Stages of Parkinson's Disease

Symptoms of Parkinson’s disease vary as the stages of Parkinson's disease progress. Understanding Parkinson’s disease stages can help people cope with the disease.

In Parkinson’s disease (PD), brain cells that make a chemical called dopamine progressively die. And, because dopamine is important for sending signals to parts of the brain responsible for movement, a lack of this chemical results in the motor symptoms of Parkinson’s disease — including balance problems, rigidity, and tremors. There are several non-motor symptoms, too, such as depression and memory problems, which can also impact quality of life, the National Institute of Neurological Disorders and Stroke explains.

However, these Parkinson’s disease symptoms don’t all develop overnight, and not every PD patient has all of the symptoms or the same severity of symptoms. But despite these variables, Parkinson’s disease is a chronic and progressive movement disorder and, over time, it follows a broad pattern.

By studying this pattern, researchers have identified five specific Parkinson’s disease stages.

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Understanding the stages of Parkinson’s disease

• Stage One. Initially, a person with PD typically has only mild symptoms that may be mistaken for musculoskeletal problems at first. Movement symptoms such as tremor occur only on one side of the body and don’t interfere with daily life. Changes in posture, walking, and facial expressions (having an expressionless face with little animation) can occur at this stage.
• Stage Two. As symptoms start to worsen, walking problems and a stooped posture are obvious. Movement symptoms, including rigidity, now affect boht sides of the body. Although a Parkinson disease patient experiencing this stage of PD can still live alone, daily tasks can be more difficult.
• Stage Three. When discussing the stages of Parkinson’s disease, doctors call this the mid-stage of PD. Movements are slowed down considerably, and problems with balance worsen — a condition known as postural instability. Because it often leads to falls, postural instability contributes greatly to disability associated with Parkinson’s disease, according to the Bachmann-Strauss Dystonia & Parkinson Foundation. A person experiencing stage three of PD can live independently, but simple daily activities like eating and getting dressed can take a great deal of time and effort.
• Stage Four. As Parkinson’s disease progresses to this stage, symptoms are severe and limit what a patient with PD can do. For example, a patient experiencing stage four PD symptoms may be able to stand but, in order to move around, needs assistance or a walker. Because of the difficulty in performing daily tasks, living alone becomes impossible for people with Parkinson’s disease at this stage.
• Stage Five. When Parkinson’s disease symptoms reach this advanced stage, legs may become so stiff that a PD patient cannot stand or walk alone even with a walker and must use a wheelchair or be bedridden. Hallucinations and delusions may also occur. At this stage, nursing care is required for all activities, 24 hours a day, according to the Parkinson’s Foundation.

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