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A doctor helping a person walk with a walker.

Learning About the 5 Stages of Parkinson’s Disease

Parkinson's Disease Stages

Numbers show about 60,000 people in the United States are diagnosed with Parkinson's disease each year. More than 10 million people in the world live with this disease. As a progressive condition, Parkinson's disease develops in stages; it does not occur overnight. This article focuses on Parkinson's disease stages and other useful information you need to know.

What is Parkinson’s Disease?



Parkinson’s disease is a neurodegenerative condition that predominantly affects dopaminergic (dopamine-producing) neurons in a brain area called substantia nigra. The disease mainly affects a person’s movement. Parkinson’s disease develops when neurons in the movement-controlling area of the brain become impaired or even die.

When the neurons are impaired (or if they die), dopamine production lowers, thus contributing to symptoms of this disease. Unfortunately, the cure for Parkinson's disease does not exist. Instead, treatment focuses on improving symptoms and the quality of life in patients.

Common Symptoms of Parkinson’s Disease

The exact signs and symptoms of Parkinson’s disease may vary from one person to another. Early signs of the disease can be mild and go unnoticed. In the beginning, symptoms may develop on one side of the body and may remain worse there even after they start affecting the other side as well. Common signs and symptoms of Parkinson’s disease may include:

  • Tremors and shaking that usually begin in a limb (hands or fingers)
  • Bradykinesia (slowed movement)
  • Muscle stiffness
  • Impaired posture and balance, sometimes leading to falls.
  • Speech changes (more monotone speech)
  • Writing changes (small handwriting)
  • Loss of automatic movements

How is Parkinson’s Disease Diagnosed?

Even though Parkinson’s disease is a serious and prevalent neurodegenerative condition, there is no specific test to diagnose it. A neurologist diagnoses the disease based on a patient’s medical history, signs and symptoms, and a neurological and physical examination. Your doctor may order:

  • Single-photon emission computerized tomography (SPECT) scan called dopamine transporter scan (DaTscan)
  • Blood tests
  • Imaging tests such as an MRI, ultrasound, and PET scan

The main purpose of these tests is to rule out other conditions.

If you, or someone you know, experience symptoms associated with Parkinson's disease, make sure to see the doctor immediately. Since many conditions have similar symptoms but require different treatments, it's paramount to diagnose Parkinson's disease as soon as possible.

Stages of Parkinson’s Disease

Parkinson’s disease is a progressive condition. The symptoms of this disease develop gradually as the condition progresses from one stage to another. Parkinson’s disease has five stages.

Stage 1

This is the initial stage of the disease. A patient has mild symptoms, and they do not interfere with their quality of life or daily activity. Tremors tend to occur on one side only. The first stage may also include symptoms such as changes in posture, walking, and facial expressions. In many cases, the symptoms are so mild they go undetected.

Stage 2

In this stage, symptoms become worse. Tremors, muscle stiffness, and other movement-related symptoms affect both sides of the body now. A patient may experience noticeable changes in posture and walk. Their balance is not affected much at this stage. While patients can still live alone at this point, their daily life is affected by the disease. The progression from the first to the second stage may take months or years. The progression from stage to stage is individual, not the same for all patients.

Stage 3

The hallmarks of the third stage of Parkinson’s disease include slow movements and loss of balance. Due to impaired balance, it is not uncommon for patients to fall. Symptoms of the disease have a major impact on a patient’s quality of life, but they can still live alone.

Stage 4

At this point, the symptoms are severe and limit a person’s lifestyle. For example, while a patient may be able to stand without assistance, they may need a walker to move. In this stage, a patient is unable to live alone.

Stage 5

Stage five is the most serious and advanced stage of Parkinson’s disease. Walking or standing may be impossible due to severe stiffness in muscles. A patient may be bedridden or require a wheelchair. Delusions and hallucinations may also occur. Dementia is also common in this stage.

Treatment Options and What to Expect

There is no cure for Parkinson’s disease, but medications could help control symptoms. In some (usually severe) cases, surgery is necessary.

Medications help with problems such as walking, tremors, and movement. They work to increase or substitute for dopamine. At the beginning of a treatment protocol, you may notice significant improvements. These effects tend to subside or become less consistent. However, you can still manage symptoms quite well.

Keep in mind that Parkinson’s disease stages usually do not progress quickly, so you will still be able to enjoy certain activities to some extent. A healthy lifestyle is important for persons with Parkinson’s disease. Some things you can do include:

  • Eating a healthy diet such as fiber-rich food to manage constipation (a common problem for persons with this disease)
  • Exercising to increase muscle strength, balance, flexibility, and overall well-being. Your doctor may suggest that you work with a physical therapist on the ideal plan for your condition
  • Avoiding falls by distributing your weight evenly between both feet. Do not lean, carry things while you walk, or walk backward
  • Working with an occupational therapist to adopt techniques that will make it easier for you to perform certain activities such as eating or bathing

In Conclusion

Parkinson’s disease is a progressive condition that develops in five stages. In the initial stage, the symptoms may be unnoticeable, but they tend to be severe in the last stage. It’s crucial for a person with symptoms to see a doctor who will diagnose the problem.

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