How Does Parkinson’s Progress?

Half a million people in the United States have a Parkinson’s disease (PD) diagnosis, although some experts estimate that the true number of people living with this condition could be closer to one million. Many people know at least a little bit about the condition, including its hallmark tremors. What many people don’t know, however, is how Parkinson’s progresses and how the progression of PD can affect treatment.

What is Parkinson’s Disease?

Parkinson’s disease is a condition that affects the nervous system, including the brain. This fact means that people with PD can show movement symptoms, like balance issues, as well as non-movement symptoms, like sleep problems.

The condition results from nerve cell damage in the brain, which many experts believe could be from a buildup of the protein alpha-synuclein. This damage impairs dopamine production, which in turn leads to the symptoms of Parkinson’s that many people know, like tremors. PD is much more than tremors, however.

What are the Symptoms of Parkinson’s?

Because Parkinson’s disease affects the brain, it results in both motor signs and non-motor symptoms alike. These side effects of Parkinson’s can affect daily living, especially as the disease progresses to the middle and late stages.

Parkinson’s symptoms, according to the National Institute of Health (NIH), include:

  • Sleeping problems
  • Slowness of movement (bradykinesia)
  • Constipation
  • Involuntary movements/tremors (dyskinesia)
  • Muscle stiffness
  • Impaired sense of smell
  • Balance problems
  • Changes in facial expressions
  • Urinary dysfunction/incontinence
  • Fluctuations in blood pressure
  • Difficulty communicating
  • Difficulty swallowing
  • Cognitive impairment
  • Mental health problems like anxiety and depression

These symptoms may vary in severity, and some may only develop as the disease progresses. Furthermore, not everyone who is diagnosed with Parkinson’s will experience each symptom listed here.

How Does Parkinson’s Disease Progress?

Experts classify this disease into stages, with each stage of Parkinson’s getting more severe than the last. According to Parkinson’s Foundation, many experts use the Hoehn and Yahr scale to track disease progression, which identifies 5 distinct stages of the disease.

Stage One

Stage one is the earliest stage of PD, and it is when someone first notices symptoms like tremors, balance issues, and difficulties with facial expressions. Diagnosis usually occurs around age 60; when people under 50 receive a diagnosis, they have what is known as young onset Parkinson’s disease.

Some experts identify 3 sub-stages for the early stages of Parkinson’s, which are as follows:

  1. Preclinical stage - Damage in the nervous system has begun, but the damage is not yet severe or extensive enough to cause noticeable symptoms.
  2. Prodromal stage - Symptoms start to show, but they are so mild that a professional can not yet make an official diagnosis.
  3. Clinical stage - This stage is when people receive their diagnosis. People here display early symptoms of the disease, which often manifest gradually on one side of the body. At this point, someone can still usually complete daily tasks without much difficulty.

Stage Two

People officially enter the second stage when symptoms progress to the point of making daily activities difficult, albeit still possible without help, and affect more than just one side of the body.

Stage Three

This middle stage of PD is when balance problems become much more pronounced, leading to greater risk of falls and subsequent injuries. People may still be able to live alone at this stage while modifying their lifestyles, including implementing fall prevention measures at home and taking more time to complete daily activities.

Stage Four

Stage four is considered an advanced stage of the disease. People in this stage can no longer safely live alone and need help with activities of daily living. Walking alone may still be possible, but many people require a mobility aid like a cane.

Stage Five

Stage five is the most advanced stage of Parkinson’s disease. People in this stage are severely disabled; they cannot live alone, need significant assistance, and cannot move around without help.

How is Parkinson’s Treated?

Parkinson’s is a neurodegenerative disorder, meaning it is a chronic condition (it persists),a progressive condition (it worsens over time), and it affects the nervous system. While there is no cure for it, knowing the stages and how it progresses can lead to better outcomes. The sooner a diagnosis is received, the better, as it can lead to early intervention and more effective treatment options that may help slow the progression of Parkinson’s.

Common treatments for this condition include:

  • Levodopa
  • Carbidopa
  • Amantadine
  • Neurologist visits
  • Deep brain stimulation (DBS)
  • Focused ultrasound
  • Self-care habits

Wellness for People Living with PD at St. Andrew’s

Receiving a Parkinson’s diagnosis for yourself or someone you love can be overwhelming. There may be several questions, including “How will I take care of my family?” and “How does Parkinson’s progress?” At St. Andrew’s, our experts are ready to answer any questions your family may have about this condition, including how we work with other families to manage this condition and improve quality of life for everyone involved.

Disclaimers: This article is for educational purposes only and does not constitute medical advice. It cannot be used to diagnose, treat, prevent, or cure any disease or condition. Please direct any and all healthcare concerns to a licensed healthcare professional.

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