Stages Of Parkinsons Disease
Experts have identified a general Parkinsons progression and created a set of Parkinsons stages, which can help determine where you are at in the disease and what your prognosis might be. However, not everybody progresses through Parkinsons disease in the same way or on the same time frame. Some people skip stages or rapidly progress to later stages. Others live for many years with mild or moderate Parkinsons and never reach the more advanced stage of the illness.
Here are five commonly recognized stages of Parkinsons, including what symptoms you might expect. Treatment also can occur during these stages to help prevent or delay later stages of the illness. This can include medication, , and lifestyle changes, such as a healthy diet and exercise program.
Can Parkinsons Disease Be Prevented
Unfortunately, no. Parkinsons disease is long-term disease that worsens over time. Although there is no way to prevent or cure the disease , medications may significantly relieve your symptoms. In some patients especially those with later-stage disease, surgery to improve symptoms may be an option.
Different Types Of Parkinsons Disease
As Parkinsons begins to take its full effect, the disease can ravage different parts of the brain and cause varying symptoms. The diagnosis of what type of Parkinsons you have depends on this . Sometimes, doctors dont know the exact cause, either, but they know you exhibit symptoms that line up with Parkinsons. Lets dig into the different forms of the wicked disease:
There are other generations of the disease, but they are the most rare forms. Nevertheless, they carry similar symptoms as all other forms of the disease.
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Stage 1 Of Parkinsons Disease
This beginning stage of Parkinsons disease has minimal symptoms, if any at all. If symptoms are present, they may include tremors and affect one side of the body. For example, one side of the face may be affected, or one hand or leg may feel slower than the other. Your family and friends may notice changes in your posture or facial expressions. Any symptoms that are present arent severe enough to interfere with daily activities. Diagnosis is difficult at this stage, and the affected person may not even seek medical attention at this point.
What Is The Outlook For Persons With Parkinsons Disease
Although there is no cure or absolute evidence of ways to prevent Parkinsons disease, scientists are working hard to learn more about the disease and find innovative ways to better manage it, prevent it from progressing and ultimately curing it.
Currently, you and your healthcare teams efforts are focused on medical management of your symptoms along with general health and lifestyle improvement recommendations . By identifying individual symptoms and adjusting the course of action based on changes in symptoms, most people with Parkinsons disease can live fulfilling lives.
The future is hopeful. Some of the research underway includes:
- Using stem cells to produce new neurons, which would produce dopamine.
- Producing a dopamine-producing enzyme that is delivered to a gene in the brain that controls movement.
- Using a naturally occurring human protein glial cell-line derived neurotrophic factor, GDNF to protect dopamine-releasing nerve cells.
Many other investigations are underway too. Much has been learned, much progress has been made and additional discoveries are likely to come.
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How Is Parkinsons Disease Diagnosed
Diagnosing Parkinsons disease is sometimes difficult, since early symptoms can mimic other disorders and there are no specific blood or other laboratory tests to diagnose the disease. Imaging tests, such as CT or MRI scans, may be used to rule out other disorders that cause similar symptoms.
To diagnose Parkinsons disease, you will be asked about your medical history and family history of neurologic disorders as well as your current symptoms, medications and possible exposure to toxins. Your doctor will look for signs of tremor and muscle rigidity, watch you walk, check your posture and coordination and look for slowness of movement.
If you think you may have Parkinsons disease, you should probably see a neurologist, preferably a movement disorders-trained neurologist. The treatment decisions made early in the illness can affect the long-term success of the treatment.
How Common Is Parkinson’s Disease Psychosis
Between 20-40% of people with Parkinsons report the experience of hallucinations or delusions. When followed as the disease progresses over the years, this number increases. The increase does not mean that the hallucinations are persistent across the majority of patients. However, it is important to note that these statistics sometimes include delirium, in which the symptoms are temporary due to medication that needs to be adjusted or infection that needs to be treated, and isolated minor symptoms or minor hallucinations, including illusions, where instead of seeing things that are not there , people misinterpret things that are really there. These are the most common types of psychosis in people with PD, with different studies placing the occurrence between 25-70% of people with Parkinsons. Typically, if the person with PD only has these minor hallucinations, their doctor will not prescribe an antipsychotic medication, though more significant psychosis that requires medication may develop over time. In one study, 10% of those with minor hallucinations had their symptoms resolved within a few years, while 52% saw their symptoms remain the same and 38% saw their psychosis symptoms get worse.
We recommend that people with Parkinsons not use a single percentage to represent the prevalence of hallucinations and PDP. Parkinsons is a complex disease and as it progresses the percentages and risk of symptoms will change.
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Stages And Progression Of Lewy Body Dementia
Claudia Chaves, MD, is board-certified in cerebrovascular disease and neurology with a subspecialty certification in vascular neurology.
If you or someone you know has recently been diagnosed with Lewy body dementia, you might be wondering what to expect as the disease progresses. Is there a fairly typical progression like Alzheimer’s disease where it begins in early stages that are fairly uniform, then moves to middle stages and then to late stages? In Lewy body dementia, the answer is a bit more complicated.
Causes Of Parkinson’s Disease
Parkinson’s disease is caused by a loss of nerve cells in part of the brain called the substantia nigra. This leads to a reduction in a chemical called dopamine in the brain.
Dopamine plays a vital role in regulating the movement of the body. A reduction in dopamine is responsible for many of the symptoms of Parkinson’s disease.
Exactly what causes the loss of nerve cells is unclear. Most experts think that a combination of genetic and environmental factors is responsible.
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Does Parkinsons Lead To Dementia
During the final stage of Parkinsons disease, your symptoms may progress from severe motor function inhibition to memory loss. Generally, any form of memory loss is known as dementia.
There are multiple forms of dementia, such as:
- Alzheimers disease
- Huntingtons disease
- Dementia caused by head trauma
- Dementia caused by alcohol and drug abuse
Parkinsons disease is listed as a form of dementia simply because memory loss occurs in its later stages. Its estimated that memory loss doesnt become a concern until at least 10 years after the initial diagnosis. While memory loss isnt a cardinal symptom of the disease, more than half of Parkinsons patients develop some form of dementia. Like Alzheimers disease, the dementia associated with Parkinsons disease progressively grows worse.
The Alzheimers Association says that if dementia does stem from Parkinsons disease, the symptoms are similar to dementia with Lewy bodies. This is because patients start to develop these protein deposits on the parts of their brain that affect movement and cognition, which can then affect memory.
Symptoms of the dementia include:
- Difficulty interpreting visual information
Myth : Parkinsons Disease Is Fatal
Fact: Although a diagnosis of Parkinsons is devastating, it is not as some people may still believe a death sentence. Parkinsons disease is not a direct killer, like stroke or heart attack. That said, much depends on the quality of your care, both from your medical team and yourself.
As the disease progresses, you may become more vulnerable to falls, which can be dangerous. Thats why exercise and physical therapy are so important.
Infection is another problem. In later stages of Parkinsons, people often miss those signals and may not notice somethings up until its too late. That can be, literally, a killer so be sure to stay up to date with checkups.
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First Signs Of Impaired Righting Reflexes This Is Evident As The Patient Turns Or Is Demonstrated When He Or She Is Pushed From Standing Equilibrium With The Feet Together And Eyes Closed
Loss of balance, with the inability to make the rapid, automatic and involuntary movements necessary to protect against falling, is one of the most troubling and dangerous aspects of Parkinsonism and one of the least easily treated. Even when manifested by only slight unsteadiness, it is the criterion separating Stage II and Stage III. All other aspects of Parkinsonism are evident and usually diagnosis is not in doubt.
However, the most important factor identifying Stage III is that the patient is still fully independent in all activities of daily living Although somewhat restricted, has work potential depending upon the type of employment. A normal life can be.
Stage 3 Of Parkinsons Disease
Stage 3 is considered the mid-point of Parkinsons disease and includes a loss of balance and coordination. Your reflexes become slower, and falls are more common in this stage. Many of the symptoms from stage 2 are present here, and daily activities such as getting dressed, eating, and getting out of bed become more and more difficult. It is important to note that patients in stage 3 can still live independently.
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Treating Parkinsons Disease Dementia
A treatment plan for PDD typically includes medications that boost the brains level of certain neurotransmitters and help improve memory and processing speed, Dr. Petrossian says. Exercise is also an important part of the treatment planDr. Petrossian recommends skill-based activities like boxing or dance to boost cognitive function as well as fitness. PDD symptoms should be monitored long-term by a neurologist, and in some cases a psychiatrist, says Dr. Okun. In many cases, physical, occupational, speech, and social work therapy can also be useful since PPD affects all aspects of life.
What Are The Symptoms Of Parkinsons Disease
The symptoms of Parkinsons disease develop gradually, as levels of dopamine fall. Early Parkinsons disease symptoms usually affect one side of the body. The main symptoms of Parkinsons disease include:
- Tremors: uncontrollable shaking, the symptom most associated with the disease, often beginning in the hands.
- Rigidity: stiffness or tensing of the muscles.
- Bradykinesia: slowness of movement, and loss of spontaneous movement.
- Postural instability: lack of balance and coordination which may lead to falling.
People with Parkinsons disease may also experience other problems, including tiredness, depression, sleep problems, cognitive impairment and difficulties with handwriting. They can also find their speech and facial expression change and some people have difficulties eating and swallowing.
Myth : Parkinsons Is Only A Motor Condition
Fact: While its true that Parkinsons disease symptoms include shaking and tremor, rigid muscles, slowness of movement, and a frozen or flat expression, its a lot more than that.
Nonmotor symptoms deserve and are getting more attention from doctors and researchers. These symptoms include cognitive impairment or dementia , anxiety and depression, fatigue, sleep problems and more.
For some patients, nonmotor symptoms are more disabling than motor symptoms, which are the focus of treatment. Be sure to talk to your doctor about other issues so you can get all of your symptoms addressed.
Dementia With Lewy Bodies
DLB is characterized by the early development of cognitive symptoms and psychotic symptoms such as hallucinations. Parkinsonian motor symptoms occur later in the progression of the disease. After Alzheimers, DLB is the leading cause of dementia. DLB typically does not occur before the age of 65. In DLB, alpha synuclein protein builds up throughout the cerebral cortex of the brain, forming collections called Lewy bodies.
DLB is often misdiagnosed as Alzheimers. Symptoms of DLB may respond to medications for Parkinsons or Alzheimers, but certain Alzheimers medications carry high risk for dangerous side effects if given to those with DLB. DLB and Parkinsons disease dementia have many features in common, and together they are known as the Lewy body dementias.
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What Lifestyle Changes Can I Make To Ease Parkinsons Symptoms
Exercise: Exercise helps improve muscle strength, balance, coordination, flexibility, and tremor. It is also strongly believed to improve memory, thinking and reduce the risk of falls and decrease anxiety and depression. One study in persons with Parkinsons disease showed that 2.5 hours of exercise per week resulted in improved ability to move and a slower decline in quality of life compared to those who didnt exercise or didnt start until later in the course of their disease. Some exercises to consider include strengthening or resistance training, stretching exercises or aerobics . All types of exercise are helpful.
Eat a healthy, balanced diet: This is not only good for your general health but can ease some of the non-movement related symptoms of Parkinsons, such as constipation. Eating foods high in fiber in particular can relieve constipation. The Mediterranean diet is one example of a healthy diet.
Preventing falls and maintaining balance: Falls are a frequent complication of Parkinson’s. While you can do many things to reduce your risk of falling, the two most important are: 1) to work with your doctor to ensure that your treatments whether medicines or deep brain stimulation are optimal and 2) to consult with a physical therapist who can assess your walking and balance. The physical therapist is the expert when it comes to recommending assistive devices or exercise to improve safety and preventing falls.
Stage 2 Of Parkinsons Disease
During stage 2, Parkinsons disease symptoms are much more noticeable. At this point, the disease begins to affect your entire body. Changes in facial expressions, speech abnormalities and increased tremors or stiffness may occur. Routine daily activities take longer to complete and posture changes are more visible. Stage 2 may occur months or even years after stage 1.
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What To Expect In The Late Stages Of Parkinsons Disease
- Stage Four of Parkinsons Disease In stage four, PD has progressed to a severely disabling disease. Patients with stage four PD may be able to walk and stand unassisted, but they are noticeably incapacitated. Many use a walker to help them. At this stage, the patient is unable to live an independent life and needs assistance with some activities of daily living. The necessity for help with daily living defines this stage. If the patient is still able to live alone, it is still defined as Stage Three.
- Stage Five of Parkinsons Disease Stage five is the most advanced and is characterized by an inability to arise from a chair or get out of bed without help. They may have a tendency to fall when standing or turning, and they may freeze or stumble when walking. Around-the-clock assistance is required at this stage to reduce the risk of falling and help the patient with all daily activities. At stage five, the patient may also experience hallucinations or delusions.1,2
Late Stages Of Parkinsons
Parkinsons disease is a degenerative disorder that worsens over time. For some individuals, a long period of time may elapse between an initial diagnosis and the appearance of severe, disabling symptoms. For others, the disease may progress rapidly. Not much is known about why some people develop severe symptoms quickly, while others stay relatively healthy for much longer. However, there are a few commonly recognized stages of disease progression that are experienced by most individuals living with Parkinsons.
In the early stages of Parkinsons disease, symptoms like tremors, stiffness, and slow movement are usually mild, may be limited to one side of the body, and often present more of an annoyance than a true impediment to activities of daily living. In the middle stages of Parkinsons, these symptoms become more severe, and may be accompanied by urinary and gastrointestinal disorders, sleep problems, depression, and dementia. In late-stage Parkinsons, symptoms are very severe, and often disabling.
Edison Home Health Care is happy to advise and assist you or any loved one who seek appropriate care of Parkinsons disease. Give us a call at 888-311-1142, or fill out a contact form and we will respond shortly.
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How Can Hospice Help Your Loved One In The Final Stages Of Parkinsons Disease
Hospice care is an extra layer of support to help you care for your loved one with end-stage Parkinsons disease. It is a special kind of care that provides comfort, support, and dignity at the end of life.
The comprehensive program focuses on physical, emotional, and spiritual quality of life through the help of a team of experts. The team includes a board-certified physician, nurse, social worker, certified home health aide , spiritual support counselor, and volunteer.
The nurse will explain the prognosis and what to expect in the upcoming days or weeks. They will also monitor pain and other symptoms. The CHHA helps with personal care needs like bathing and changing bed linens. The social worker helps address social, emotional and practical challenges including complex and inter-related needs. The spiritual support counselor helps explore spiritual concerns.
Most importantly, the hospice team will be there for you during this difficult time, bringing you peace of mind. The team is on call 24 hours a day even at 2:00 am.
Hospice is about making your final months and weeks as good as possible. This means focusing on what really matters to you.