5 Stages of Parkinson’s Disease

profile head and brain

Parkinson’s Disease development is categorized using a few staging schemes. The Hoehn and Yahr Stages and the Unified Parkinson’s Disease Rating Scale (UPDRS) are the two most well-known staging systems.   

In 1967, Hoehn and Yahr defined five stages of Parkinson’s Disease based on the degree of clinical dysfunction. Clinicians use it to chart the course of motor symptoms in Parkinson’s disease. 

Stage 1 – Initial stage

Mild symptoms that often only affect one side of the body characterize this stage. There may be tremors or other movement problems, but they are often minor and have little influence on daily activities. There are modifications to walking, facial expressions, and posture.

Stage 2 – Mild Symptoms

Bilateral symptoms occur, affecting both sides of the body. Tremors, rigidity, and bradykinesia become more pronounced. Movements may become slower, and the person may have balance and coordination issues. Activities of daily living can still be performed independently, but with more effort 

Stage 3 – Moderate Parkinson’s

Significant impairment in balance and coordination. Slowness of movement (bradykinesia) becomes more apparent. Falls become more frequent, and daily activities require assistance.

Stage 4 – Advanced Parkinson’s

Tremors and rigidity may still be present, but they are generally less pronounced.

The symptoms are completely established and profoundly incapacitating. The individual can still walk and stand without assistance, but may need to use a cane/walker for safety. The individual needs extensive assistance with everyday tasks and is unable to live alone.

Stage 5 – Severe Parkinson’s

Also called End-Stage Parkinson’s. The most advanced stage, characterized by a high level of disability and dependence on others for daily activities. The individual may be confined to a wheelchair or bed. Symptoms may include severe tremors, rigidity, and bradykinesia.

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