Feline cognitive dysfunction syndrome (FCDS) is characterized by behavioral and cognitive changes in aging cats. Despite neuropathological evidence of age-related brain changes, assessment tools for FCDS remain limited compared to those available for dogs. This study aimed to develop and validate the Elderly Cat Cognitive Assessment Tool (E-CAT), a caregiver-based questionnaire for FCDS. Based on available evidence, 60 behavioral items pertaining to FCDS were complied. Caregivers of 109 cats aged 11 years and older (54 with chronic conditions and 55 healthy) completed the questionnaire. After the content validity and statistical assessments, 26 items were retained in the E-CAT, and grouped into four categories: Orientation, Activity, Social Interaction, and Emotional State. A summary E-CAT score was computed, compared by comorbidity status and age groups, and correlated to other validated instruments, including the Feline Health-Related Quality of Life (HRQoL) questionnaire and the Feline Musculoskeletal Pain Screening Checklist (MiPSC). E-CAT scores were significantly higher in cats with comorbidities (p = 0.003), older cats (p < 0.001), and cats with clinical pain (p < 0.001). A negative correlation was found between E-CAT score and HRQoL score (Spearman’s rho = − 0.623, p < 0.001), indicating that cats with lower levels of cognitive functions had poorer quality of life. The E-CAT is a promising tool for detecting behavioral and cognitive changes in aging cats. However, to establish diagnostic utility of the E-CAT, larger longitudinal studies and further validation in different populations, including cats with and without confirmed FCDS, are needed.
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