Pittsburgh Agitation Scale (PAS)

4-item survey to monitor the severity of agitation associated with dementia based on direct observations of the patient.

Audience: PRACTITIONER

Published by EVAL Foundation

Revision 2 · Published October 22, 2025

Citation

<p><span style="background-color:rgb(255,255,255);color:rgb(33,33,33);">Rosen J, Burgio L, Kollar M, Cain M, Allison M, Fogleman M, Michael M, Zubenko GS. A user-friendly instrument for rating agitation in dementia patients. Am J Geriatr Psychiatry. 1994 Winter;2(1):52-9. PMID: 21629007.</span></p>

Summary

According to Rosen et al (1994), "There are many rating instruments designed to assess symptoms of agitation in patients with dementia. Most scales require that raters assess multiple specific behaviors over several days, limiting the use of such scales to clinical staff who have direct contact with patients but do not have the time to complete a comprehensive assessment following each period of observation. Also, scales that assess behavior over several days must rely on "secondhand" information describing behaviors not directly observed by the rater. The Pittsburgh Agitation Scale (PAS) is an easy-to-use instrument, based on direct observations of the patient, that was developed to monitor the severity of agitation associated with dementia. Interrater reliability and measures of validity have been established with clinical staff on a busy psychogeriatric inpatient unit and with research personnel in a nursing home setting."&nbsp;ScoringThe Pittsburgh Agitation Scale (PAS) is scored based on the intensity of observed behaviors across four behavior groups. Each of the four groups is rated on a scale from 0 to 4, based on the intensity and disruptiveness of the behaviors observed during the rating period:Aberrant VocalizationMotor AgitationAggressivenessResisting Care&nbsp;The rating for each group is the highest intensity score observed during that period, using anchor points to determine the level of severity (0 being "Not present" and 4 being the most severe).&nbsp;Note: According to some sources, the scores for these four items are not totaled into a single overall score, although other contexts suggest a total score is used for tracking improvement. The primary focus is on the individual item scores and the overall pattern. The maximum possible score if they were totaled would be 4 x 4 = 16.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;

Instructions

Circle only the highest intensity score for each behavior group that you observed during this rating period.&nbsp;Use the anchor points as a guide to choose a suitable level of severity.&nbsp;Not all anchor points need be present.&nbsp;Choose the more severe level when in doubt.

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Current: Revision 2

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