Are The 5 Stages Of Parkinsons Pointless
February 26, 2020 By: PerkyParkie
Parkinsons disease is such a complicated illness. There are many layers to it, which can make it difficult to fully understand. But it can be comforting to know what the future will bring. We believe that with our knowledge of the disorder, we can have some level of control on how it will impact our bodies and mind. With the hope to know how fast our PD is progressing, some Parkies will look to the 5 stages of Parkinsons scale, but how helpful is this method?
There are few tools to collect data to help diagnose Parkinsons disease and even less when determining its severity.The Hoehn and Yahr scale grew in popularity when it was published in 1967. It detailed criteria to determine in which of the 5 stages a Parkie would fall into. It looks like this:
Stage 1: Unilateral, with mild functional impairment.
Stage 2: Bilateral or midline, without impairment of balance.
Stage 3: Mild to moderate bilateral, some postural instability.
Stage 4: Severe disability, able to walk or stand unassisted.
Stage 5: Wheel-chair bound or bedridden unless aided.
While many people know about the 5 stages of Parkinsons diseaseis that a true measure of someones illness? I dont believe so. Why do you ask? Lets look at the limitations that come with using the stages
-No one wants to be put in a box unless you are a cat they love boxes. It doesnt help us to understand our Parkinsons if we are just tossed into a category.
Are There Any Factors That Slow Or Increase The Pace Of Parkinsons
Though there is currently no drug to halt the progression of the Parkinsons, there are some factors that can alter how quickly it develops. There is a growing body of evidence to suggest that regular exercise and healthy eating can slow the progression of Parkinsons, says Dr Stott.
For example, researchers in the Netherlands have recently demonstrated in a randomised clinical trial that six months of exercising slowed the progression of 65 people with Parkinsons .
Inactivity and social isolation also appear to be associated with faster progression, hence the need to encourage affected individuals to partake in regular exercise ideally in a social environment, he adds.
An investigation into the genetics of Parkinsons shows some promise as to explaining the difference in progression among patients. Dr Stott explains: There is evidence indicating that some genetic variations can influence the speed of progression some variations are associated with increased rate of progression, while others result in a slower rate. We are not sure why these genetic variations are having these effects, but the biology is currently being explored.
What Is Advanced Parkinsons Disease
The traditional classification and disease progression of Parkinsons disease orient on disease milestones that can be most obviously followed along motor domains. In this sense, the topography and severity of segmental motor symptoms, followed by more bilateral segmental involvement, finally appearance of gait disturbance, postural impairment and bedridden immobile states provide well defined but also in some way broadly scaled categories of disease stages. Although this and similar classifications are valuable to approximate and describe the motor severity over time, the classifications fall short to comprehensively describe and characterize the full, continuous and multidimensional spectrum of disease-related motor and non-motor symptoms. In recent years, diverse non-motor domains, quality of life, psychosocial burden and stigma have received major attention as determinants of PD disease course and outcome parameters of clinical trials . Diversity in neurodegeneration patterns and involvement of several neurotransmitters and their contribution to motor and non-motor symptom parallel the phenotypic variability .
Characterizing PD patients on such broad scales is essential, since the phenotype of individual patients varies substantially. This diversity leads to ultimate differences in patients therapeutic requirements, and will very differentially affect patients subjective well-being, self-perceived disease-related impairments, and health-related quality of life.
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Confinement To Bed Or Wheelchair Unless Aided
The patient may exhibit: inability to arise from a chair or get out of bed without help a tendency to fall when standing or turning freezing, stumbling or pulsion when walking. Without someone immediately present to provide assistance, the patient is in danger of falling.A typical example of diagnosis using this method of staging would be: a 64 year old with Stage III PD, more marked on the left than the right, of seven years duration. Another would be: A 55 year old with severe fluctuations in response to Sinemet, with PD of Stages II/IV, of ten years duration. The second example indicates that the patient is at Stage II when at his best or on and at stage 3 IV when at his worst or off. This gives the reader a succinct description of the progression of the disease and the current status of the patient.This method of grading severity is rather a potpourri, combining the symptoms of the patient, the physical signs as observed by the physician and the patients functional ability. In some instances, it is not applicable. For example, while general experience has been that is the onset of disturbances of balance that heralds future disability, some patients may have such severe tremor that they are incapacitated even though balance in intact. Others may have mild disturbance of balance for many years without losing independence. There are occasional patients who are more incapacitated by severe unilateral disease than are others by milder bilateral disease.
Get A Consultation From All American Hospice
If you or someone you know is diagnosed or having the early symptoms of Parkinsons disease, feel free to ask for assistance from All American Hospice Care. Were here to provide our utmost support to help individuals in their journey with Parkinsons. Contact us today for a consultation and to know more about us and our services.
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How Do I Prevent Falls From Common Hazards
- Floors: Remove all loose wires, cords, and throw rugs. Minimize clutter. Make sure rugs are anchored and smooth. Keep furniture in its usual place.
- Bathroom: Install grab bars and non-skid tape in the tub or shower. Use non-skid 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 and 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 non-skid rubber mats near the sink and stove. Clean 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 might be helpful to arrange most of your activities on the lower level to reduce the number of times you must climb the stairs.
- Entrances and doorways: Install metal handles on the walls adjacent to the doorknobs of all doors to make it more secure as you travel through the doorway.
What Can Be Done
The first step is to get a referral to a speechlanguage pathologist . This professional will take a medical history and interview you about eating and swallowing. Next you will probably have a swallowing evaluation, using either a video x-ray or an endoscopic exam. During this procedure, you will swallow different consistencies of food and liquids, and the SLP can observe the entire swallowing process: from your first sip and bite, through the mouth, down the throat and esophagus, and into the stomach. This is the best way to find out the extent and cause of swallowing problems. Then the SLP can recommend treatment.
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Trouble Moving Or Walking
Do you feel stiff in your body, arms or legs? Have others noticed that your arms dont swing like they used to when you walk? Sometimes stiffness goes away as you move. If it does not, it can be a sign of Parkinson’s disease. An early sign might be stiffness or pain in your shoulder or hips. People sometimes say their feet seem stuck to the floor.
What is normal?If you have injured your arm or shoulder, you may not be able to use it as well until it is healed, or another illness like arthritis might cause the same symptom.
Five Stages Of Parkinsons Disease
The Hoehn and Yahr Scale, published in 1967, describes five stages of the progression of Parkinsons Disease across all patients.
Parkinsons disease is progressive. It worsens over time. It also affects people in different ways. Symptoms may vary in their severity between patients. Not all people will experience all the symptoms. Symptoms may progress at different rates, as well. The list of five stages helps describe where a patient is in the progression of the disease.
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What Causes Parkinsons Disease
The cause of Parkinsons disease is not fully understood but it is believed to be due to a combination of genetic and environmental factors.
- Genetics are responsible for about 10% to 15% of all cases of Parkinson’s disease
- Environmental factors associated with an increased risk of developing Parkinson’s disease include:
- Increased age: About 1% of people over age 60 have Parkinson’s disease
- Gender: more common in men than in women
How Long Can A Person Live With Stage 5 Parkinson
When patients reach stage five the final stage of Parkinson’s disease they will have severe posture issues in their back, neck, and hips. In end–stage of Parkinson’s disease, patients will also often experience non-motor symptoms. These can include incontinence, insomnia, and dementia.
One may also ask, what do Parkinson’s patients usually die from? But the most common cause of death in those with Parkinson’s is pneumonia, because the disease impairs patients‘ ability to swallow, putting them at risk for inhaling or aspirating food or liquids into their lungs, leading to aspiration pneumonia.
what happens in stage 5 Parkinson’s?
Stage Five of Parkinson’s 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.
How quickly can Parkinson’s progress?
While symptoms and disease progression are unique to each person, knowing the typical stages of Parkinson’s can help you cope with changes as they occur. Some people experience the changes over 20 years or more. Others find the disease progresses more quickly.
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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.
How To Assist Residents Based On Their Pd Symptoms
PD Symptoms Stiff limbs and exhaustion
Encourage and assist with physical and occupational therapy exercises such as walking when able.
Provide assistive devices, such as a walker or cane, when transferring from a chair and as needed.
Provide periods of rest throughout the day.
Swallowing difficulties
Encourage the resident to eat very small bites and to chew food thoroughly before swallowing.
Provide foods that are soft and/or moist, such as pudding and fruits with high water content.
Serve thickened liquids such as milkshakes or juices in gelatin form.
Avoid serving foods with crumbs, such as crackers or cake, that could get caught in the resident’s throat.
Follow speech therapy recommendations as indicated.
Falls
Ensure pathways are clutter- and barrier-free.
Provide nonslip shoes that are lightweight and fit well.
Provide adaptive equipment and assistance as needed.
Encourage and assist with physical therapy and balance-strengthening exercises.
Communication difficulties
Speak slowly and clearly with short sentences.
Be sensitive to the tone of your voice.
Be patient and allow time for the resident to respond.
Choose times when the medications are working to have important conversations.
Drooling
Provide tissues and assist with care as needed.
Avoid serving sugary foods that increase saliva.
Ensure dentures fit properly, when applicable.
Encourage and assist with proper body and head alignment for proper swallowing.
Drepression and anxiety
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Stage Two Of Parkinsons Disease Early Disease
At Stage two symptoms appear on both sides of the body or at the midline without impairment to balance. This stage may develop months or years after stage one.
Symptoms in stage two may include:
- the loss of facial expression on both sides of the face,
At this stage the individual is still able to perform tasks of daily living.
A diagnosis may be easy at this stage if the patient has a tremor.
It is also possible that the disease may be misdiagnosed as only advancing age. This could happen if the only symptoms are slowness or lack of spontaneous movement, and the stage one diagnosis of PD never occurred.
What Are The Primary Motor Symptoms Of Parkinsons Disease
There are four primary motor symptoms of Parkinsons disease: tremor, rigidity, bradykinesia and postural instability . Observing two or more of these symptoms is the main way that physicians diagnose Parkinsons.
It is important to know that not all of these symptoms must be present for a diagnosis of Parkinsons disease to be considered. In fact, younger people may only notice one or two of these motor symptoms, especially in the early stages of the disease. Not everyone with Parkinsons disease has a tremor, nor is a tremor proof of Parkinsons. If you suspect Parkinsons, see a neurologist or movement disorders specialist.
Tremors
Rigidity
Bradykinesia
Postural Instability
Walking or Gait Difficulties
Dystonia
Vocal Symptoms
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What Are The Causes Of Parkinsons Disease
Even with in-depth studies and research, the leading cause of Parkinsons disease is still unknown.
However, this disease is explained through the loss of nerve cells in the substantia nigra, a section of the brain where dopamine is produced. When this nerve cells damage goes up to 80%, symptoms of the disorder become more evident.
Dopamine is the hormone messenger that helps the brain and the nervous system to coordinate movements. When dopamine decreases, the message is not as clear, making it hard to control body movements such as walking and talking.
Only 10% to 15% of Parkinsons disease cases are attributed to genetics. Most of these cases are discovered at a later stage, making it hard to prevent them.
The other 85% to 90% can be because of an individuals surroundings. Environmental toxicants such as pesticides and herbicides can damage the cell and increase the risk of having Parkinsons disease, although only by a modest degree.
Some researchers also argue that this disorders main culprit is the mixture of both genetics and the environment. Despite the many theories surrounding this disease, the evidence of why it exists remains inconclusive.
Want To Learn More About The Latest Research In Parkinsons Disease Ask Your Questions In Our Research Forum
Stage 3As motor symptoms become worse, patients may begin to experience loss of balance leading to falls and movement can become very slow. Although many patients can still live independently they may have difficulty in everyday activities such as eating or dressing.
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Stage 4In this later stage, symptoms are now extremely limiting. Many patients can still stand without assistance but movement is greatly impaired. Most will need help with everyday activities and will not be able to look after themselves.
Stage 5This is the most advanced stage of the disease and most patients will experience difficulty in walking and standing, often requiring a wheelchair. Assistance will be needed in all areas of daily life as motor skills are seriously impaired. In addition, people with advanced Parkinsons disease may also begin to suffer hallucinations.
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Parkinsons News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.
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Stage Three Of Parkinsons Disease
Stage three is considered mid-stage and is characterized by loss of balance and slowness of movement.
Balance is compromised by the inability to make the rapid, automatic and involuntary adjustments necessary to prevent falling, and falls are common at this stage. All other symptoms of PD are also present at this stage, and generally diagnosis is not in doubt at stage three.
Often a physician will diagnose impairments in reflexes at this stage by standing behind the patient and gently pulling the shoulders to determine if the patient has trouble maintaining balance and falls backward . An important clarifying factor of stage three is that the patient is still fully independent in their daily living activities, such as dressing, hygiene, and eating.