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5 Stages of Parkinson’s Disease

by Dana, November 12, 2018

Delving deeper into the previous topic, today we are exploring the 5 Stages of Parkinson’s disease. This scale was established in 1967 by Margaret Hoehn and Melvin Yahr as a way of assessing the progression of this neurological disorder, which primarily compromises motor skills over time. Although some patients might be familiar with viewing their symptoms on a scale of mild to severe, the Hoehn and Yahr five-stage scale is commonly used by physicians. The ambiguities created when determining a patient’s well-being in accordance with the five-stage system has led to the rise of the Unified Parkinson’s Disease Rating Scale, which takes into account cognitive and social functioning, as well as movement and speech. The five-stage scale is a great basic tool that helps Parkinson’s patients be attuned to their symptoms and communicate effectively with doctors, which is why we’re making it the next subject in our series on Parkinson’s disease.

5 Stages of Parkinson’s Disease

Stage 1

In this stage, symptoms are mild enough that the individual may not think there’s a need to seek medical attention, or the physician may be unable to make a diagnosis. Mild tremors may occur on one side of the body, in addition to changes in walking, posture, and facial expressions. Other symptoms include rigidity and slowness of movement in one arm or leg.

Stage 2

Symptoms are now seen on both sides of the body and become progressively worse, though this stage may occur months or years after stage one. If the person isn’t properly diagnosed during stage one – possibly due to the absence of tremors in the first and second stages – the symptoms of increasing slowness and lack of spontaneous movement could be mischaracterized as signs of advancing age. Individuals and their families should look for problems with walking and posture, as well as speech abnormalities, including softness of voice and slurred words. The affected individual can still live independently, though daily tasks are more difficult. 

Stage 3

Key symptoms include loss of balance and slowness of movement. A diagnosis of Parkinson’s is generally not in question at this stage. Although an individual with stage three Parkinson’s may still be living independently, limited motor skills may inhibit activities such as dressing, eating, and showering. Balance issues may be noticeable for the first time, and falls are common. Other signs of Parkinson’s from the previous stages are present, and may worsen.

Stage 4

The severity of the disease is pronounced. Although the individual may be able to walk or stand without help, a walker may be necessary for movement. This person would be unable to live alone and would require assistance with some, if not all, activities of daily living. 

Stage 5

The most advanced stage of Parkinson’s disease, characterized by a near-total loss of balance and motor control. Stiffness would likely impede the ability to stand or walk, and falls can occur when standing or turning. At this stage, a person would be bedridden, or confined to a wheelchair, and may also suffer from hallucinations or delusions. Round-the-clock hour care is necessary. 

Treatment

Although there is no cure for Parkinson’s disease, research has demonstrated that it can be managed in the initial stages with medication, physical therapy, and regular exercise. Stimulating the brain with social and creative activities is also important. As the disease progresses, deep brain stimulation – involving the implantation of electrodes in the brain – may be considered, but usually only when medication is no longer effective. In the final stages of Parkinson’s, care shifts from preventative to palliative, and efforts are taken to provide relief from symptoms.

Notably Parkinson’s disease is unique to each individual, meaning that a person may experience some or all of the aforementioned symptoms. Treatment plans are designed with the particular needs of a patient in mind.

5 Stages of Parkinson’s Disease is part of a series of posts from Care Indeed concerning the diagnostics, symptoms, and treatment of Parkinson’s.