Caring for a Cat With Dementia: Signs, Routines and Support

By Tailwisp Editorial TeamUpdated October 20, 20264 min read

It can be heartbreaking to see an old cat wander the house at night, stare at a wall or forget where the litter box is. Feline cognitive dysfunction, sometimes called cat dementia, is a recognized condition in older cats. While it cannot be cured, there is a lot you can do to help your cat feel safe and comfortable.

What is cognitive dysfunction?

Feline cognitive dysfunction is a gradual decline in brain function linked to aging. Changes in the brain, such as protein deposits and reduced blood flow, are thought to play a role. Studies suggest that a significant number of cats over eleven show at least one sign, and the rate rises with age. See senior cat care guide.

Signs

Vets sometimes use the acronym DISHAAL to describe the changes.

• Disorientation: getting lost in familiar places, staring at walls, standing in corners.
• Interactions: less interest in people, or clinginess.
• Sleep changes: more daytime sleep, restlessness at night.
• House soiling: forgetting the litter box.
• Activity changes: less play, or pacing.
• Anxiety: increased fear or irritability.
• Learning and memory: forgetting routines or commands.

Excessive vocalization, especially at night, is common. See why do cats meow at night.

Rule out other causes

Many diseases cause similar signs, and some are treatable.

• Hyperthyroidism. See hyperthyroidism in cats.
• High blood pressure and kidney disease. See chronic kidney disease in cats.
• Pain, especially arthritis. See arthritis in cats and signs of pain in cats.
• Vision or hearing loss. See caring for a blind cat and caring for a deaf cat.
• Brain tumors, infections or other neurological problems.
• Diabetes. See diabetes in cats.

Your vet will do a physical exam, blood and urine tests and may check blood pressure. Dementia is a diagnosis of exclusion.

Making the home easier

• Keep a routine. Feed, play and groom at the same times each day.
• Keep furniture in place.
• Add night lights in hallways.
• Place litter boxes, food and water in several easy-to-reach spots, with low entries. See senior cat home modifications.
• Use ramps and non-slip floors.
• Block hazards, such as stairs and balconies. See cat proofing your home.
• Provide cozy beds in quiet areas. See how to choose a cat bed.

Enrichment

Gentle stimulation can support the brain. Offer short play sessions, puzzle feeders, new smells and window views. Rotate toys, and use food puzzles that are easy. See puzzle feeders and slow feeders for cats and window perches and bird feeders. Keep sessions short, and watch for fatigue.

Diet and supplements

Some diets for senior cats contain antioxidants, omega-3 fatty acids and other nutrients aimed at brain health. Some supplements have limited evidence. Ask your vet before adding anything. See best food for senior cats and are vitamins and supplements necessary for cats.

Medication

Some vets prescribe medication, such as selegiline, which is approved for dogs and sometimes used in cats, or other drugs for anxiety or sleep. Treatment depends on the cat. Never give human drugs. See cat poisoning: what to do.

Night crying

Try a play session and a meal before bed, a warm bed, a night light and a quiet radio. Do not shout. If crying persists, talk to your vet about pain, anxiety or sleep aids.

Litter box problems

Do not punish. Add boxes, use low sides, and clean accidents with an enzyme cleaner. See how to remove cat urine odor.

Caregiver support

Caring for a cat with dementia can be tiring. Ask family to share tasks, keep notes, and talk to your vet about quality of life. See cat quality of life and saying goodbye.

Keeping a diary and tracking progress

Note the time and type of each episode, such as night crying, accidents or disorientation, along with appetite and weight. A short log helps your vet to judge whether treatments are working, and helps you to spot patterns, such as crying after a late meal. Take short videos of strange behavior to show the vet. Review the diary every few weeks, and ask whether the care plan needs changes. Celebrate good days, since they matter.

When to see a vet

See a vet when you first notice changes, and for regular rechecks. Use the US vet directory to find a clinic.