Factor Analysis of the Brief Agitation Rating Scale in a Large Sample of Norwegian Nursing Home Patients

Abstract

Background: Agitation and aggression are prevalent in dementia and put heavy strains on caregivers. Validated assessment tools measuring these symptoms are required to evaluate patients before therapy and during the follow-up period. Given the daily routine in nursing homes, abbreviated instruments are preferable. The Brief Agitation Rating Scale (BARS) is a short form of the Cohen-Mansfield Agitation Inventory. Our aim was to examine the Norwegian version of the BARS by performing a factor analysis. Methods: The data came from 1,870 nursing home patients. The primary caregivers were interviewed by research nurses using the Clinical Dementia Rating Scale, Lawton’s Physical Self-Maintenance Scale and the BARS. Results: The exploratory factor analysis of the BARS revealed 3 dimensions: physically aggressive behavior, physically nonaggressive behavior and verbal agitation. Linear regression analysis showed that reduced functioning in activities of daily living was associated with physically aggressive behavior and verbal agitation, whereas increased severity of dementia and better functioning in activities of daily living were related to physically nonaggressive behavior. In addition, verbal agitation was positively related to a higher number of drugs being taken per day. Conclusions: The factor analyses confirmed that the Norwegian version of the BARS measures the clinically relevant dimensions of agitation in dementia.

A systematic review of the clinical effectiveness and cost-effectiveness of sensory, psychological and behavioural interventions for managing agitation in older adults with dementia

“…Agitation was measured according to the NPI agitation score at each follow-up point, which could take one of nine values (0, 1,2,3,4,6,8,9,12), with higher values indicating more severe levels of agitation.…”

“…l Level 2b: lower-quality RCTs and higher-quality non-randomised studies (scoring ≤ 11). l Level 2c: moderate-quality non-randomised studies (scoring [6][7][8][9]. l Level 4: these scored < 6.…”

The Effect of Person-Centred Dementia Care to Prevent Agitation and Other Neuropsychiatric Symptoms and Enhance Quality of Life in Nursing Home Patients: A 10-Month Randomized Controlled Trial

“…The BARS is a subscale of the Cohen-Mansfield Agitation Inventory (CMAI) [44]. The Norwegian version [45,46] consists of 9 items: hitting, pushing, grabbing, wandering, restlessness, repetitive sentences, repetitive mannerisms, complaining and making strange noises. The frequencies of these symptoms are rated from 1 (never) to 7 (several times per hour), resulting in a minimum score of 9 and a maximum score of 63.…”

Physical disability and cognitive impairment among recipients of long-term care

“…This finding is in contrast to others, who has found that aggressive behaviour could be treated as a separate dimension for nursing home residents. [52] This further underscores the point that some IADL variables have a strong cognitive element. Thus, the distinction between physical and cognitive variables may be more relevant than that between ADL, IADL and cognitive variables.…”