Barthel Index: Barthel Index of Activities of Daily Living

Functional independence in ADLs. Free with attribution.

geriatrics, rehabilitation 10 items Updated 2026-05-05

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What is Barthel Index? Barthel Index (Barthel Index of Activities of Daily Living) is a validated instrument used to assess functional independence in adls. It comprises 10 items.

What is Barthel Index?

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)

Clinical context: when Barthel Index is used

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.

Score Barthel Index

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.

How Barthel Index is scored

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.

Barthel Index score interpretation

The cutoffs below are drawn from the published validation literature. Always interpret in clinical context.

Score rangeBandInterpretation
0–20Total dependenceTotal dependence.
21–60Severe dependenceSevere dependence.
61–90Moderate dependenceModerate dependence.
91–99Slight dependenceSlight dependence.
100–100IndependentIndependent.

How to score Barthel Index: a step-by-step worked example

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.

Step 1 — Score each item

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.

#ItemExample responseScore
1FeedingIndependent10
2BathingIndependent5
3GroomingIndependent5
4DressingIndependent10
5BowelsContinent10
6BladderOccasional accident5
7Toilet useIndependent10
8Transfers (bed↔chair)Major help (1–2 people)5
9Mobility on levelWalks with help10
10StairsNeeds help5

Step 2 — Add up the scores

Add up all the item scores you noted in Step 1.

10 + 5 + 5 + 10 + 10 + 5 + 10 + 5 + 10 + 5 = 75

Step 3 — Look up the band

Find the row in the interpretation table whose range contains your total:

Total = 75 falls between 61 and 90Moderate dependence

Step 4 — What does this mean clinically?

Moderate dependence. Moderate dependence.

A score is one input alongside history and examination. Barthel Index supports clinical judgment — it does not replace it.

Score Barthel Index with your own answers above →

Limitations & common pitfalls

How Barthel Index compares to other geriatrics scales

If Barthel Index doesn't fit your context, related instruments in geriatrics include:

ScaleMeasuresItemsTime
GDS-15Depression screening in older adults15
Katz ADLFunctional independence in basic ADLs6
CAMBedside delirium screen4
Lawton IADLFunctional independence in instrumental ADLs8
Timed Up and GoMobility and fall risk in older adults1
ASA Physical StatusPre-operative health status1
BDI-IISeverity of depression≈ 5 minutes
CHA2DS2-VAScAnnual stroke risk in non-valvular atrial fibrillation8

Frequently asked questions about Barthel Index

What does Barthel Index measure?

Barthel Index (Barthel Index of Activities of Daily Living) is a validated instrument that assesses functional independence in adls.

How many items are on Barthel Index?

Barthel Index contains 10 items. Items are summed to produce a total score.

What is a high Barthel Index score?

Scores of 100–100 fall in the "Independent" band. Independent.

What is a low Barthel Index score?

Scores of 0–20 fall in the "Total dependence" band. Total dependence.

Is Barthel Index free to use?

Barthel Index is free to use with attribution. Mahoney FI, Barthel DW. Md State Med J 1965 (use freely with citation)

What is the source paper for Barthel Index?

Mahoney FI, Barthel DW. Md State Med J. 1965;14:61-65.

Can Barthel Index replace clinical judgment?

No. Barthel Index is a structured assessment aid. A score is one input alongside history, examination, and clinical context. Treatment decisions should never rest on a screening score alone.

References & validation

Barthel Index is supported by the following peer-reviewed sources: