Stages of Parkinson’s Disease

Stage 1 is the earliest stage, characterized by mild symptoms and unilateral involvement, meaning that only one side of the body is affected. Since symptoms are usually minimal and there is little to no functional impairment, most sufferers will not notice anything different during this stage. That said, family and friends may notice changes in posture, movement, and facial expressions. If symptoms do occur, they usually include tremors in one hand, rigidity, clumsy legs, and loss of facial expression on one side of the face.

Stage 2 is considered an early to moderate form of Parkinson’s disease, characterized by bilateral involvement and more noticeable symptoms. These typically include tremors, stiffness, trembling, rigidity of the muscles in the trunk, decreased blinking, speech abnormalities, and changes in facial expressions. The sufferer may experience difficulties walking and a change in posture, but balance will not be impaired. It can take several months or even years for Parkinson’s disease to progress from stage 1 to stage 2.

Stage 3 is the middle stage, characterized by loss of balance, slowness of movement, and decreased reflexes. As such, falls become much more common and daily tasks are significantly affected, yet sufferers are still able to dress, eat, and complete basic hygiene tasks themselves. In addition to compromised balance, individuals may be unable to make rapid, automatic, and involuntary adjustments.

Stage 4 is a severely disabling form of Parkinson’s disease, one in which the sufferer is noticeably incapacitated. While the individual may be able to walk and stand without assistance, many will use a walker or other type of assistive device for additional support. Furthermore, the sufferer can no longer live an independent life and requires assistance with daily living activities. This need for help is the defining factor that separates stage 3 from stage 4.

Stage 5 is the last and most severe stage, characterized by advanced stiffness in the legs, freezing or stumbling upon standing, falling when walking or turning, and the inability to rise from a chair or from bed without help. Both the use of a wheelchair and around-the-clock assistance are required to reduce the risk of injury and help with daily tasks. Sufferers may also experience hallucinations and delusions.

While the 5 stages of Parkinson’s disease are primarily based on motor symptoms, approximately 80 to 90 percent of sufferers experience non-motor symptoms as well. These non-motor symptoms include fatigue, constipation, difficulties with sense of smell, speech and swallowing problems, insomnia and other sleep disorders, vision problems, mood disorders such as anxiety and depression, and cognitive changes ranging from slowing of thought to difficulties with memory and planning.

The length of time it takes to progress from one stage to the next differs from individual to individual, and some sufferers will never even reach stage 5. Furthermore, not all symptoms will occur in all individuals, and some treatments are available to help with various symptoms. Generally speaking, the earlier the diagnosis and the earlier the stage at which diagnosis is made, the more effective the treatment will be at alleviating symptoms.

Resources:
https://parkinsonsdisease.net/basics/stages/
https://www.healthline.com/health/parkinsons/stages