The 5 Stages of Parkinson’s Disease - Signs and Symptoms
Parkinson’s disease is one of the most
mysterious and poorly understood diseases of all. The disease affects
the nervous system and impairs a person’s range of movement, motor
control, and cognition. These symptoms develop and worsen over a long
period of time, usually following a certain pattern. It’s important to
note that being diagnosed with Parkinson’s is not a sentence, as timely
treatment can reduce and delay the progression of tremors, movement
limitations, and other symptoms of the disease.
Understanding how the disease unfolds is
crucial for patients and family members alike - it will give you a
general idea of the expected symptoms when they’re likely to start, and
how they may impact your day-to-day activities.
What is Parkinson’s disease?
Parkinson's disease is what is known as a
neurodegenerative disorder, which is a progressive disorder of the brain
or peripheral nervous system. Hand tremors may be the emblematic
symptom of the disease, but research confirms that Parkinson’s primarily
affects a specific brain area called substantia nigra, and not
individual nerves in the body.
According to The Parkinson’s Foundation, 1 million Americans and 10
million people worldwide suffer from the disease. Although the specific
cause of the disease remains unknown, scientists point out an array of
risk factors that can increase your risk of developing Parkinson’s:
Genetics - 10-15% of Parkinson’s patients have a family member also
suffering from the disease.
Age - Typically, Parkinson’s develops after age 50-60. Young Onset
Parkinson’s disease is rare - it accounts for only about 4% of patients
in the US.
Gender - Men are twice as likely to develop Parkinson’s than women.
Environment - Chemical occupational hazards, head injury, and
exposure to pesticides and herbicides may also contribute to one’s risk
of developing Parkinson’s disease.
The 5 stages of Parkinson’s disease
Parkinson’s symptoms typically follow a specific pattern, but it does
progress at different speeds for different patients. Some patients may
never experience all the symptoms of the disease, whereas others may
have all the severe symptoms. One person may develop severe tremors but
little to no cognitive decline while another one could only experience
dementia and balance issues.
Symptoms develop gradually, but 10 years after being diagnosed, most
people will experience at least one major issue related to Parkinson’s.
The Hoehn and Yahr scale is used to divide symptoms into 5 stages
ranging from mild to severe. It helps doctors, patients, and caretakers
evaluate the progression of the disease.
Stage One
Early on, Parkinson's disease may be barely noticeable. A person may
feel stiffness or a slight tremor in one hand, but these early symptoms
are often too vague. Your arms may not swing as much when you walk and
your legs may feel heavy. You may feel that your speech became softer or
somewhat slurred, and your writing turns smaller and more crowded.
Family members and friends may notice a change in posture. They may also
point out that your facial expressions have become less pronounced and
your face shows little emotion. At this stage, most people are
completely functional, and prescription medications usually help
diminish any apparent symptoms.
Stage Two
Stage Two of Parkinson’s is the moderate stage where symptoms start to
progress, but a person is still independent in their daily tasks,
although some complicated activities may be challenging. The progression
to Stage Two is slow - it can take months or years. At this stage, a
person will usually notice stiffness and muscle rigidity in both sides
of the body, but they typically don’t have trouble balancing. The
changes in posture and walking become more apparent, and the person may
experience speech difficulties.
Stage Three
The middle stage of Parkinson’s disease is
Stage Three. It usually takes between 3 and 7 years for a patient to
develop Stage-Three Parkinson’s. At this stage, a person’s movements and
speech become significantly slower and one starts experiencing problems
with balance. When you start to walk or need to change direction, you
may feel like your feet are stuck to the floor. Your steps may become
smaller too.
Most individuals are completely independent at this stage, but tremors
and stiffness may make some activities, such as eating soup or tying
shoelaces, a bit troublesome. Medications may be prescribed in higher
doses or more frequently.
Stage Four
When a patient reaches Stage Four of Parkinson’s, they are sadly no
longer independent and require assistance standing and moving around,
which may involve a cane or walker. Some patients never get to this
stage. Other daily activities may become significantly troublesome due
to tremors, pain, and posture issues throughout the body. It usually
takes a full decade for a person to develop Stage Four Parkinson’s
disease.
Stage Five
This is the severest and most debilitating form of Parkinson’s. Patients
at this stage require constant care and assistance, as stiffness in the
legs makes it very difficult or impossible for them to walk. Apart from
being confined to a wheelchair or bedridden, almost half of patients at
this stage experience cognitive and mental difficulties too.
Dementia, confusion, hallucinations, and
delusions are all symptoms a patient may experience at this point.
Patients may behave irrationally because they can’t think clearly or
they may see or hear things that aren’t there.
Even though certain symptoms are associated with specific stages of the
disease, some symptoms can appear at any stage or even years before the
more typical symptoms of Parkinson’s. Constipation, drooling, loss of
smell, forgetfulness and depression are just a few of such symptoms.
Ways to reduce your risk of Parkinson’s disease
Due to the fact that the cause of Parkinson's remains unknown, there are
no certain ways to prevent this disease. Some research has shown that
aerobic exercise, lower cholesterol levels, higher levels of vitamin D
and uric acid in the blood are all associated with a lower risk of
Parkinson’s later in life.
Some evidence suggests that those who take NSAIDs (non-steroidal
anti-inflammatory drugs) are less likely to develop Parkinson’s disease.
Finally, there are also a few studies that show that people who smoke
and consume caffeinated beverages actually have a lower incidence of
Parkinson’s, but more research is needed to confirm those claims.