What Are The Different Stages Of Parkinsons Disease
Each person with Parkinsons disease experiences symptoms in in their own unique way. Not everyone experiences all symptoms of Parkinsons disease. You may not experience symptoms in the same order as others. Some people may have mild symptoms; others may have intense symptoms. How quickly symptoms worsen also varies from individual to individual and is difficult to impossible to predict at the outset.
In general, the disease progresses from early stage to mid-stage to mid-late-stage to advanced stage. This is what typically occurs during each of these stages:
Early stage
Early symptoms of Parkinsons disease are usually mild and typically occur slowly and do not interfere with daily activities. Sometimes early symptoms are not easy to detect or you may think early symptoms are simply normal signs of aging. You may have fatigue or a general sense of uneasiness. You may feel a slight tremor or have difficulty standing.
Often, a family member or friend notices some of the subtle signs before you do. They may notice things like body stiffness or lack of normal movement slow or small handwriting, lack of expression in your face, or difficulty getting out of a chair.
Mid stage
Mid-late stage
Standing and walking are becoming more difficult and may require assistance with a walker. You may need full time help to continue to live at home.
Advanced stage
Parkinson’s Disease Diet And Nutrition
Maintaining Your Weight With Parkinson’s Disease
Malnutrition and weight maintenance is often an issue for people with Parkinson’s disease. Here are some tips to help you maintain a healthy weight.
- Weigh yourself once or twice a week, unless your doctor recommends weighing yourself often. If you are taking diuretics or steroids, such as prednisone, you should weigh yourself daily.
- If you have an unexplained weight gain or loss , contact your doctor. He or she may want to modify your food or fluid intake to help manage your condition.
- Avoid low-fat or low-calorie products. . Use whole milk, whole milk cheese, and yogurt.
How To Test For Parkinson’s Disease
No blood test exists that definitively diagnoses Parkinson’s disease. Currently, a strong presumptive diagnosis of Parkinson’s disease is made by a doctor’s observation of the patient’s symptoms, medical history and neurologic examination, and response to a treatment schedule with the combination medicine generically termed carbidopa-levodopa .
Definitive diagnosis of Parkinson’s disease can be difficult. As stated above, there is no specific blood test or diagnostic study currently available to make the diagnosis. In fact, a brain tissue sample, though not practical in living patients, is the only way to be relatively sure of the diagnosis. This is usually done at autopsy. Studies have shown that a misdiagnosis rate in the past of 25% to 35% was not uncommon. This rate drops to about 8% when a movement disorder specialist physician helps make the diagnosis. Consequently, consultation with a specialist is usually recommended.
People that suspect they may be experiencing symptoms of Parkinson’s disease should consult with their primary care doctor and ultimately may need a referral to a neurologist who specializes in movement disorders.
Early-Stage Diagnosis
Late-Stage Diagnosis
Possible Imaging Technique Diagnosis
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What Is And Isn’t Parkinson’s Disease
I am often asked if Parkinson’s Disease is a form of Alzheimers. Parkinson’s is not Alzheimers, ALS or a brain tumor, and the prognosis for Parkinson’s, though not a perfect scenario, leaves room to live a productive life.
PD is a progressive and chronic neurological disease that often begins with mild symptoms that advance gradually over time. Symptoms can be so subtle in the early stages that they go unnoticed, leaving the disease undiagnosed for years. For patients with Parkinson’s, there is a reduction in the body chemical dopamine, which controls movement and mood so simple activities like walking, talking and writing can be impacted.
Due to the complexity of PD, diagnosis is based on a variety of factors. The best diagnosis is made by an expert doing a careful history and exam followed by tracking responses to therapy. There is no blood or laboratory test to diagnose Parkinson’s disease.
While Parkinson’s reaches all demographics, the majority of people with PD are age 60 or older. Men and people with a family history of the disease have an increased risk.
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Does your loved one seem to be dragging one of their feet when they walk? Are they shuffling slightly? Has one of their arms lost its swing when they walk? Do they seem stiff in their movements? You have an objective perspective and may notice these things sooner.
No one who is happy or joyful likes to be asked, Whats wrong with you? That can happen with an early sign of PD known as the masked face. Why masked face? Because the facial muscles have tightened and people with PD have a harder time smiling or showing emotion.
Another symptom that I struggle with is my voice getting softer, making it hard for others to hear me. I had a soft voice to begin with, and when it got softer it made it more difficult to converse. Speech and vocal exercises can be done to strengthen the vocal cords if the problem is due to PD.
If you think someone you know might have early signs of PD, you might want to approach them as if they hadnt noticed their symptoms. For example, dont stare at them when they are shaking and ask, Do I make you nervous? Ask them if theyve noticed that their hand shakes slightly. If they bring it to your attention, encourage them to have it checked out. If they are concerned and you act like its nothing, especially when you notice it, coupled with other signs related to early PD, they will feel silly and may think they are imagining things.
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Symptoms Of Parkinsons Disease
Parkinson’s disease has four main symptoms:
- Tremor in hands, arms, legs, jaw, or head
- Stiffness of the limbs and trunk
- Slowness of movement
- Impaired balance and coordination, sometimes leading to falls
Other symptoms may include depression and other emotional changes; difficulty swallowing, chewing, and speaking; urinary problems or constipation; skin problems; and sleep disruptions.
Symptoms of Parkinsons and the rate of progression differ among individuals. Sometimes people dismiss early symptoms of Parkinson’s as the effects of normal aging. In most cases, there are no medical tests to definitively detect the disease, so it can be difficult to diagnose accurately.
Early symptoms of Parkinson’s disease are subtle and occur gradually. For example, affected people may feel mild tremors or have difficulty getting out of a chair. They may notice that they speak too softly, or that their handwriting is slow and looks cramped or small. Friends or family members may be the first to notice changes in someone with early Parkinson’s. They may see that the person’s face lacks expression and animation, or that the person does not move an arm or leg normally.
People with Parkinson’s often develop a parkinsonian gait that includes a tendency to lean forward, small quick steps as if hurrying forward, and reduced swinging of the arms. They also may have trouble initiating or continuing movement.
What Are The Surgical Treatments For Parkinsons Disease
Most patients with Parkinsons disease can maintain a good quality of life with medications. However, as the disease worsens, medications may no longer be effective in some patients. In these patients, the effectiveness of medications becomes unpredictable reducing symptoms during on periods and no longer controlling symptoms during off periods, which usually occur when the medication is wearing off and just before the next dose is to be taken. Sometimes these variations can be managed with changes in medications. However, sometimes they cant. Based on the type and severity of your symptoms, the failure of adjustments in your medications, the decline in your quality of life and your overall health, your doctor may discuss some of the available surgical options.
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What Can You Do If You Have Pd
- Work with your doctor to create a plan to stay healthy.;This might include the following:
- A referral to a neurologist, a doctor who specializes in the brain
- Care from an occupational therapist, physical therapist or speech therapist
- Meeting with a medical social worker to talk about how Parkinson’s will affect your life
For more information, visit our;Treatment page.
Page reviewed by Dr. Chauncey Spears, Movement Disorders Fellow at the University of Florida, a Parkinsons Foundation Center of Excellence.
Stooping Or Hunching Over
Are you not standing up as straight as you used to? If you or your family or friends notice that you seem to be stooping, leaning or slouching when you stand, it could be a sign of Parkinson’s disease .
What is normal?If you have pain from an injury or if you are sick, it might cause you to stand crookedly. Also, a problem with your bones can make you hunch over.
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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.
What Should You Do
Whether it’s stress and fatigue, a medical condition, pregnancy, a prescription, or something else that is causing you to let items slip through your fingers, consulting your physician is the first step to addressing the issue. Visit your primary care doctor and share any information you think may be relevant to your dropping problem. Even if the cause is simple stress, your doctor will be able to recommend strategies to help you stay focused and mitigate your anxiety.
This content is accurate and true to the best of the authorâs knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.
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Why Is Expert Care Important
Early expert care can help reduce PD complications. Findings show that 60 percent of people with Parkinson’s fall short of getting the expert care they need. The National Parkinson Foundation has estimated that about 6,400 people with Parkinson’s die;unnecessarily;;each year due to poor care.
Trained neurologists will help you recognize, treat and manage the disease. Common approaches include medication, surgical treatment, lifestyle modifications , physical therapy, support groups, occupational therapy and speech therapy. The best approach is interdisciplinary care, where you are seen by multiple specialists on a regular basis and all of the specialists talk and arrange the best possible coordinated care. This is what is referred to as a patient-centric approach to Parkinson’s care.
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3. Loss of SmellMany people temporarily lose their sense of smell due to colds or the flu, but if the loss is sustained over a length of time without any noticeable congestion, then it could be an early sign of Parkinsons disease.
4. Sleeping DisordersTrouble sleeping can be attributed to many illnesses and Parkinsons disease is one of them. Waking due to sudden body movements, or thrashing your legs in your sleep could be a warning sign of the condition.
5. Stiffness in Walking and MovingGeneral stiffness that cant be attributed to exercise aches and pains and doesnt ease up when moving around could be an early warning sign of Parkinsons disease. Many patients complain that it feels like their feet are literally stuck to the floor.
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6. ConstipationUnable to move your bowels is also a common early sign of Parkinsons disease. Although this is a common enough problem in healthy people, Parkinsons patients are more susceptible;to constipation. If you suddenly find youre constipated and consider your diet normal then you should have a doctor check you out.
7. Low or Soft VoiceA sore throat or a cold can change the way you speak, but if you have been experiencing a sudden softness to the tone of your voice and are now speaking in a quieter or hoarser tone, this could be an early symptom of Parkinsons disease.
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What Are Signs And Symptoms Of Parkinsons Disease
Early diagnosis can greatly increase the effectiveness of Parkinsons treatment. However, Parkinsons symptoms are easy to dismiss as normal signs of aging or other conditions such as stroke or head trauma. For these reasons, people may ignore symptoms or doctors may have a harder time with diagnosis.
What Is The Prognosis And Life Expectancy For Parkinson’s Disease
The severity of Parkinson’s disease symptoms and signs vary greatly from person to peson, and it is not possible to predict how quickly the disease will progress. Parkinson’s disease itself is not a fatal disease, and the average life expectancy is similar to that of people without the disease. Secondary complications, such as pneumonia, falling-related injuries, and choking can lead to death. Many treatment options can reduce some of the symptoms and prolong the quality of life.
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Testing For Parkinsons Disease
From Geoffs first visit with a neurologist it took 4 to 5 months before an official Parkinsons diagnosis was made. Delays in this process were due to availability of times for the next appointment, time to book in for tests, get results back and to monitor symptoms for any changes. Interestingly, Geoff did not show some of the classic signs of Parkinsons like hand tremor which would require more investigation to be able to identify Parkinsons as the problem. He would later find out that a lack of a tremor is not uncommon with Young Onset Parkinsons, which is the specific type of Parkinsons that Geoff was diagnosed with.
There is no specific test to identify Parkinsons other than careful monitoring of body movement, reaction and function, which is still at best only an indicator. To be diagnosed with Parkinsons, you must be tested for and to eliminate every other possible disease or illness which includes brain tumour or cancer, stroke, body chemistry.
So you undergo X-rays, MRI, various blood tests all the time hoping for an answer, praying that whatever they may find isnt too serious, then frustrated and disappointed when the tests would come back all clear.
The Nervous System & Dopamine
To understand Parkinson’s, it is helpful to understand how neurons work and how PD affects the brain .
Nerve cells, or neurons, are responsible for sending and receiving nerve impulses or messages between the body and the brain. Try to picture electrical wiring in your home. An electrical circuit is made up of numerous wires connected in such a way that when a light switch is turned on, a light bulb will beam. Similarly, a neuron that is excited will transmit its energy to neurons that are next to it.
Neurons have a cell body with branching arms, called dendrites, which act like antennae and pick up messages. Axons carry messages away from the cell body. Impulses travel from neuron to neuron, from the axon of one cell to the dendrites of another, by crossing over a tiny gap between the two nerve cells called a synapse. Chemical messengers called neurotransmitters allow the electrical impulse to cross the gap.
Neurons talk to each other in the following manner :
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How Is Parkinson’s Disease Diagnosed
Diagnosis is difficult at every stage of the disease, but particularly in the early stages. No single test can provide a diagnosis. A diagnosis will likely involve physical and neurological examinations, conducted over time to assess changes in reflexes, coordination, muscle strength, and mental function. Your doctor might also see how you respond to medicine.
You may need to have brain imaging tests to rule out other conditions that might be causing your symptoms. Such tests could include MRI and CT scans and possibly some other types of scans. Blood tests may also be done to exclude other illnesses.
Falls And Common Household Hazards
If you or a loved one has Parkinson’s disease, here are tips for preventing falls around the home:
- Floors. Remove all loose wires, cords, and throw rugs. Minimize clutter. Make sure rugs are anchored and smooth. Keep furniture in its accustomed place.
- Bathroom. Install grab bars and nonskid tape in the tub or shower. Use nonskid bath mats on the floor or install wall-to-wall carpeting.
- Lighting. Make sure halls, stairways, and entrances are well lit. Install a night light in your bathroom or hallway. Make sure there is a light switch at the top and bottom of the staircase. Turn lights on if you get up in the middle of the night. Make sure lamps or light switches are within reach of the bed if you have to get up during the night.
- Kitchen. Install nonskid rubber mats near the sink and stove. Clean up spills immediately.
- Stairs. Make sure treads, rails, and rugs are secure. Install a rail on both sides of the stairs. If stairs are a threat, it may be helpful to arrange most of your activities on the lower level to reduce the number of times stairs must be climbed.
- Entrances and doorways. Install metal handles on the walls adjacent to doorknobs of all doors to make it more secure as you travel through the doorway.
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