A Penn Vet Expert (and Cat Lover) Offers Advice on Aging Cats and Cognition

Cat lovers, take note:

Has your tabby companion of 10 years started giving yowling serenades at 3 AM? Or perhaps your Siamese of a certain age has gone from a lifetime of Mr. Cool to Clingy Kitty.

Well, the tabby isn’t being a brat, and your stately Siamese isn’t suddenly calling on its inner cute. Their behaviors may be sending a message that you and your cat’s veterinarian should heed.

Both senior cats could be displaying signs of aging feline brain changes, including possible early cognitive decline, according to Carlo Siracusa, professor of clinical animal behavior and welfare and Director of Penn Vet’s Small Animal Behavior Service, Department of Clinical Service and Advanced Medicine.

Other common clues to cognitive aging in cats follow the pattern Siracusa and his colleagues call VISHDAAL. Besides increased vocalization, especially at night, and changes in interaction (being more clingy or more reserved), other related behaviors include sleep/wake disruptions, house soiling, disorientation (staring, wandering), anxiety, altered activity (such as pacing or becoming withdrawn), and learning or memory slips. 

“These are not ‘just old age.’ They’re red flags to share with your vet,” said Siracusa, a cat lover who studies and publishes research into feline aging and cognition. It’s an area he and his fellow researchers believe merits more awareness by both owners and clinicians.

Siracusa offered some suggested steps that can go a long way toward improving the lives of feline friends as they age.

Minimal stress environments can protect cognition

“Gentle, cat-friendly handling and consistent, enriched routines reduce stress loads that can worsen signs of cognitive of decline,” said Siracusa. He suggested adding easy-access litter boxes at home and making sure your cat has ample resting spots, preferably in warm areas. Enrichment toys like food puzzles, along with short play sessions, help engage memory and motor patterns, but your cat should also have multiple quiet times during the day when he or she is left undisturbed to rest. Feeding should follow the natural pattern of multiple small meals throughout the day rather than a single large feeding. And for aging pets, familiarity is a positive thing.

“Adventures and changes in life are not good for older animals,” Siracusa said. “If you have a very old animal and you are planning a move, maybe you might want to wait. Or at minimum, you should plan a very smooth transition. Don’t expect that because your dog or cat was fine when it was three years old, it’s going to be the same when it’s 12 years old.”

Screen early and often

This is something both veterinarians and owners can help with. Siracusa encourages veterinarians to use available owner questionnaires – the Feline Cognitive Dysfunction Rating Chart or newer E-CAT – to track cats’ cognitive changes over time and discuss the results with owners. He recommended that the screening begins while the cat is still relatively young, so there is a good basis for comparison. Even healthy cats older than eight years should have senior wellness exams every six months, the animal behaviorist said.

Owners, meanwhile, should keep track of any changes they notice in their pet’s behavior. Siracusa suggested keeping a log and sharing their observations at vet visits.

“Owners should be aware that no behavior change is too small to report at these checkups,” Siracusa said.

It’s not only old age: Inflammation, stress, and body condition matter

Siracusa said that research by him and his colleagues has shown that certain biomarkers and metabolic status, including body condition score, are linked to specific cognitive and behavioral changes, particularly sleep-wake disruptions and anxiety. At the same time, higher stress and diminished spatial memory are associated with weaker social cognitive skills. In their published research, Siracusa and colleagues found that this took the form of reduced gaze alternation toward caregivers during problem-solving, such as accessing a locked container with food.

“Together, these findings support an ‘inflammaging’ pathway, or low grade and chronic inflammation associated with aging, and highlight modifiable risk factors, such as increased weight or stress,” Siracusa said. “It is therefore important that cat owners prioritize weight control, predictable routines, stress reduction, and control of chronic inflammatory disease, such as oral and gastrointestinal disease.”

Veterinarians, he suggested, should track senior cats’ body condition scores and muscle waste, routine lab biomarkers, alongside behavioral checklists, and make recommendations to minimize the risk of cognitive decline.

Rule out cognitive decline look-alikes and treat what you find

“Cognitive dysfunction is a diagnosis of exclusion,” Siracusa said. “Many common senior conditions can mimic or magnify VISHDAAL signs.”

Those physical conditions include arthritis or other pain, hypertension, hyperthyroidism, chronic kidney disease, and sensory loss. Targeted therapy for physical illness often improves behavior and cognition, he said.

A diagnosis of cognitive dysfunction can also be confirmed through these rule-outs, along with the behavioral signs observed and scores on veterinary questionnaires, he added. Treatment may then include environmental enrichment, routine adjustment, nutrition strategies, and medications and supplements.

But, Siracusa stressed, cat owners need to be aware of behavioral changes in their aging feline friends – and not only the problematic ones, such as house-soiling and night-vocalizing.

“Sometimes even things we see as positive should be shared with our vets,” Siracusa said. “So our cat is following us everywhere. He’s approaching us and purring more than usual. It might be that the cat is telling us, ‘I’m not feeling well. I need help.’

“Even positive changes, if they are unusual for that animal, should be reported to the veterinarian.”