Parkinson’s disease impacts people in many different ways. Not everyone will experience all of the symptoms of Parkinson’s, and if they do, they won’t necessarily experience them in quite the same order, or at the same level of intensity. Even so, there are typical patterns of progression in Parkinson’s disease that are defined in stages.
You might hear your doctor refer to your Hoehn and Yahr stage. This scale, first introduced in 1967, is a simple rating tool used by clinicians as a means to generally describe how motor symptoms progress in Parkinson’s. Another more comprehensive tool is the Unified Parkinson’s Disease Rating Scale (UPDRS). It takes into account factors other than motor symptoms, including mental functioning, mood and social interaction.
While symptoms are unique to each person, and the progression of symptoms varies from person to person, knowing the typical stages of Parkinson’s can help you cope with changes as they occur. In some people, it could take 20 years to go through these stages. In others, the disease progresses more quickly.
Stages of Parkinson's Disease
During this initial stage, the person has mild symptoms that generally do not interfere with daily activities. Tremor and other movement symptoms occur on one side of the body only. Friends and family may notice changes in posture, walking and facial expressions.
In stage two of Parkinson’s, the symptoms start getting worse. Tremor, rigidity and other movement symptoms affect both sides of the body. Walking problems and poor posture may become apparent. In this stage, the person is still able to live alone, but completing day-to-day tasks becomes more difficult and may take longer.
Stage three is considered mid-stage in the progression of the disease. Loss of balance and slowness of movements are hallmarks of this phase. Falls are more common. Though the person is still fully independent, symptoms significantly impair activities of daily living such as dressing and eating.
During this stage of Parkinson’s, symptoms are severe and very limiting. It’s possible to stand without assistance, but movement may require a walker. The person needs help with activities of daily living and is unable to live alone.
This is the most advanced and debilitating stage of Parkinson’s disease. Stiffness in the legs may make it impossible to stand or walk. The person requires a wheelchair or is bedridden. Around-the-clock nursing care is required for all activities. The person may experience hallucinations and delusions. While stage five focuses on motor symptoms, the Parkinson’s community acknowledges that there are many important non-motor symptoms as well.
For more information about the forms and stages of Parkinson’s, please watch this video: