Functional independence in ADLs. Free with attribution.
Barthel Index (Barthel Index of Activities of Daily Living) is a validated clinical instrument used to assess functional independence in adls. The instrument contains 10 items.
Source / attribution: Mahoney FI, Barthel DW. Md State Med J 1965 (use freely with citation)
The instrument's primary construct — functional independence in adls — is operationalized through a fixed set of items, each with a defined response format. This standardisation is what allows Barthel Index scores to be compared meaningfully across clinicians, sites, and studies.
Like all screening or assessment instruments, Barthel Index is a structured aid — not a diagnostic test in isolation. Results should be interpreted alongside history, examination, and clinical context. Where a score crosses an actionable threshold, the next step is typically a more detailed clinical evaluation rather than a definitive diagnosis.
Answer all 10 items below to see your Barthel Index score and interpretation.
Each item is scored on a 3-point scale (0–10). Your score updates live as you answer.
All scoring runs in your browser. No data is sent anywhere — close the tab and the answers are gone.
Barthel Index uses simple summation: each item's selected response is converted to a numeric value, and the values are added to produce a total score. Reverse-scored items are inverted before summation.
Scoring notes: Educational use only.
The cutoffs below are drawn from the published validation literature. Always interpret in clinical context.
| Score range | Band | Interpretation |
|---|---|---|
| 0–20 | Total dependence | Total dependence. |
| 21–60 | Severe dependence | Severe dependence. |
| 61–90 | Moderate dependence | Moderate dependence. |
| 91–99 | Slight dependence | Slight dependence. |
| 100–100 | Independent | Independent. |
This is an illustrative walkthrough, not a real patient. Follow the same four steps with your own answers — or use the live calculator at the top of this page.
Read each question and choose the response that best fits. Each response has a number next to it — that number is the item's score. The example below uses illustrative answers.
| # | Item | Example response | Score |
|---|---|---|---|
| 1 | Feeding | Independent | 10 |
| 2 | Bathing | Independent | 5 |
| 3 | Grooming | Independent | 5 |
| 4 | Dressing | Independent | 10 |
| 5 | Bowels | Continent | 10 |
| 6 | Bladder | Occasional accident | 5 |
| 7 | Toilet use | Independent | 10 |
| 8 | Transfers (bed↔chair) | Major help (1–2 people) | 5 |
| 9 | Mobility on level | Walks with help | 10 |
| 10 | Stairs | Needs help | 5 |
Add up all the item scores you noted in Step 1.
10 + 5 + 5 + 10 + 10 + 5 + 10 + 5 + 10 + 5 = 75
Find the row in the interpretation table whose range contains your total:
Total = 75 falls between 61 and 90 → Moderate dependence
Moderate dependence. Moderate dependence.
A score is one input alongside history and examination. Barthel Index supports clinical judgment — it does not replace it.
If Barthel Index doesn't fit your context, related instruments in geriatrics include:
| Scale | Measures | Items | Time |
|---|---|---|---|
| GDS-15 | Depression screening in older adults | 15 | — |
| Katz ADL | Functional independence in basic ADLs | 6 | — |
| CAM | Bedside delirium screen | 4 | — |
| Lawton IADL | Functional independence in instrumental ADLs | 8 | — |
| Timed Up and Go | Mobility and fall risk in older adults | 1 | — |
| ASA Physical Status | Pre-operative health status | 1 | — |
| BDI-II | Severity of depression | — | ≈ 5 minutes |
| CHA2DS2-VASc | Annual stroke risk in non-valvular atrial fibrillation | 8 | — |
Barthel Index (Barthel Index of Activities of Daily Living) is a validated instrument that assesses functional independence in ADLs. It is designed for clinicians, medical students, evidence-synthesis researchers. The 10 items are summed to produce a total score.
Barthel Index contains 10 items. Item scores are summed to produce the total. Scores run from 0 to 100, grouped into 5 interpretation bands from ‘Total dependence’ up to ‘Independent’.
On the Barthel Index (total score 0–100), scores of 100 fall in the ‘Independent’ band — interpreted as: Independent. The full ladder is: 0–20 — Total dependence: Total dependence.; 21–60 — Severe dependence: Severe dependence.; 61–90 — Moderate dependence: Moderate dependence.; 91–99 — Slight dependence: Slight dependence.; 100 — Independent: Independent. A higher score reflects a more severe presentation, and crossing a cutoff is a prompt to step up assessment or care — but these bands are screening thresholds, not diagnoses.
Scores of 0–20 fall in the ‘Total dependence’ band: Total dependence. A low score is reassuring but does not by itself rule out the underlying condition — if symptoms or clinical suspicion persist, reassess over time or use a complementary evaluation rather than relying on the number alone.
Barthel Index is free to use with attribution — clinical, educational, and research use is permitted provided the original source is credited. If you publish results or reproduce the scale, include the citation to the source paper.
Mahoney FI, Barthel DW. Md State Med J. 1965;14:61-65. This is the original publication for the Barthel Index — the reference to cite when reporting results.
No. Barthel Index is a structured assessment aid, not a diagnostic test. Its proper role is clinical assessment of functional independence in ADLs — it standardizes assessment and flags who needs closer evaluation, but the result must be weighed alongside history, examination, and clinical context. When a score conflicts with your clinical impression, clinical judgment takes precedence; treatment decisions should never rest on a screening score alone.
Barthel Index is supported by the following peer-reviewed sources: