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More than 10 million people worldwide suffer from Parkinson’s disease and what are the 5 stages of Parkinson’s disease1 are one of the most common queries that are often searched on the net.
If you are also eager to find out more about this neurogenic ailment,2 continue reading this exclusive guide which describes in detail all the stages of the ailment, its symptoms, and the treatment available for the same.
What Is Parkinson’s Disease?
Parkinson’s is a progressive disease related to the nervous system that affects the dopaminergic neuron at the substantia nigra.3
It gets its name from Dr. James Parkinson, who also published “An Essay on the Shaking Palsy” describing non-motor and motor function impairment.
It has main symptoms like sleep problems and tiredness, low dopamine, poor posture, depression, forgetting, fatigue, behavioral changes, and other movement symptoms.
Some may have problems with mobility, and some may only have mild cognitive difficulties. Also, it can’t be easy to predict.
People in their 60s have their diagnosis. The ones who have their diagnosis before 50 are said to have onset Parkinson’s.
According to the National Parkinson Foundation, it shows that 65 percent of people have the onset of Parkinson’s before the age of 20 because of genes. About 30 % of people have onset between the age of 20 and 30.
What Causes Parkinson’s Disease?
Before we know what are the 5 stages of Parkinson’s disease, let us find out what causes Parkinson’s disease.
People develop Parkinson’s disease when the nerve cells or neurons in the brain, which control mobility, become impaired. The neurons produce a brain chemical named dopamine which is associated with movement in human beings.
They also lose the nerve ending that produces norepinephrine; it controls body functions like heart rate and blood pressure.
People who have Parkinson’s disease have Lewy bodies in their brain cells. Lewy bodies are unusual clumps of protein alpha-synuclein4. Scientists are researching its relationship to gene mutation.
In most cases, Parkinson’s disease is hereditary, and for some, it is due to gene mutation. In general, not everyone suffers, and it happens randomly and doesn’t run in the family.
Motor Symptoms
Before we learn about the 5 stages of Parkinson’s disease it is vital to know what are the motor symptoms of Parkinson’s disease5.
- Tremor: It starts in one hand, foot, or leg and gradually affects both sides of the body. It also affects the jaw, chin, mouth, or tongue.
- Rigidity: It could be muscle rigidity that affects the limbs or torso. In the early stages, it is wrongly diagnosed that it can be arthritis or an orthopedic problem.
- Bradykinesia: Bradykinesia means slow movement, and it is a widespread symptom of Parkinson’s disease. There is a reduction in facial expression; the eyes don’t blink much, trouble turning over in bed, and problems buttoning shirts.
- Postural Instability: Postural instability happens when you are not steady and can’t prevent falling. People who have Parkinson’s disease can fall backward or fall if they are slightly pushed.
There are 3 stages of motor symptoms too:
- Mild Stage: Here, there are mild symptoms that won’t hamper you from doing any work, and with the help of advice diagnosis or treatment, it can be kept in check. You might notice:
- Legs start feeling heavy
- Handwriting changes
- Stiffness of arms and legs
- One side of the body doesn’t function properly
2. Intermediate Stage: Also considered mid-stage. There will be more cognitive changes in 3-7 years and eventually affect daily activities. Also, the medicines wear off between doses. You will notice :
- Trouble swallowing
- Frequently falling
- Slow movements
- Speaking in a feeble tone
3. Advanced Stage: This is the most advanced stage where medication doesn’t help and is confined to a bed or wheelchair. They cannot live on their own. Need help with daily tasks
Non-Motor Symptoms
Generally, Parkinson’s disease is thought to only affect movement. However, there are non-motor symptoms, and they are pretty common. Such placement can be more troublesome and disabling than motor symptoms. Non-motor symptoms have a say in determining what are the 5 stages of Parkinson’s disease.
These are the early signs of Parkinson’s disease
- Sleep disorder
- Depression
- Constipation
- Loss of smell
It can include all the symptoms:
- Constipation
- Fatigue
- Dandruff
- Hallucinations and delusions
- Lightheadedness
- Having issues with attention, planning, memory
- Loss of sense of smell or taste
- Pain
- Sleep disorders
- Erectile dysfunction
- Weight loss
- Urinary problems
- Vision problems
Providing medical advice on Parkinson’s disease
Before finding out what are the 5 stages of Parkinson’s disease progression, it is vital to know what is the diagnosis, treatment, and medication provided accordingly.
Diagnosis
There are no particular tests to diagnose Parkinson’s disease. Your doctor can provide medical advice, like some sets of tests, like the dopamine transporter scan ( DaTscan). Blood tests are to be done to rule down other diseases with the same symptoms.
Treatment
There is no treatment for Parkinson’s disease, But there are medications to control the symptoms. In later stages, doctors can provide medical advice diagnosis to have surgery to control the symptoms.
Medication
Medications are given according to the 5 stages of Parkinson’s disease.
- Drugs to increase the level of dopamine in the brain
- Drugs that affect the brain chemicals in the body
- Drugs help in controlling non-motor symptoms.
Carbidopa-Levodopa – Levodopa is a natural chemical passed into your brain, and it gets converted to dopamine. Levodopa is combined with carbidopa to prevent the early conversion to dopamine outside your brain. Also, it will reduce the symptoms of nausea or lightheadedness.
Inhaled Carbidopa-Levodopa– This form of the drug helps manage symptoms when oral medicals don’t work.
Carbidopa-Levodopa Infusion- This drug is administered through a feeding tube in gel to the small intestine. It is given to patients in the advanced stage of Parkinson’s.
Dopamine Agonists – These medications mimic dopamine in your brain.
MAO B Inhibitors – They prevent the breakdown of brain dopamine by inhibiting the brain enzyme monoamine oxidase B(MAO B).
Anticholinergics: These medications are given to manage tremors and rigid muscles. However, it has side effects like impaired memory, confusion, hallucination, constipation, and dry mouth.
Amantadine: doctors give these to provide short-term relief in the early stage of Parkinson’s disease
What are the Five Stages of Parkinson’s Disease?
The Parkinson’s Foundation has explained them. Every stage has new symptoms that people are going to endure.
Stage 1
In the initial stage, the symptoms are not severe. These are some of the Parkinson’s symptoms that cause changes in
- Tremors
- Posture
- Facial expressions
- Walking
In the first stage of Parkinson’s disease, the signs and symptoms are not noticeable. Even if a person has a diagnosis, the doctor will provide treatment and prescribe medications to control the symptoms.
Stage 2
The symptoms such as tremors, trembling and muscle stiffness affect both sides of the body. Doing daily tasks will become difficult and even take longer. In stage 2 of Parkinson’s disease, there will be walking, speech, and posture issues.
Stage 3
In stage 3 of Parkinson’s disease, there will be a problem relating to balance, slow movements, and slow reflexes. Also, people having Parkinson’s disease will have coordination issues. They will face difficulty in dressing. There are medicines and physical therapy that will help in subsiding the symptoms.
Stage 4
Stage 4 of Parkinson’s disease is a debilitating stage when the symptoms worsen, and the person cannot live independently and needs daily care.
Stage 5
At such advanced stages of Parkinson’s stages, the person loses their mobility completely. The doctor’s advice on diagnosis or treatment will be they need a wheelchair, and around-the-clock assistance to help them in daily living. They can also have dementia, and confusion, and not reduce the medication.
Parkinson’s disease doesn’t affect life expectancy. However, it can make the person weak and prone to many infections. Also, there can be a risk of falling or choking. They always need constant attention and help in doing their daily tasks.
Unified Parkinson’s Disease Rating Scale
The UPDRS is a rating tool used to determine what are the 5 stages of Parkinson’s disease in patients.
The UPDRS has a series of ratings for Parkinson’s symptoms. It has Five segments :
- Mentation, Behaviour, and mood
- ADL
- Motor section
- Modified Hoehn and Yahr scale
- Schwab and England ADL scale.
The answer to the scale is calculated by a certified medical professional who specializes in Parkinson’s disease during a patient’s interview and provides medical advice diagnosis. A score of 199 on the UPDRS scale can be inferred to be total disability and a score of zero is no disability.
The national institute of neurological disorders and Stroke (NINDS) aims to be fully knowledgeable about the brain and nervous system and reduce the burden of neurological disease. Along with other academic research institutions and peer-reviewed studies, NINDS supports three types of research which are
- Scientific discoveries in the lab
- Clinical -developing and therapeutic approaches to Parkinson’s disease
- Translational-focused on tool
NINDS aims to understand better and diagnose PD, develop a new treatment, and prevent PD.
As the disease progresses, These Parkinson’s symptoms significantly impair activities. So performing daily tasks can be very difficult, and they need an assistive device to make these tasks easier.
According to Parkinson’s Foundation, people with Parkinson’s disease need occupational therapy to help them with their daily tasks as the disease progresses. Their areas can be mobility, prevention of falls, helping them to sit or stand, bed mobility, eating, and drinking, self-care, and handwriting.
The kind of health solutions that are needed for Parkinson’s disease required are :
- Cooking tools
- Eating utensils
- Bathroom aids
- Dressing tools
- Bedroom aids
- Writing tools
- Computer gear
- Voice devices
- Walking aids
- Organizing tools
After knowing what are the 5 stages of Parkinson’s Disease from tertiary references and other strict sourcing guidelines, it is possible that these symptoms can be for other disorders or diseases. So it is always advised that you need to consult your doctor before fully being sure that you or your family member has Parkinson’s disease. Was the article helpful?
FAQs:
- Most people with Parkinson’s disease have a normal or near-normal life expectancy. Modern medications and treatments mean that people can manage their symptoms and reduce the occurrence or severity of complications, which might otherwise be fatal.
- There’s currently no cure for Parkinson’s disease, but treatments are available to help relieve the symptoms and maintain your quality of life. These treatments include supportive therapies, such as physiotherapy.
- Research is actively underway to develop new medications that can slow or stop Parkinson’s disease (PD) progression, while also working to improve the lives of people living with PD today. Learn how lifestyle choices and medication therapy can help you manage Parkinson’s symptoms and what is in the pipeline for 2023.
- Krüger, Rejko, et al. “Classification of advanced stages of Parkinson’s disease: translation into stratified treatments.” Journal of Neural Transmission 124 (2017): 1015-1027. ↩︎
- Farkas, Gary J., and David R. Gater. “Energy expenditure and nutrition in neurogenic obesity following spinal cord injury.” Journal of physical medicine and rehabilitation (Wilmington, Del.) 2.1 (2020): 11. ↩︎
- Fearnley, Julian M., and Andrew J. Lees. “Ageing and Parkinson’s disease: substantia nigra regional selectivity.” Brain 114.5 (1991): 2283-2301. ↩︎
- Dikiy, Igor, and David Eliezer. “Folding and misfolding of alpha-synuclein on membranes.” Biochimica et Biophysica Acta (BBA)-Biomembranes 1818.4 (2012): 1013-1018. ↩︎
- Sveinbjornsdottir, Sigurlaug. “The clinical symptoms of Parkinson’s disease.” Journal of neurochemistry 139 (2016): 318-324. ↩︎
Last Updated on by ayeshayusuf
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