What are the 5 stages of parkinson disease? When someone is diagnosed with Parkinson’s disease, they may not understand what to expect as the condition progresses. Doctors use a staging system known as the Hoehn and Yahr scale to break down a patient’s progression into five stages, but each person’s experience will vary. Regardless, it is important to seek medical attention when you notice the signs and symptoms of PD.
The early stages of Parkinson Disease
In the early stages of PD, tremors or shaking are often the first recognizable symptoms, and they can sometimes be mistaken for anxiety or depression. Symptoms also include changes in posture, movement and facial expressions. They usually only affect one side of the body (although they can spread to both sides over time).
People at this stage of PD may begin to experience cognitive changes, such as slowed thinking or trouble remembering. They may also experience a change in their sleep habits, or find it more difficult to concentrate. In some cases, medications can help mitigate some of these issues in the early stages of PD.
The moderate and final stage of Parkinson Disease
During the moderate stage of PD, symptoms become more noticeable and can interfere with daily activities. These include tremors or shaking, stiffness or difficulty with movement and changes in posture, walking and facial expressions. In this stage, movement symptoms can begin to slow down a condition known as bradykinesia and it’s more likely that they’ll impact both sides of the body.
As a person moves into the fourth and final stage of PD, they’re unlikely to be able to stand or walk without the aid of a walker. They’re not able to live independently at this point, and they may need around-the-clock care.
Stiffness makes it very difficult to move, and the muscles in the legs freeze upon attempting to stand up. This can lead to falls and fractures. Those who have reached this stage of PD are also more likely to suffer from hallucinations and delusions.
While there is no cure for Parkinson’s disease, the symptoms of the disease can be managed with medication and other therapies. A neurologist can help to develop a treatment plan that best suits your individual needs.
Thinking and memory decreases in Parkinson’s Disease
Despite being best known for its motor symptoms such as bradykinesia, resting tremor and rigidity, Parkinson’s disease (PD) is associated with a wide spectrum of non-motor symptoms including cognitive impairment.
Thinking and memory changes, also called cognitive dysfunction, are a major concern for many people with PD because they have a significant impact on quality of life, over and above the motor symptoms, and can be a leading cause of depression.
While there is a broad range of potential thinking and memory changes, some people only experience mild symptoms that do not interfere with daily activities. Others develop more profound cognitive changes that affect the ability to plan and complete tasks, think clearly or respond to questions, make decisions, remember things and use the language.
People with more advanced cognitive decline may experience compulsive behaviors, hallucinations or delusions and can become easily confused.
Cognitive decline in Parkinson Disease
Cognitive decline in PD occurs as a continuum from normal cognition to mild cognitive impairment (MCI) and then dementia in the context of PD (PDD). MCI and dementia in PD are not universal and progression is varying, with some individuals reverting to normal cognition or even progressing to AD rather than PDD.
In general, cognitive problems are more common in older people and are more pronounced with greater duration of PD. However, the rate of deterioration varies across individuals and is also affected by different genetic mutations that increase or decrease risk of developing PD.
Researchers are still trying to understand exactly what causes thinking and memory changes in PD, but they know that both brain chemicals and cell damage play a role. For example, PD is associated with deficits in the dopamine, acetylcholine and noradrenaline brain cells that are important for cognition.
In addition, a protein in brain cells that is required for memory and thinking, called alpha-synuclein, misfolds and clumps into a toxic aggregation known as Lewy bodies.
While there is no single test for cognitive decline, your doctor will take a history of your symptoms and perform basic tests such as the Mini-Mental State Examination (MMSE). Your doctor may also order blood or brain imaging to check for other conditions that can impact your thinking, such as low thyroid or vitamin B12.
PD can also be associated with other health conditions, so it’s important to talk to your healthcare team about any concerns you have about your thinking.