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Signs Of Parkinsons Disease And Stages

Know about the parkinsons disease, what it is, warning symptoms, motor and non-motor symptoms, stages to identify warning signs and more.

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Written by Dr. Rohinipriyanka Pondugula

Reviewed by Dr. M L Ezhilarasan MBBS

Last updated on 7th Oct, 2025

Parkinsons Disease And Stages

Introduction

Parkinson's disease is a progressive neurodegenerative disorder that affects millions of people worldwide. While often associated with a tell-tale tremor, the reality of Parkinson's is far more complex, encompassing a wide range of motor and non-motor symptoms that evolve. Understanding the early signs and the typical stages of Parkinson's disease is crucial for patients, families, and caregivers. This comprehensive guide will walk you through the fundamental aspects of Parkinson's, from the first whispers of symptoms to the established stages of the condition. We'll demystify the medical terminology, explain what to expect as the disease progresses, and highlight the importance of a proactive management plan. Remember, early recognition and intervention can make a significant difference in maintaining quality of life. If you or a loved one is experiencing persistent symptoms that concern you, consulting a neurologist is the most important first step.

What is Parkinson's Disease? The Basics

Parkinson's disease is a brain disorder that leads to difficulties with movement, balance, and coordination. It results from the loss of nerve cells (neurons) in a specific area of the brain called the substantia nigra. These neurons are responsible for producing a vital chemical messenger known as dopamine.

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Apollo Hospitals Indraprastha, Delhi

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The Role of Dopamine

Dopamine acts as a neurotransmitter, facilitating smooth, coordinated muscle movement by carrying signals between the brain and the body. When approximately 60-80% of these dopamine-producing cells are damaged or lost, the characteristic motor symptoms of Parkinson's begin to appear. The cause of this cell death is not entirely known, though a combination of genetic and environmental factors is believed to play a role. It's important to note that Parkinson's itself is not fatal, but its complications can be serious.

The Early Warning Signs of Parkinson's Disease

The onset of Parkinson's is usually gradual, and early signs can be easy to dismiss as normal signs of ageing or stress. 
However, recognising these clues is key to early diagnosis.

Motor Symptoms: The Most Recognisable Clues

These are the symptoms most people associate with Parkinson's disease.

Tremor: The Classic Symptom

A slight shaking or tremor, often starting in a finger, thumb, hand, or chin while the limb is at rest, is a hallmark sign. 
This "pill-rolling" tremor between the thumb and forefinger usually disappears during voluntary movement and sleep.

Bradykinesia: Slowness of Movement

This is one of the most disabling early symptoms. Over time, Parkinson's disease may reduce your ability to move, 
making simple tasks difficult and time-consuming. Your steps may become shorter, or you might find your feet dragging 
when you walk.

Rigidity: Muscle Stiffness

Muscle stiffness can occur in any part of the body. This stiffness can be painful and limit your range of motion. It's often 
described as "cogwheel" or "lead-pipe" rigidity by physicians.

Postural Instability: Balance Problems

Impaired balance and coordination, known as postural instability, can lead to a forward or backward lean and an 
increased risk of falls. This symptom typically appears in the later stages of the disease.

Non-Motor Symptoms: The Less Obvious Indicators

Often overlooked, these symptoms can appear years before motor issues and significantly impact quality of life.

Loss of Smell (Anosmia)

A reduced ability to smell (anosmia) or distinguish between smells is a very common early warning sign, sometimes 
occurring a decade before motor symptoms.

Sleep Disorders and REM Sleep Behaviour Disorder

This involves physically acting out vivid, often unpleasant dreams with vocal sounds and sudden, often violent, arm and 
leg movements during REM sleep.

Mood Changes: Depression and Anxiety

Depression and anxiety are common non-motor symptoms of Parkinson's. They can be a reaction to the diagnosis or a 
direct result of changes in brain chemistry.

Autonomic Dysfunction

This includes constipation, low blood pressure leading to dizziness when standing up (orthostatic hypotension), 
excessive sweating, and urinary issues.

Understanding the Stages of Parkinson's Disease

Parkinson's is a progressive condition, meaning symptoms change and intensify over time. To standardise this progression, clinicians often use the Hoehn and Yahr scale.

The Hoehn and Yahr Scale: A Clinical Measurement

This scale divides the progression of motor symptoms into five stages. It provides a snapshot of a patient's disability 
level and is useful for tracking the disease's course.

Stage 1: Unilateral Symptoms (Mild)

Symptoms are mild and appear on only one side of the body. Tremors and other movement symptoms may be 
noticeable but not disabling. Daily activities are largely unaffected.

Stage 2: Bilateral Symptoms (Mild to Moderate)

Symptoms begin to affect both sides of the body. Posture and gait may change, but balance is not yet significantly 
impaired. Tasks may take longer to complete.

Stage 3: Mid-Stage with Balance Impairment (Moderate)

This is a significant turning point. Loss of balance and slowness of movement are hallmarks. Falls become more common. While the person is still fully independent, symptoms significantly impair activities like dressing and eating.

Stage 4: Severe Disability but Still Able to Walk (Advanced)

Symptoms are severe and limiting. The person may be able to stand without assistance but will likely need a walker for 
mobility. Assistance with daily activities is required, and living alone may be unsafe.

Stage 5: Wheelchair-Bound or Bedridden (Advanced)

In this most advanced stage, stiffness in the legs can make it impossible to stand or walk. The person requires constant 
nursing care. Hallucinations and delusions may also occur.

Diagnosis and When to Seek Help

There is no single test for Parkinson's. Diagnosis is based on medical history, a review of signs and symptoms, and a 
neurological and physical examination. A doctor may suggest a carbidopa-levodopa trial; significant improvement with 
this medication often confirms a Parkinson's diagnosis. If you notice persistent symptoms like a tremor, stiffness, or 
slowness of movement, it is essential to consult a doctor. Early intervention can help manage symptoms effectively. For 
a convenient and expert consultation, you can book an appointment with a neurologist online through Apollo24|7 to discuss your concerns.

Living Well with Parkinson's: Management and Treatment

While there is no cure, treatments can dramatically improve symptoms. The primary approach is medication, primarily 
levodopa, to replenish dopamine levels. Physical, occupational, and speech therapy are vital for maintaining mobility 
and independence. In some cases, a surgical procedure called Deep Brain Stimulation (DBS) may be recommended. A 
healthy diet, regular exercise, and a strong support system are equally important components of comprehensive care.

Conclusion

Recognising the signs and understanding the stages of Parkinson's disease is the first step toward empowerment and effective management. The journey with Parkinson's is unique for every individual, and the progression can vary widely. While the diagnosis can be daunting, it's important to remember that modern medicine offers a robust toolkit for symptom control. A proactive approach—seeking early diagnosis, adhering to a treatment plan, and embracing a healthy lifestyle—can profoundly impact one's quality of life. Research is ongoing, bringing new hope for better treatments and, ultimately, a cure. If you have concerns about any symptoms, do not hesitate to seek professional medical guidance. Taking action early can help you navigate this path with greater confidence and support.

Consult a Top Neurologist for Personalised Advice

Dr. Aditendraditya Singh Bhati, Neurosurgeon

Dr. Aditendraditya Singh Bhati

Neurosurgeon

18 Years • MBBS(2004), DNB Neurosurgery(2014); MNAMS; Fellow Neuroendoscopy

Delhi

Apollo Hospitals Indraprastha, Delhi

recommendation

85%

(100+ Patients)

1000

1500

Dr. E Prabhakar Sastry, General Physician/ Internal Medicine Specialist

Dr. E Prabhakar Sastry

General Physician/ Internal Medicine Specialist

40 Years • MD(Internal Medicine)

Manikonda Jagir

Apollo Clinic, Manikonda, Manikonda Jagir

recommendation

88%

(125+ Patients)

1000

1000

Consult a Top Neurologist for Personalised Advice

Dr. Aditendraditya Singh Bhati, Neurosurgeon

Dr. Aditendraditya Singh Bhati

Neurosurgeon

18 Years • MBBS(2004), DNB Neurosurgery(2014); MNAMS; Fellow Neuroendoscopy

Delhi

Apollo Hospitals Indraprastha, Delhi

recommendation

85%

(100+ Patients)

1000

1500

Dr. Ganeshgouda Majigoudra, Neurologist

Dr. Ganeshgouda Majigoudra

Neurologist

10 Years • MBBS, MD ( GENERAL MEDICINE) DM (NEUROLOGY)

Bengaluru

Apollo Clinic, JP nagar, Bengaluru

1000

Dr. E Prabhakar Sastry, General Physician/ Internal Medicine Specialist

Dr. E Prabhakar Sastry

General Physician/ Internal Medicine Specialist

40 Years • MD(Internal Medicine)

Manikonda Jagir

Apollo Clinic, Manikonda, Manikonda Jagir

recommendation

88%

(125+ Patients)

1000

1000

Dr Rajashekar Mummadi, Neurologist

Dr Rajashekar Mummadi

Neurologist

3 Years • MBBS, DNB General Medicine, DRNB Neurology

Hyderabad

Dr Ram's Neuro Clinic, Hyderabad

650

Dr Debnath Dwaipayan, Neurosurgeon

Dr Debnath Dwaipayan

Neurosurgeon

9 Years • MBBS, MS(Gen. Surgery), DrNB (Neurosurgery)

Delhi

Apollo Hospitals Indraprastha, Delhi

1000

Consult a Top Neurologist for Personalised Advice

Dr. Aditendraditya Singh Bhati, Neurosurgeon

Dr. Aditendraditya Singh Bhati

Neurosurgeon

18 Years • MBBS(2004), DNB Neurosurgery(2014); MNAMS; Fellow Neuroendoscopy

Delhi

Apollo Hospitals Indraprastha, Delhi

recommendation

85%

(100+ Patients)

1000

1500

Dr. Ganeshgouda Majigoudra, Neurologist

Dr. Ganeshgouda Majigoudra

Neurologist

10 Years • MBBS, MD ( GENERAL MEDICINE) DM (NEUROLOGY)

Bengaluru

Apollo Clinic, JP nagar, Bengaluru

1000

Dr. E Prabhakar Sastry, General Physician/ Internal Medicine Specialist

Dr. E Prabhakar Sastry

General Physician/ Internal Medicine Specialist

40 Years • MD(Internal Medicine)

Manikonda Jagir

Apollo Clinic, Manikonda, Manikonda Jagir

recommendation

88%

(125+ Patients)

1000

1000

Dr Rajashekar Mummadi, Neurologist

Dr Rajashekar Mummadi

Neurologist

3 Years • MBBS, DNB General Medicine, DRNB Neurology

Hyderabad

Dr Ram's Neuro Clinic, Hyderabad

650

Dr Debnath Dwaipayan, Neurosurgeon

Dr Debnath Dwaipayan

Neurosurgeon

9 Years • MBBS, MS(Gen. Surgery), DrNB (Neurosurgery)

Delhi

Apollo Hospitals Indraprastha, Delhi

1000

More articles from Parkinsons Disease

Frequently Asked Questions

1. What is the life expectancy for someone with Parkinson's disease?

Parkinson's disease itself is not fatal. People with Parkinson's have a near-normal life expectancy. However, complications from the disease, such as pneumonia or falls, can be serious. Quality of life and longevity are greatly improved with proper medical care and management.

 

2. What is the difference between Parkinson's disease and essential tremor?

A key difference is when the tremor occurs. Parkinson's tremor is most prominent at rest and often decreases with movement. An essential tremor typically occurs during action (like holding a cup or writing) and is less common at rest. Essential tremor also often runs in families.

 

3. Can Parkinson's disease be cured?

Currently, there is no cure for Parkinson's disease. However, there are highly effective treatments that focus on managing symptoms, improving mobility, and maintaining a good quality of life. Research into disease-modifying therapies is actively ongoing.

4. What are the non-motor symptoms of Parkinson's that appear years before diagnosis?

These 'prodromal' symptoms can include a loss of smell (anosmia), chronic constipation, REM sleep behaviour disorder (acting out dreams), and depression. Not everyone with these symptoms will develop Parkinson's, but they are recognised as strong early indicators.

5. How fast does Parkinson's disease progress?

The rate of progression varies significantly from person to person. Factors like age at onset and overall health can influence the speed. Some people may remain in the early stages for many years, while others may progress more quickly. A consistent treatment plan can help slow the functional decline.