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Stages of Parkinson’s
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Stages of Parkinson’s

Parkinson’s Disease impacts people in different ways. Not everyone will experience all the symptoms of Parkinson’s, and if they do, they won’t necessarily experience them in quite the same order or at the same intensity. There are typical patterns of progression in Parkinson’s disease that are defined in stages.

1. Stage One
2. Stage Two
3. Stage Three
4. Stage Four
5. Stage Five
Theory of Parkinson's Disease Progression

Stage One

During the initial stage the person has mild symptoms that generally do not interfere with daily activities. Tremor and other movements symptoms occur on one side of the body only. Changes in posture, walking, and facial expressions occur.

Stage Two

Symptoms start getting worse. Tremor, rigidity, and other movement symptoms affect both sides of the body. Walking problems and poor posture may be apparent. The person is still able to live alone but daily tasks are more difficult and lengthy.

Stage Three

Considered mid-stage, loss of balance and slowness of movements or hallmarks. Falls are more common. The person is still fully independent, but symptoms significantly impair activities such as dressing and eating.

Stage Four

At this point, symptoms are severe and limiting. It's possible to stand without assistance, but movement may require a walker. The person needs help with activities of daily living and has enabled to live alone.

Stage Five

This is the most advanced and debilitating stage. Stiffness in the legs may make it impossible to stand or walk. The person requires a wheelchair or as bedridden. Around the clock nursing care is required for all activities. The person may experience hallucinations and delusions. The Parkinson's community acknowledges that there are many important non-motus symptoms as well as Motors symptoms.

Theory of Parkinson's Disease Progression: Braak's Hypothesis

The current theory (part of the so-called braak's hypothesis) is that the earlier signs of Parkinson's are found in the enteric nervous system, the medulla and the olfactory bulb, which controls sense of smell. Under this theory, Parkinson's only progresses to the substandtia nigra and cortex over time.

The theory is increasingly born out by evidence that non-motor symptoms, such as a loss of sense of smell, sleep disorders, and constipation may proceed the motor features of the disease by several years. For this reason, researchers are increasingly focused on these non-motor symptoms to detect Parkinson's Disease as early as possible and to look for ways to stop its progression.