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Abstract
Objective: To examine the test–retest reliability and validity of the Norwegian Brief Agitation Rating Scale (BARS), a short form of the Cohen-Mansfield Agitation Inventory (CMAI) assessing the frequency of agitation in dementia.
Methods: We investigated the internal consistency, test–retest reliability and the validity of BARS. In the validity study, we compared the BARS scores with the Neuropsychiatric Inventory – Nursing Home Version subscale Agitation/Aggression (NPI-NH/AA) and the Cornell Scale for Depression in Dementia subscale Agitation (CSDD/A).
Results: In the reliability study, Cronbach's alpha was 0.76; the test–retest reliability of the BARS showed a Spearman's rho of 0.64, but this increased to 0.86 when we deleted the item ‘complaining’. In the validation study, the BARS score correlated with the NPI-NH/AA and the CSDD/A scores, Spearman's rho 0.55 and 0.52, respectively. These correlations changed when controlling for the Clinical Dementia Rating (CDR) Scale stages. The highest correlations between the BARS and the NPI-NH/AA and the BARS and the CSDD/A were found among patients with CDR score 2.
Conclusions: The study indicates that the Norwegian version of BARS is a reliable and valid instrument to test agitation in dementia, but a version without the item ‘complaining’ would be better.
Acknowledgements
We thank all the participants, patients and carers, and especially the leadership at the nursing homes that allowed us to perform the study, even though they are already contending with a lot of financial restrictions and reduced staffing. This study was funded by unrestricted grants from the South Eastern Norway Regional Health Authority and Innlandet Hospital Trust.