses
291.2 - Alcoholic Dementia, Other
292 - Drug Psychoses; Drug-induced Mental Disorders
292.8 - Drug-induced Mental Disorders, Other Specified
292.82 - Drug-induced Persisting Dementia
293 - Transient Mental Disorders Due to Conditions Classified Elsewhere
293.9 - Transient Mental Disorder in Conditions Classified Elsewhere, Unspecified; Organic Psychosis, Infective NOS, Posttraumatic NOS, Transient NOS; Psycho-organic Syndrome
294 - Persistent Mental Disorders Due to Conditions Classified Elsewhere
294.1 - Dementia in Conditions Classified Elsewhere; Dementia of the Alzheimers Type
294.11 - Dementia in Conditions Classified Elsewhere with Behavioral Disturbance; Aggressive Behavior; Combative Behavior; Violent Behavior; Wandering off
294.8 - Persistent Mental Disorders Due to Conditions Classified Elsewhere, Other; Amnestic Disorder NOS; Dementia NOS; Epileptic Psychosis NOS; Mixed Paranoid and Affective Organic Psychotic States
299 - Pervasive Developmental Disorders
331 - Cerebral Degenerations, Other
331.1 - Cerebral Degenerations, Other; Frontotemporal Dementia
331.11 - Cerebral Degenerations, Other; Frontotemporal Dementia; Picks Disease
331.19 - Cerebral Degenerations, Other; Frontotemporal Dementia; Other Frontotemporal Dementia; Frontal Dementia
331.8 - Cerebral Degeneration, Other
331.82 - Cerebral Degeneration, Other; Dementia with Lewy Bodies; Dementia with Parkinsonism; Lewy Body Dementia; Lewy Body Disease

Definition

Dementia is a general term describing a group of disorders in which memory and thought processes (cognition) become impaired for a period of at least 6 months. Unlike mental retardation, dementia involves a change in thinking abilities relative to baseline.

Dementia can be caused by about 50 different disorders, but 50% to 70% of cases are caused by Alzheimer's disease, and 20% to 30% by vascular disease. In many forms of dementia, such as Alzheimer's disease, Lewy body disease, and other neurodegenerative disorders, symptoms develop slowly, are relatively stable rather than fluctuating, and continue into a slow decline. However, other forms of dementia, such as vascular dementia associated with small strokes (multi-infarct dementia) may begin abruptly and worsen in stepwise fashion, with relative stability between each decline. In dementia secondary to head trauma or encephalitis, memory problems are worst at the outset, and remain relatively stable or may even improve with time.

Impaired memory is a prominent and early symptom of dementia. New skills and knowledge are difficult to learn, while old skills and knowledge are eventually lost. Valuables may be lost, such as a wallet or keys. The person may become lost, even in familiar surroundings. Late in dementia, individuals may forget their occupation, family members, or even their name. Other symptoms are difficulty naming objects or people (anomia), rambling speech, difficulty performing certain activities (apraxia), or failure to recognize certain objects (agnosia). Executive functions, such as thinking abstractly, planning, and initiating complex activities, can be impaired. Poor judgment and insight are common. The individual usually has little or no awareness of memory loss or other abnormalities. Individuals have an unrealistic view of their capabilities or their future. For example, they may talk of starting a business or driving. There can be mood and sleep disturbances. False beliefs (delusions) are common, especially paranoid delusions involving others stealing from them or conspiring against them. Individuals with dementia may have further deterioration of cognitive abilities with stress, either physical stress such as a viral illness or minor surgery, or psychological stress such as bereavement.

Alzheimer's disease is the most common cause of dementia, followed by Lewy body disease (DSM-IV-TR 832). Other possibilities include stroke and Parkinson's disease, Huntington's disease, brain injury, tumor, infection (AIDS, syphilis), autoimmune diseases such as lupus, hypothyroidism or other endocrine diseases, liver disease, a neurological disease such as multiple sclerosis, normal pressure hydrocephalus, or heavy metal poisoning with lead or mercury. Dementia could also be a long-lasting effect of drug or alcohol abuse.

Risk: The occurrence of dementia increases with age. The age of onset is usually late in life, with the highest risk above 85 years.

Incidence and Prevalence: Prevalence ranges from about 1.5% for individuals age 65 to 69, up to 16% to 25% for those over 85 (DSM-IV-TR 832).

Source: Medical Disability Advisor






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