Parkinson's disease is a nervous system disorder that affects around 1 percent of people aged 65 years and older. Symptoms usually develop slowly over several years. They may be subtle at first, so early signs are easy to miss.
If someone notices symptoms of Parkinson's disease, they should consider contacting their doctor for more information. Early treatment can improve the condition's long-term outcome.
In this article, we cover 13 early signs of Parkinson's disease.
Early symptoms of Parkinson's can include tremors in the hands and cramped handwriting.
Many healthcare professionals consider tremors to be a key characteristic sign of Parkinson's disease. Tremors involve a persistent twitching or shaking of the hands, legs, or chin.
Tremors associated with Parkinson's disease are called "rest tremors." This means that the tremors stop when a person uses the affected body part.
Tremors are very subtle when they first appear. At this stage, the person experiencing the tremors is usually the only one who notices them. Tremors will gradually worsen as the disease progresses.
Tremors typically appear on one side of the body and then spread to other parts of the body later on.
2. Difficulty walking
Subtle changes in a person's walking pattern could be an early sign of Parkinson's disease.
Someone who has Parkinson's disease might walk slowly or drag their feet as they walk. Many refer to this as a "shuffling gait."
The person might walk at an irregular pace, suddenly walking faster or slower or changing the length of their stride.
3. Cramped or small handwriting
Micrographia is a disorder that involves abnormally small or cramped handwriting.
Doctors associate micrographia with medical conditions that affect the nervous system, or neurodegenerative disorders, such as Parkinson's disease.
4. Loss of smell
Hyposmia occurs when someone loses their ability to smell. This is also called olfactory dysfunction. A loss of smell is a relatively common symptom, affecting 70–90 percent of people with Parkinson's disease.
Loss of smell is one of the most noticeable symptoms of Parkinson's disease that is not related to movement. It can appear several years before the disease affects a person's movement.
People who have hyposmia as a symptom of Parkinson's disease might experience:
- a dulled sense of smell
- difficulty detecting odors
- difficulty identifying odors
- difficulty telling the difference between odors
Doctors use smell identification tests to diagnose hyposmia, but the accuracy of these tests varies widely.
Having hyposmia does not always mean that someone has Parkinson's disease. A person's sense of smell can change for many reasons, such as age, smoking, or exposure to harsh chemicals. Hyposmia is also a symptom of other medical conditions, including Alzheimer's disease and Huntington's disease.
5. Sleep problems
A person in the early stages of Parkinson's might experience a range of sleep problems.
Parkinson's disease can severely affect a person's ability to sleep. People who have Parkinson's disease may experience a wide range of sleep-related symptoms, including:
- excessive daytime fatigue
- sleep apnea
- uncontrolled or sporadic movements while asleep
6. Poor balance
Parkinson's disease specifically targets nerve cells called basal ganglia, which reside deep within the brain. Basal ganglia nerves control balance and flexibility, so any damage to these nerves can impair a person's balance.
Doctors use a test called the pull test to assess a person's balance. The pull test involves a healthcare professional gently pulling a person's shoulders backward until they lose their balance and recording how long it takes them to regain it.
Healthy individuals recover after one or two steps, while people with Parkinson's disease may take a higher number of smaller steps to fully balance themselves.
Bradykinesia is a term that means slowness or absence of movement.
Bradykinesia causes a variety of symptoms, such as stiffness of the limbs and slow movements. A person who has bradykinesia might walk slower or have difficult starting a movement.
Some people who have this symptom might misinterpret it as muscle weakness. However, this symptom does not affect muscle strength.
8. Facial masking
Facial expressions involve many subtle, complex muscle movements. People with Parkinson's disease often have a reduced ability to make facial expressions. This is called facial masking.
Facial masking is related to bradykinesia. The facial muscles move more slowly or rigidly than usual. People who have facial masking may appear blank or emotionless, though their ability to feel emotions is not impaired. Facial masking can also cause someone to blink their eyes slower.
A person with facial masking might have difficulty communicating with others because changes in their facial expressions are less noticeable than usual.
9. Vocal changes
Changes in the volume and quality of a person's voice is another early sign of Parkinson's disease.
Vocal changes may involve speaking in a softer tone, or starting to speak at a usual volume and then the voice becomes softer or fades away.
In other cases, a person might lose the usual variation in the volume and tone of their voice, so that the voice appears monotonous.
10. Stooping or hunched posture
People who have Parkinson's disease may notice changes in their posture due to other symptoms of the disease, such as muscle rigidity.
People naturally stand so that their weight is evenly distributed over their feet. However, people who have Parkinson's disease may start bending forward, making them appear hunched or stooped over.
Constipation is a common problem that can have a wide range of causes. Constipation is one of the most common non-motor symptoms associated with Parkinson's disease. Nearly 25 percent of people with the condition experience constipation before they develop motor symptoms.
12. Psychological symptoms
Talking to a therapist might help a person with Parkinson's cope with emotional changes caused by the disease.
Parkinson's disease can severely affect a person's psychological well-being. The disease lowers the body's natural levels of dopamine, which can cause changes in mood and behavior.
Some psychological symptoms associated with Parkinson's disease include:
- difficulty making plans or staying organized
- reduced problem-solving ability
13. Weight loss
People with Parkinson's disease might experience mild to moderate weight loss for several reasons.
Tremors and other motor symptoms associated with Parkinson's may increase the body's natural energy requirements. Non-motor symptoms, such as loss of smell, depression, or digestive issues, might cause people to eat less, which may result in weight loss.
Parkinson's disease is difficult to diagnose, especially in the earlier stages. This is because the symptoms are subtler and more sporadic. However, knowing what symptoms to look for may encourage people to seek medical attention before they progress.
Early symptoms of Parkinson's disease include:
- difficulty walking
- cramped or small handwriting
- loss of smell
- sleep problems
- poor balance
- facial masking
- voice changes
- stooping or hunched posture
- psychological symptoms
- weight loss
Having these symptoms does not always mean that a person has Parkinson's disease. People over the age of 60 should consider speaking with their healthcare provider if they experience any of the symptoms listed above.
Early diagnosis leads to earlier treatment, which can improve a person's overall quality of life.