People with dementia often have painful conditions that go unnoticed because of their communication problems. Signs of pain in this population may include agitation and observable behaviors associated with discomfort. Agitation, discomfort, and severity of dementia were evaluated in 33 Veterans Affairs nursing home patients using the Cohen-Mansfield Agitation Inventory, the Discomfort Scale, and the Global Deterioration Scale, respectively. Findings revealed statistically significant positive relationships between agitation and severity of dementia (r = 0.34, P = 0.01), discomfort and severity of dementia (r = 0.44, P = 0.01), and agitation and discomfort (r = 0.50, P = 0.003). In a multiple regression analysis, agitation was significantly associated with discomfort (R(2) =.14, P = 0.02) after controlling for dementia severity. These preliminary findings suggest that discomfort may be a source of agitation.