What Are the Five Stages of Parkinson’s Disease?

Parkinson’s Disease

January 4, 2019

Parkinson’s disease is a chronic, progressively degenerative neurological disease that predominantly affects the older population. Parkinson’s is characterized by a constellation of clinical manifestations, including slowness in movement, stiffness, tremor, and postural instability. It is a movement disorder when progressed, affects physical actions such as walking and talking.

Parkinson’s disease affects 1 in 500 people in Canada. Over 100,000 Canadians are living with Parkinson’s today. Approximately, 6,600 new cases of Parkinson’s disease are diagnosed each year in Canada. If you belong to a group of Parkinson caregivers for one of these patients, it is essential for you to educate yourself as much as you can. Educating yourself about the disease makes it easier for you to understand what your patient is facing. Knowledge about Parkinson’s disease would prepare you better to be a Parkinson caregiver throughout the diagnosis.

Understanding these stages helps Parkinson caregivers connect better with what their patients are going through. Also, it prepares the Parkinson caregivers’ care to change and adapt.

Stage One

In the initial stage, the symptoms are moderate and seen only on one side of the body by the Parkinson caregivers. There is usually minimal or no functional deficiency. The signs at stage one may be so slight that the person doesn’t require medical attention. The physician may also find it tough to make a diagnosis.

Symptoms at stage one include:

  • Tremor, such as immediate tremor of one hand
  • Rigidity
  • One hand or leg may feel clumsier than another
  • One side of the face is affected which impacts the expression

This stage is tough to diagnose. A physician may wait to check if the symptoms worsen over time before making an elaborate diagnosis. A physician may also prescribe tests, such as an MRI, to rule out other possible causes of the disease. However, prescribed medications can work effectively to reduce symptoms at this stage.

Stage Two

Stage two is still considered early in Parkinson’s and characterized by symptoms on both sides of the body or at the midline. This stage may develop over months or years after stage one. Rigidity, tremors, and trembling may be extra noticeable, and changes in facial expressions increase over time.

While muscles stiffness prolongs tasks completion, stage two does not damage balance. Difficulties in walking may develop or increase, and the person’s posture slightly starts changing.

People at this stage see indications on both sides of the body (though one side may be faintly affected). Sometimes one may experience speech difficulty too.

Symptoms in stage two may include:

  • Diminishing of facial expressions on both sides of the face
  • Decreased blinking
  • Speech abnormalities such as, soft voice, monotone voice, fading volume, slurring speech
  • The stiffness of the trunk muscles
  • Neck or back pain and a stooped posture
  • Overall slowness in all daily living activities 

On the contrary, at stage two, the individual is still able to perform the chores of daily living.

Diagnosis is relatively easy at this stage if the patient has a tremor. It is also possible that the disease may be misdiagnosed at an advancing age. This could happen if the only symptoms are slowness or lack of spontaneous movement, or the stage one diagnosis of Parkinson’s disease never occurred.

Stage Three

An increase in symptoms characterizes stage three or mid-stage Parkinson’s disease. A person experiences most or all of the symptoms of stage two, additionally:

  • Problems with balance
  • Slow movements
  • Slow reflexes

Balance is compromised by the inability to make rapid, automatic, and involuntary adjustments necessary to prevent falling. All other symptoms of Parkinson’s disease are still present at this stage, and generally, diagnosis is not in doubt at stage three.

Often a physician will diagnose impairments at this stage by standing behind the patient and gently pulling the shoulders. This helps him determine if the patient has trouble maintaining balance and falls backward.

An important note at stage three is that the person is still fully functional in their daily life activities, such as dressing, hygiene, and eating. They aren’t majorly dependent on Parkinson caregivers as yet.

Stage Four

During stage four of Parkinson’s, daily activities can be challenging or even impossible. It is likely that the person will require some form of regular care, independent living is not usually possible. Parkinson caregivers need to be more accommodating and helpful at this stage as many people are unable to live alone at this stage because of significant decreases in movement and reaction times. Living alone at stage four or later makes many daily tasks impossible and is considered extremely dangerous for the patient.

Stage Five

Stage five is the last and most hindering stage of Parkinson’s disease. A person will not be able to stand or move around due to rigidity and stiffness. Depending on the person’s age and health, they could be bedridden or provided a wheelchair for mobility.

Unlike earlier stages, a person requires constant nursing aides from Parkinson caregivers. Aides help the person perform daily activities and prevent dangerous situations or accidents from occurring.

In stage five, a person may even experience:

  • Hallucinations
  • Delusions
  • Dementia
  • Poor response to medication
  • Confusion
  • Dizziness

Up to 30 percent of people at stage four and five experience a state of confusion, episodic hallucinations, and delusions. Hallucinations happen when you see things that aren’t possible there. Illusions occur when you believe things that are untrue, even when provided with evidence that your belief is false. Dementia is also common that affects 75 percent of people with Parkinson’s. Side effects from medications at later stages often outweigh the benefits.

While the symptoms worsen gradually, it is noteworthy that some patients with Parkinson’s disease never reach stage five. Also, the duration of time to progress through the different stages varies from individual to individual. Additionally, there are treatments available that help at every stage of the disease. However, the earlier the diagnosis (and preferably during the initial stages), the more effective the treatment is at lessening symptoms.

Our professional and caring Parkinson caregivers are ready to cater to your needs. Call us to speak with a specialist today!

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