Seven-year CatPAWS study shows multimorbidity is common in aging cats

A new longitudinal study is putting numbers behind something many feline clinicians see every day: older cats rarely age with just one problem. The Cat Prospective Ageing and Welfare Study, published June 24, 2026, followed 209 client-owned cats for up to seven years and found that 96% developed at least one abnormality, while 84% developed multimorbidity. Dental disease, orthopedic abnormalities, and heart murmurs were the most prevalent findings, and the authors also identified higher mortality risk in pedigree cats and in cats showing muscle loss during midlife. (frontiersin.org)

The paper extends a research program that began with CatPAWS enrollment work at the University of Liverpool. In that earlier baseline analysis of 206 cats aged 7 to 10 years, published in 2022, only 12% of cats that completed full clinical assessment had no evidence of disease. At enrollment, dental disease was present in 54%, heart murmurs in 29%, azotemia in 10%, hyperthyroidism in 3%, and orthopedic abnormalities in 58% of cats that permitted orthopedic examination. The study team launched CatPAWS to monitor pet cats from middle age onward through the Feline Healthy Ageing Clinic, with the goal of better defining normal aging versus early disease. (frontiersin.org)

The new mortality and multimorbidity paper appears to confirm that these early abnormalities often accumulate rather than remain isolated. The available study summary reports that 59 of 209 cats died during follow-up, or 28.2% of the cohort, with neoplasia the leading cause of death, followed by cardiovascular, endocrine, and renal disorders. The same Liverpool research stream has also shown that bodyweight, body condition score, and especially muscle condition change nonlinearly with age: muscle loss begins before many cats would be considered geriatric, then accelerates later, and cats with chronic disease show steeper declines. That makes the mortality signal around midlife muscle loss especially noteworthy for clinicians trying to identify risk earlier. (livrepository.liverpool.ac.uk)

Outside the study itself, the findings line up closely with current feline practice guidance. AAHA/AAFP life-stage guidance says mature adult and senior cat visits should focus on early detection of disease and comorbidities, with particular attention to pain assessment, musculoskeletal examination, abdominal and thyroid palpation, blood pressure, and changes in grooming, appetite, thirst, activity, and behavior. The guidelines also note that osteoarthritis is both significant and underdiagnosed in cats, which helps explain why orthopedic abnormalities keep surfacing so prominently in prospective screening studies. (aaha.org)

That consistency matters because feline preventive care still depends heavily on whether pet parents bring in cats that appear outwardly well. Prior screening research in apparently healthy mature adult and senior cats likewise found a high prevalence of physical examination abnormalities and occult systemic disease, supporting regular health screening from at least 7 years of age. Taken together, the evidence suggests that waiting for obvious clinical signs may mean missing the window when multimorbidity is just beginning and interventions are simpler, more affordable, and easier for pet parents to accept. (pubmed.ncbi.nlm.nih.gov)

Why it matters: For veterinary professionals, the practical takeaway isn’t just that older cats get sick more often. It’s that risk stratification may need to start earlier and become more multidimensional. A cat that is middle-aged, pedigree, losing muscle, grooming differently, sleeping more, or moving less may not have one isolated issue, but a cluster of emerging conditions involving dental disease, pain, renal change, endocrine disease, or cardiovascular findings. That argues for routine trend-based monitoring rather than one-off screening, and for making muscle condition scoring as routine as weight and body condition scoring in feline wellness care. (pmc.ncbi.nlm.nih.gov)

There’s also a communication opportunity here. One of the recurring lessons from CatPAWS is that pet parent perception doesn’t always match objective findings. The 2022 enrollment paper found that owner-reported changes in behavior, eating, grooming, and activity were common, but many cats still arrived framed as healthy. For practices, this supports clearer messaging that “normal aging” and “healthy aging” aren’t the same thing, especially once cats enter the 7-to-10-year range. (frontiersin.org)

What to watch: The next step will be whether these CatPAWS findings influence screening recommendations, clinic workflows, or nutritional and muscle-preservation strategies for midlife cats, particularly as more longitudinal data emerge on which early abnormalities best predict survival and quality of life. (pmc.ncbi.nlm.nih.gov)