Behavioral changes in older cats

As cats age, they often suffer from declines in bodily functions, including cognitive functioning. Cognitive decline, called feline cognitive dysfunction, is thought to affect more than 55% of cats aged 11 to 15 years and more than 80% of cats aged 16 to 20 years. Cats with cognitive dysfunction may experience declines in memory, learning, visual and auditory processing. This decline may cause sleep disturbances, disorientation and decreased activity. Cats may forget things they once knew well, such as the location of their litter box or food bowls. This may increase anxiety and a tendency to react aggressively. It may also change their relationships with you and other animals in the home. Understanding the changes your cat is going through will help you compassionately and effectively address behavioral problems that may arise as they age.

Some effects of aging are not related to cognitive dysfunction. Often, these effects can contribute to behavioral changes that only appear to be cognitive decline. Be sure to report any changes you notice in your cat to your veterinarian. Don’t assume that your cat is simply getting older and nothing can be done to help. Many behavioral changes are signs of treatable conditions, and there are a number of treatments that can help ease symptoms, including any pain your cat may be experiencing.

Cognitive dysfunction

The following behavior patterns may indicate cognitive dysfunction in an older cat:

Learning and Memory

• Goes to the toilet past the litter box
• He goes to the toilet where he sleeps or eats
• Sometimes it seems that he doesn’t recognize familiar people and animals.

Confusion/spatial disorientation

• Lost in familiar places
• Staring or fixating on objects, or simply staring
• Wandering aimlessly
• Gets stuck and can't get around or over obstacles

Relationships / Social Behavior

• Less interested in affection, communication, does not meet people or familiar animals, etc.
• Needs constant contact, becomes too dependent and obsessive

Decreased activity, indifference

• Less likely to examine things and react less to things happening around her
• Less grooming
• Eats less

Anxiety/increased irritability

• Seems restless or agitated
• Screams louder and/or more insistently
• Overall, he behaves more irritably.

Sleep-Wake Cycle / Altered Day-Night Routine

• Sleeps restlessly, wakes up during the night
• Sleeps more during the day
• Screams more at night

Ruling out other causes of the cat's behavior

If your cat has any of the symptoms or changes listed above, the first step is to take her to the veterinarian to determine if there is a specific medical cause for her behavior. Any medical or degenerative condition that causes pain, discomfort, or decreased mobility, such as arthritis, dental disease, thyroid dysfunction, cancer, decreased vision or hearing, or urinary tract disease, can cause increased sensitivity or irritability, increased anxiety when touched or approached, increased aggression (because your cat may threaten and bite rather than run away), increased responsiveness to your voice, decreased ability to adjust to changes, and decreased ability to get to her usual elimination area.

If medical conditions are ruled out, and if very early behavior problems unrelated to aging (for example, problems that began long before the cat began to age) are ruled out, your cat's behavior may be explained by the effects of aging on the brain.

Treatment of cognitive dysfunction

If cognitive dysfunction is the only logical explanation for the changes in your cat's behavior, the next step is to find treatment. Treatment generally involves making helpful changes to your cat's environment and maintaining a stable daily routine.

There are also medications that may help cats with cognitive dysfunction, such as selegiline hydrochloride (brand name Anipryl®). This drug is currently only licensed for use in dogs with cognitive dysfunction, but some behaviorists and veterinarians have also reported improvement in cats.

Your veterinarian may also prescribe an anti-anxiety medication. To learn about the different anti-anxiety medications that are used to help cats, see Treating Behavior Problems in Cats.

Defecation/urination in inappropriate places

Inappropriate urination/defecation is a common symptom of cognitive dysfunction in cats. In fact, it is the most common reason for older cats to be seen by behavior specialists. Many medical conditions can contribute to inappropriate urination/defecation, including sensory decline, neuromuscular diseases that affect mobility, brain tumors, kidney dysfunction, and endocrine disorders. In short, any disorder that increases the frequency of a cat’s defecating/urinating or reduces control over its bladder or bowel can lead to inappropriate urination/defecation. Accordingly, the first step in treating this problem in any cat, regardless of age, is to take it to the veterinarian for a thorough examination.

If your veterinarian rules out medical conditions, the following suggestions may help:

• Increase the number of litter boxes available to your cat. Place at least one litter box on each floor of your home in case your cat has difficulty walking up and down stairs.
• Place additional litter boxes where they are easy to find. Cats with cognitive dysfunction may forget the location of the litter box. Keep the old litter boxes in their places, but place new boxes in open areas so that the cat can always find a suitable place to eliminate.
• Use low-sided litter boxes. Many older cats experience difficulty and pain when trying to get in and out of high-sided litter boxes.

Confusion and disorientation

Disorientation is often the first sign that owners recognize as cognitive decline in their older cats. It is estimated that disorientation occurs in at least 40% of cats aged 17 years and older.

Disorientation can be reduced by increasing the predictability of the cat's environment and routine. Avoid changing food and litter, as well as the location of the food bowl and litter box. Try to maintain as consistent a routine as possible. If your cat is distressed, it may be best to keep her in a relatively small area, such as one floor of the house or, in more severe cases, one room. This will make it easier for her to find what she needs.

Restlessness / Waking up at night

A cat’s sleep-wake cycle may be disrupted by cognitive dysfunction. However, as with most symptoms of cognitive dysfunction, there are many other reasons for increased nighttime activity. For example, a cat that sleeps more during the day may be more restless and active at night. Sensory changes, such as vision or hearing loss, can affect a cat’s depth of sleep. An increased need to urinate, coupled with a decreased ability to find or reach a litter box, may prompt a cat to wake up and wander around. Ask your veterinarian for a full examination to identify medical conditions that may be causing restlessness, discomfort, or an increased need to urinate. In the meantime, try to restore normal sleep and wake hours. It’s best to increase her activity level by playing with her during the day and in the evening to encourage her to sleep at night.

Anxiety can also cause increased restlessness at night. The hallmark of geriatric anxiety is that it can manifest as nighttime anxiety. This can be anxiety about the cat being separated from family members (who are sleeping) or anxiety about moving around the house in the dark. Your cat may keep you awake by screaming and running around the room, purring near your head, and pawing at you for attention. Anxiety caused by cognitive dysfunction can be alleviated with medication. You can also consult with a certified practical animal behaviorist and your veterinarian to see if medication can help.

Excessive meowing

Older cats may meow excessively for a number of reasons, including disorientation, hearing loss, or pain due to one or more medical conditions. As with other symptoms of cognitive dysfunction, the first step is to take your cat to the veterinarian for a thorough examination and to rule out or treat medical conditions.

In general, cognitive dysfunction increases meowing associated with anxiety, disorientation, or separation anxiety. Anxiety meowing is usually plaintive. An older cat’s meowing can become a problem if it is too frequent or at inappropriate times, such as when you are sleeping. Showing your own frustration or punishing your cat for meowing can increase her anxiety and make the problem worse. It is better to combat excessive meowing by increasing your cat’s activity during the day and gradually changing her sleep-wake cycle.

Pheromone or drug therapy may help reduce your cat’s anxiety. You can use cat pheromone sprays or diffusers in areas where your cat typically spends time. Anti-anxiety medications may also help reduce meowing. You may also want to consult a certified animal behaviorist and your veterinarian.

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