If your loved one has been diagnosed, you may be wondering what are the 5 stages of Parkinson’s disease?
It is a progressive condition that affects the brain, which impacts both cognitive and motor functioning over a number of stages as the disease progresses.
This being said, it’s hard to pin point specifically 5 stages of Parkinson’s disease as every individual's experience is different.
In this article, we’ll look at the illness and comment on the 5 stages of Parkinson’s disease which are most common.
Here’s a summary of what we’ll cover:
- Parkinson’s is an increasingly common neurological disease which is thought to be caused by a combination of genetic and environmental factors.
- It’s a progressive condition which worsens over time, causing your loved one’s cognitive and motor function to decline.
- There are some treatments and medicines for Parkinson’s that can help to manage the symptoms and live a normal life.
- There are links between Parkinson’s and lewy body dementia, with some people developing it after their initial diagnosis.
What is Parkinson’s Disease?
Parkinson’s disease is the fastest growing progressive neurological condition in the world today.
Around 145,000 people in the UK are living with the condition.
With the highest concentration of people living with Parkinson’s in their 70s.
Parkinson’s affects the brain causing cells to degrade or die, thus affecting how we think, feel, move and behave.
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Parkinson’s and Lewy Bodies
Lewy bodies have also been found in the brain cells of many people who have Parkinson’s.
These are clumps of a protein called alpha-synuclein, that inhibits the production of chemicals in the brain.
Notably, Lewy bodies have an impact on dopamine production, which is a common symptom for people with Parkinson’s.
This is the same protein found in the brain cells of people who have Lewy body dementia which you can learn about in our guide ‘What is dementia?’.
What are the causes of Parkinson’s?
It is still relatively unknown as to what causes Parkinson’s to develop in individuals.
Like other neurological conditions such as dementia and Alzheimer’s, researchers are working hard to understand the disease and find a way of managing it.
Based on existing medical research, Parkinson’s is thought to be a combination of both genetic and environmental factors.
Genetic factors
The majority of cases of Parkinson’s are in people who have no family history of the condition.
Sometimes parents of people with Parkinson’s have the same gene that can cause the condition, but they won’t develop it themselves.
Similarly, that gene may activate if the right combination of genetic and environmental factors exist.
As with other cognitive conditions, exposure to toxins, pollutants and nutrition are being researched as potential triggers for these genes.
How is the brain affected by Parkinson’s?
The cause of the symptoms of Parkinson’s is nerve cell loss in the part of the brain called the substantia nigra.
This part of the brain lies within the basal ganglia, which is an area of the brain that manages movement.
The cells in this part of the brain are either damaged or die during Parkinson’s and scientists haven’t been able to identify the cause.
Parkinson’s and dopamine production
This loss of these cells leads to a reduction in the production of dopamine which is used in sleep and movement, memory and concentration.
Dopamine is heavily used in movement of the body, and of course has an impact on our mood.
Dopamine is a ‘happy’ chemical, so a reduction of it can explain the low mood and anxiety associated with Parkinson’s.
Check out our guide on how to keep your brain active as you age to learn more about improving memory and sleep.
Parkinson’s and norepinephrine production
Parkinson’s also causes the loss of nerve cells that make norepinephrine, another extremely useful chemical.
This one is the main messenger of our sympathetic nervous system which manages heart rate and blood pressure.
The loss of norepinephrine can explain some other symptoms that are not associated with movement or mood.
Changes in blood pressure, slow digestion, and feeling abnormally tired can all be caused by low levels of norepinephrine.
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What are the symptoms of Parkinson’s
This loss of dopamine and norepinephrine causes many of the symptoms associated with Parkinson’s.
These symptoms are not all guaranteed to be felt by everyone who has been diagnosed with the disease.
Some people might find that symptoms change, sometimes frequently, increasing or decreasing as the disease progresses.
Rather than treating the condition specifically, some symptoms can be managed using holistic medicines or therapy.
Cognitive symptoms of Parkinson’s
Cognitive changes are a symptom of Parkison’s disease, but not everyone will always experience them.
These symptoms can be similar to those that accompany a dementia diagnosis and include difficulties in focus and planning.
As well as this, other cognitive symptoms of Parkinson’s at any stage of the disease can include,
- Depression and anxiety
- Emotional changes and mood swings
- Behavioural changes
- Memory recall problems
- Language abnormalities
- Problems with vision and perception
How is Parkinson’s treated?
Similar to dementia – another neurological condition affecting brain cells – there is no cure for Parkinson’s disease.
However, there are some treatments that can reduce the symptoms and bring some relief.
Medication, physiotherapy, occupational therapy, and in some cases, brain surgery can be employed.
What treatments are available?
Treatments can slow down the condition but they may not work for everyone.
Some of the treatments available are:
- Dopamine agonist is a medicine used to increase the levels of dopamine in the brain.
- Drugs that increase the sensitivity of neurotransmitters, making them more receptive to dopamine and norepinephrine
- Enzyme inhibitor that slows down the disposal of dopamine in the brain so it can do its work for longer.
- A medicine to help relax stiff muscles and minimise tremors.
- Surgical intervention for deep-brain stimulation via electrodes to ease or control some of the physical symptoms.
How can a more holistic approach to treatment help?
Management of the non-movement related symptoms may include a more holistic approach to the condition.
- Antidepressants and anti-anxiety medication may be useful in managing moods and stress symptoms.
- Digestion support such as fibre supplements or laxatives may assist with digestion issues.
- Sleeping aids, either drugs or sleep hygiene routines may also add to general health and wellbeing.
- Supportive therapies such as counselling, massage and physical therapy may also be helpful.
Diagnosis of Parkinson’s
Similar to other neurological conditions such as dementia, there is no blood or laboratory test to diagnose Parkinson’s.
Usually a neurological test, similar to tests for dementia, is applied and can be essential in eliminating the possibility of other conditions.
This is an important part of Parkinson’s diagnosis, as symptoms can be similar to Lewy body dementia and multiple system atrophy.
Because of these similarities, some medications may be given to gauge the person’s response and help form a treatment plan.
What are the 5 Stages of Parkinson’s disease?
It is important to note that these stages of Parkinson’s are not universally experienced.
Some people may develop some of the symptoms and not others or experience variation in their intensity.
That is to say that there are no definitive or set stages for the condition to pass through.
With that said, let’s answer the question – what are the 5 Stages of Parkinson’s disease – in detail.
Stage 1
Some early symptoms may be detected, but are more likely to be passed off as other health concerns.
For example, trouble sleeping, constipation, restless legs and a diminished sense of smell.
None of these conditions, separate or together, definitively indicate Parkinson’s.
Most people don’t consider them as collective symptoms, rather as minor, unrelated health concerns.
Stage 2
The early stages of the condition may be so mild that symptoms are barely noticeable.
These symptoms may be associated with ageing, perhaps being over or under active, not feeling well, or lifestyle changes.
A gentle wobble may be felt on getting up out of a chair or perhaps some stiffness, and feeling a little slower than usual.
Stage 3
Mild symptoms may be spotted by friends and family first.
These can include speaking more softly than usual, noticing handwriting has grown smaller and more cramped looking, writing more slowly.
Facial expressions may be less expressive than before and animation in the face is diminished, which may impact communication.
Limb movements and walking may be different, slower or more stiff than prior.
Stage 4
One limb or side of the body may be more affected by stiffness, slow movement and tremors than the other.
A ‘Parkinson’s Gait’ may develop, which is characterised by leaning forward, taking small and quick steps, and moving the arms very little.
Getting started moving and maintaining movement may be difficult such as getting up from a chair after prolonged exercise.
Stage 5
If symptoms have been seen predominantly in one limb, or one side of the body, this will usually progress to both sides.
Shakes or stiffness may still be more severe on one side than the other, but usually all limbs are affected eventually.
Symptoms may ease and then get worse or come and go.
Depending on treatment given and response to that treatment, mobility may become reduced.
What care is available?
As symptoms tend to get worse as the condition progresses, it’s likely more support will be needed for day to day activities.
There are plenty of domiciliary care options such as home care visits or carers who sleep overnight.
Where trained care staff can support with companion care and home help, plus services such as respite care or end of life care.
Similarly, options for your loved one to go into a care home and get supported with Parkinson’s disease are also available.
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What is the link between Parkinson’s and cognitive decline?
Most people find that they respond well, and are able to live a normal life with supportive therapies and medication.
Some people who have Parkinson’s may experience some cognitive decline, though this is not guaranteed.
Memory loss, difficulty in understanding and a loss of executive function may occur.
Sometimes this decline can be attributed to medication, or depression which is often associated with Parkinson’s.
What is Parkinson’s dementia?
Some people may also develop Parkinson’s dementia later on in the progress of the condition.
As noted above, Lewy bodies – a protein deposit – are often seen in the brain cells of people with the condition.
If this additional neurological condition develops as a result of Parkinson’s, increased cognitive decline can be expected.
Memory loss and difficulty thinking and processing information may eventually make daily life difficult without additional support.
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