Parkinson’s disease affects the nervous system, causing tremor, movement problems, difficulty sleeping and other issues. Symptoms worsen over time, and doctors classify them broadly in five stages.

Parkinson’s disease involves a wide range of symptoms. According to the National Institute of Neurological Disorders and Stroke (NINDS), a major cause of the symptoms is low dopamine activity in the brain. As dopamine activity continues to fall, the symptoms can become more severe.

However, it is worth noting that Parkinson’s disease affects people differently. Some people may lose all mobility, while others may continue to experience only mild symptoms. It is not possible at the point of diagnosis to predict how the condition will eventually affect an individual.

In this article, learn about the signs and symptoms of Parkinson’s disease and what to expect at each stage of the condition.

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Parkinson’s disease can cause motor and non-motor symptoms.

Motor symptoms

Motor symptoms are those that relate to movement. The four key symptoms of Parkinson’s disease are all motor symptoms:

  • bradykinesia, or slow movements
  • shaking and tremors, usually with a back-and-forth movement
  • rigid muscles, leading to stiffness in the limbs
  • problems with balance, which can increase the risk of falling

Non-motor symptoms

Non-motor symptoms of Parkinson’s disease can include:

The American Parkinson Disease Association notes that Parkinson’s disease can also result in cardiovascular symptoms, such as changes in heart rate or irregular blood pressure.

A person may also experience hallucinations and delusions. These symptoms are usually a side effect of Parkinson’s disease medications. However, in some cases, they can be a symptom of the disease itself or of dementia.

In a 2018 study consisting of 117 people with Parkinson’s disease, the most common non-motor symptoms included:

SymptomSymptom prevalence
urinary dysfunction82.6%
problems involving sleep80.6%
gastrointestinal disorders80.0%
thermoregulatory dysfunctions58.6%
cardiovascular issues50.9%
sexual dysfunction47.9%

The symptoms may have a minor impact when they first appear, but they can become more severe over time.

A person should speak with a doctor about any new or changing symptoms and make sure that they know about all the medications they are taking. The doctor can determine whether they need to review the person’s drugs or adjust their dosage.

In time, complications can arise with Parkinson’s disease.

Learn about 11 common complications of Parkinson’s disease.

Doctors sometimes use five stages to describe the progress of Parkinson’s disease. Each stage presents new or changing symptoms that a person is likely to encounter.

It is worth noting that not everyone will reach the advanced stages. Some people find that the symptoms remain mild and that they can continue to live independently and be mobile.

Dividing the condition into stages helps doctors and caregivers understand and address some of the challenges a person is experiencing as it progresses.

Stage 1

During the initial stages, the symptoms are not typically severe. A person can perform everyday tasks with minimal difficulty.

Some signs and symptoms of this stage include changes in:

  • tremors, which are usually more pronounced on one side of the body than the other
  • posture
  • facial expressions
  • walking

A person may not seek or receive a diagnosis at this stage, as the signs and symptoms may not be very noticeable. If a person has received a diagnosis, a doctor might prescribe medication to help control the symptoms.

Stage 2

Tremors, trembling, and stiffness affect both sides of the body and become more noticeable.

As stiffness increases, the person may find that daily tasks are harder to carry out and take longer than before.

Walking, speech, and posture problems are often more noticeable in stage 2 of Parkinson’s disease.

Stage 3

During stage 3, a person will experience most or all of the symptoms of stage 2 plus some others, including:

  • problems with balance
  • slow movements
  • slow reflexes

There is also a higher risk of falling due to coordination problems. Dressing and other self-care tasks may become more difficult.

Medication and occupational or physical therapy may help people manage the symptoms and daily living.

Stage 4

At stage 4, daily activities become even more challenging. A person will likely need some form of daily care, as independent living is not usually possible.

The person may be able to stand on their own but require a walker or another assistive device to walk.

Stage 5

At stage 5, a person may not be able to stand or move around due to stiffness. Depending on their age and overall health, they may need a wheelchair for mobility.

The individual will need constant care to carry out daily activities and protect them from hazards, such as falling.

The person may also experience:

  • dementia
  • confusion
  • a reduced response to medication

Parkinson’s disease is not life threatening, but it can put a strain on the body. A person may become more prone to certain types of infections, and there may be a risk of falling or choking.

Advances in treatment now mean that many people with Parkinson’s disease can expect to live for as long as a person without the condition.

Learn more about life expectancy with Parkinson’s disease.

A doctor will often use a scale when talking about Parkinson’s disease. The scale can help determine the progression of the condition.

The Hoehn and Yahr scale, which is similar to the five stages of Parkinson’s disease above, focuses on the progression of motor symptoms. A doctor will allot points that match signs and symptoms to the scale.

The Unified Parkinson’s Disease Rating Scale addresses a variety of symptoms, including:

  • mental activity, mood, and behavior
  • daily living activities
  • movement ability
  • complications of therapy

Looking at a wide variety of symptoms helps doctors get a better idea of how Parkinson’s disease is affecting a person’s everyday life overall.

Learn more about how doctors diagnose Parkinson’s disease.

Parkinson’s disease resources

To discover more evidence-based information and resources for Parkinson’s disease, visit our dedicated hub.

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The National Institute on Aging states that the symptoms of Parkinson’s disease develop when nerve cells in the area of the brain that controls movement become damaged or die. This area of the brain is called the basal ganglia.

When these cells are healthy, they produce dopamine. As they become damaged, they make less dopamine, resulting in the motor symptoms of Parkinson’s disease.

The non-motor symptoms of Parkinson’s disease may develop when a person loses the nerve endings that produce norepinephrine. Norepinephrine is the chemical messenger of the sympathetic nervous system, which controls various functions in the body.

The lack of norepinephrine may produce symptoms, including:

  • fatigue
  • changes in heart rate
  • irregular blood pressure
  • constipation

Scientists are still unsure what causes these neurons and cells to die.

What causes Parkinson’s disease?

The NINDS states that the exact cause of Parkinson’s disease is unclear.

Some cases of the disease may be hereditary and have an association with specific gene mutations, including the PARK7, PRKN, and SCNA genes. Approximately 10–15% of all Parkinson’s disease cases develop as a result of genetics.

However, although there is an association between genetics and the risk of developing Parkinson’s disease, most cases do not appear to run in families.

Instead, researchers believe that Parkinson’s disease occurs due to a combination of environmental and genetic factors.

Environmental risk factors for Parkinson’s disease include:

  • head injury, such as a traumatic brain injury
  • exposure to pesticides and herbicides, such as paraquat
  • exposure to metals
  • exposure to solvents and polychlorinated biphenyls, such as trichloroethylene

There is no cure for Parkinson’s disease. However, treatment can help relieve the symptoms.

The treatment options include:

  • Medications: A person can take medications to increase their dopamine levels and control non-motor symptoms. The main medication to treat Parkinson’s disease is levodopa. A doctor may also prescribe carbidopa to prevent or reduce some of the side effects of levodopa.
  • Deep brain stimulation (DBS): A doctor may suggest DBS if medications prove ineffective. A surgeon will implant electrodes into a part of the brain and connect them to a small electrical device. This painlessly stimulates the areas of the brain that control movement.
  • Therapies: A person with Parkinson’s disease may benefit from:

A person should aim to eat a nutritious diet and exercise regularly. They may also benefit from practicing yoga and tai chi to increase their flexibility.

Learn more

Learn more about treatment for Parkinson’s disease:

Financial help with Parkinson’s medications

A person may find the following organizations helpful when it comes to paying for medication:

Learn more about Medicare and Parkinson’s disease.

Currently, there is no known cure for Parkinson’s disease. However, once a person receives a diagnosis, medications and therapies can help manage the symptoms, especially in the early stages.

In time, Parkinson’s disease can have a severe impact on a person’s quality of life. For example, it can affect their ability to move and communicate with others.

Parkinson’s disease does not have a direct effect on life expectancy, but it can increase the risk of potentially life threatening complications, such as choking or falling.

Medication and other treatments can help improve the quality of life of people living with Parkinson’s disease.

Parkinson’s disease can cause a person to experience symptoms related to movement. These include slow movement, shaking and tremors, rigid muscles, and difficulty with balance. Researchers believe that these symptoms develop due to a decrease in dopamine in the brain.

There are many non-motor symptoms of Parkinson’s disease. These include urinary problems, constipation, sleep difficulties, sexual dysfunction, fatigue, and depression. These symptoms may occur due to the loss of a chemical messenger in the brain called norepinephrine.

Although there is no cure for Parkinson’s disease, treatment options can help reduce the severity of the symptoms.