Fine-grained observational approaches to pain assessment (e.g. the Facial Action Coding System; FACS) are used to evaluate pain in individuals with and without dementia. These approaches are difficult to utilize in clinical settings as they require specialized training and equipment. Easy-to-use observational approaches (e.g. the Pain Assessment Checklist for Limited Ability to Communicate-II; PACSLAC-II) have been developed for clinical settings. Our goal was to compare a FACS-based fine-grained system to the PACSLAC-II in differentiating painful from non-painful states in older adults with and without dementia.