It Might Not Be "Just Aging" — New Guidelines to Recognize Dementia in Dogs

"Recently, I've been feeling restless at night and pacing around the room."
"When called, the response is slow. The number of toilet accidents has increased."
"Suddenly cries out anxiously. Thought they were asleep, but they wake up and wander at night."

When living with a senior dog, you may encounter such "changes." The problem is whether these are simply due to aging or if they are signs of cognitive decline as a disease , which can be unclear to both the owner and sometimes even the medical side.

In this gray area, a "common language" has finally been established. In January 2026, an international group of experts in canine cognitive research and clinical practice published guidelines for diagnosing and monitoring **Canine Cognitive Dysfunction Syndrome (CCDS)**. Phys.org

What is CCDS (Canine Dementia): "Progressive Changes" Similar to Alzheimer's Disease

According to releases from Phys.org and NC State, CCDS is defined as a chronic, progressive, age-related neurodegeneration similar to Alzheimer's disease in humans. The characteristic is that "brain issues manifest as changes in daily behavior." Specifically, changes in activity levels, sleep disturbances, anxiety, accidents, and learning and memory impairments are noted. Phys.org

The important point here is that symptoms often dismissed as "just because they're old" can significantly impact the quality of life (QOL). Nighttime wandering and crying can disrupt not only the dog's sleep but also the family's. Scolding for accidents doesn't improve the situation and can even increase anxiety. That's why a system for early detection and continuous monitoring was needed.

What has been the challenge so far?—The issue of "diagnoses varying by person"

Natasha Olby (NC State), a key figure in creating the guidelines, points out that "while diagnoses are increasing, there is no standardized method." Phys.org

In fact, a survey of veterinarians in 2025 highlighted the lack of "accepted guidelines for diagnosis and management" as a challenge, suggesting gaps in knowledge and response. Frontiers

What are the issues if diagnosis isn't standardized?

• Different evaluation methods at each hospital can lead to different conclusions for the same dog

• It's difficult to compare progress, and the effects of treatment or care are easily dismissed as **"just imagination"**

• In research, inconsistent definitions of subjects hinder treatment development

These guidelines serve as a "foundation" to reduce such "discrepancy issues."

Key Point 1 of the New Guidelines: Understanding Symptoms in Seven Areas with "DISHAA"

The guidelines (abstract published on PubMed) organize behavioral changes in CCDS using the framework called DISHAA .

• D: Disorientation (wandering aimlessly, getting lost)

• I: Changes in social interactions (changes in distance, response)

• S: Sleep disturbances (day-night reversal, waking at night)

• H: House soiling

• A: Decreased learning and memory

• A: Changes in activity levels

• A: Increased anxiety
  (occurring to a degree that affects daily life in the above areas)  PubMed

The key is that symptoms are not just "vaguely aging" but can be observed in each area . This translates the owner's "vague feelings" into words, making it easier to share with veterinarians.

Key Point 2: Staging Severity from "Mild to Severe" (Making Care Prioritization Easier)

The guidelines present severity in three stages (mild to severe). Mild is when "signs are subtle, infrequent, and low in intensity, with functions maintained." As it progresses, changes become noticeable, requiring adjustments in daily life, and in severe cases, there are serious impairments in basic functions—this is the organization. PubMed

This impacts decision-making within the household.

It becomes easier to prioritize care, such as "Is it okay to focus on monitoring now?" "Should we increase environmental adjustments?" "Should nighttime measures be prioritized?"

Key Point 3: Two Levels of "Certainty Levels," Including Objective Information Like MRI

For diagnosis, two levels of certainty are proposed.

• Level 1 : Based on consistent history of progressive DISHAA signs, exclusion of other causes through physical, orthopedic, and neurological examinations and tests, persistence of signs even after managing comorbidities, etc.

• Level 2 : In addition to Level 1, includes more objective findings such as cortical atrophy on brain MRI and normal range of cerebrospinal fluid (CSF) cell count . PubMed

Not everyone can undergo an MRI. Therefore, the design is realistic by firmly defining Level 1 (clinical-based) and, if possible, supporting it with Level 2.

Key Point 4: "From When and How Often" to Monitor?—Screening Recommended from Age 7

The guidelines recommend monitoring cognitive changes in senior dogs using a simple survey from around age 7 . If changes are reported, a more detailed CCDS scale (questionnaire) is used for evaluation, with follow-ups every six months . Furthermore, all dogs over 10 years old are recommended to be evaluated with the scale every six months . Phys.org

The significance of "every six months" is the idea of creating a graph of changes rather than rushing to the hospital after symptoms appear. Like human health checkups, the trend is more important than a single number.

What Owners Can Do: Increase the "Materials" for Diagnosis

Although the guidelines are aimed at veterinarians, they are directly relevant to owners as well. What can be done at home is not difficult tests, but rather improving the "quality of information" as follows.

• Take videos of nighttime wandering or crying

• Note down "when, where, and how long" in a memo (weekly basis is fine)

• Instead of scolding for accidents, record the frequency and circumstances

• Cooperate in excluding factors that cause similar symptoms, such as eyes, ears, pain, endocrine issues (consultation)

Since Level 1 diagnosis is based on "history and exclusion," daily logs become effective. PubMed

Reactions on Social Media: Owners' "Common Experiences" Highlight the Need for Guidelines

This news resonates not only among experts but also within the senior dog community. Looking at posts on social media (such as Reddit), the following voices are repeatedly expressed.

1) "Caregiving is mentally draining"—Lack of sleep and feelings of isolation

There are quite a few posts from owners facing cognitive decline in senior dogs, expressing sentiments like "I'm nearing my limit" or "It's mentally tough." Continuous nighttime wandering or dealing with accidents can also exhaust the family's life. Reddit

2) "Is this a disease? Training issue? Aging?"—The anxiety of not being able to judge

Many seek advice on questions like "How did you know it was 'dementia'?" or "The symptoms don't seem typical," highlighting the difficulty of distinguishing the condition. Reddit
That's why frameworks like DISHAA, which organize areas and track with questionnaires, become tools to reduce "ambiguity." PubMed

3) "When should I let go?"—The ongoing "question without a right answer"

Since it is a progressive disease, ultimately, there are cases where the heavy decision of "how far to support" cannot be avoided. On social media, there are posts grappling with rapid deterioration or the timing of letting go. Reddit

The guidelines themselves do not dictate decisions on euthanasia, but the staging of severity can serve as a common language in family discussions. PubMed

4) "I hope treatment advances"—Definitions to advance research

The desire for "treatment options" and "wishing I had noticed earlier" are