If your senior cat is slowing down, it may not just be old age. Being more vocal, sleeping more, not using the litter box, and being clingier than usual are a few signs of cognitive decline.

As with humans and other animals, cats become increasingly susceptible to age-related disorders as they grow older. Feline cognitive dysfunction (FCD) is a progressive neurodegenerative disease with symptoms resembling those associated with Alzheimer’s disease and dementia in humans.

Feline dementia is often overlooked because people assume their cat is “just getting old” and don’t report new symptoms to their veterinarian. But any changes are worth mentioning.

Here are the signs to pay attention to.

As cats age, they sometimes behave in altered ways, such as vocalizing much more, changing their usual habits or social interactions, and not using the litter box. In more than 25% of cats over the age of 11 years, there are no clear causes of these changes.

Determining whether the causes are medical or due to cognitive decline is not always simple.

Some of the signs include:

  • spatial disorientation (and getting lost if outdoors)
  • no interest in playing
  • excessive sleeping or altered sleep cycles
  • staring blankly into space or at walls for long periods
  • no interest in food and water
  • urinating and defecating outside the litter box
  • loud vocalizing, frequently in the middle of the night
  • forgetting the location of food bowls, litter boxes, or favorite resting spots
Medical Perspective

One of the biggest misconceptions I see is that every behavioral change in a senior cat is simply a normal part of aging. While aging certainly affects cats, changes such as increased vocalization, confusion, altered sleep patterns, or litter box accidents should always be discussed with your veterinarian. Sometimes these signs point to an underlying medical condition, and sometimes they may indicate cognitive decline, but either way, they deserve attention.

— Vincent J. Tavella, DVM, MPH

Quotes represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.

The AAFP feline senior care guidelines use the acronym DISHA-AL to describe clinical signs of cognitive decline:

  • Disorientation
  • Interaction changes
  • Sleep–wake cycle alterations
  • House-soiling
  • Activity changes
  • Anxiety
  • Learning/memory

Compared to dogs, CDS is likely underrecognized in cats because clinical signs are less specific and there are few validated diagnostic tools. And, unlike dogs, there is no validated feline-specific scoring system yet.

In cats, biomarker research remains scarce, and more long-term studies are needed. A diagnosis is mainly based on a combination of owner-reported behavioral changes and ruling out any other causes, like pain, high blood pressure, or hyperthyroidism.

Paying close attention and even taking photos, videos, and notes of your cat can help you and your vet to determine whether their behavior signals a medical issue, environmental cause, or cognitive decline.

Questions a vet may ask

Questions a veterinarian may ask you to help determine if your cat is experiencing cognitive decline include:

  • How often does your cat act confused, forgetful, or depressed?
  • What’s the highest surface your cat will jump onto? Is there any lameness?
  • When was the last time you saw your cat stretch and yawn luxuriously?
  • Is your cat using the litter box?
  • Have your cat’s interactions with any housemates changed?
  • Is your cat more aloof or more affectionate and clingy than before?
  • Does your cat vocalize, meow insistently, or yowl for no apparent reason?
  • Have your cat’s grooming and sleeping habits changed in any way?
  • How have your cat’s eating and drinking habits changed?
  • How willing is your cat to play with toys or hunt if given the opportunity?

Because many signs of cognitive dysfunction overlap with other age-related diseases, veterinarians often recommend the following before making a presumptive diagnosis:

  • blood work
  • blood pressure measurement
  • urinalysis
  • a thorough physical examination

There is no cure for cognitive decline, but the first step to managing your cat’s health is to establish clear communication with your vet.

It can be scary to sense that something is wrong with your aging cat, and it can be tempting to gloss over concerning symptoms. It’s totally normal to be upset and fearful when your cat has any kind of condition. But your vet’s goal is the same as your goal at heart: to help your cat have the best quality of life possible.

To help delay decline, some research suggests adding omega-3 fatty acids to your cat’s diet for the anti-inflammatory and neuroprotective effects.

Enriching their environment with structured play and stimulation may also enhance synaptic plasticity and cognitive resilience. Not only toys, but things like puzzle feeders can add cognitive enrichment.

To help reduce stress for your cat, ensure they have a calm, predictable environment with easy access to essential resources, including food, water, and litter boxes.

Calming pheromones (sprays or plug-ins) may also help reduce stress.

Your vet may also recommend a specific diet or supplements for your particular cat.

Despite growing interest, scientific studies on feline cognitive dysfunction are scarce, leaving gaps in the diagnostic, biomarker, and interventional domains.

Currently, the main way to assess dementia in cats is to look at behavioral changes and rule out other clinical diagnoses.

Providing a consistent, comforting environment with easy access to everything they need can help, though dementia is not curable.

Work with your vet to create a management plan for your cat to help give them the best senior life possible.