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The 5 Stages of Parkinson’s Disease

Getting older is underrated by most. It’s a joyful experience to sit back, relax and watch the people in your life grow up, have kids of their own and flourish. Age can be a beautiful thing, even as our bodies begin to slow down. We spoke with David Shprecher, DO, movement disorders director at Banner Sun Health Research Institute about a well-known illness which afflicts as many as 2% of people older than 65, Parkinson’s disease (PD).

What is Parkinson’s disease?

Parkinson’s is a neurological illness caused by degeneration or breaking down of nerve cells in the nervous system,” explained Dr. Shprecher. “The nature of Parkinson’s disease is progressive, meaning that it gets worse over time. There is not currently a cure for Parkinson's disease.” To comprehend the natural progression of the disease in people with Parkinson's, we should understand its five stages, as explained by the Parkinson’s Foundation.

Stage one (early stage)

People with Parkinson's disease experience mild symptoms that generally do not interfere with daily living and activities. Tremor and other movement symptoms occur on one side of the body only. They may also experience changes in posture, walking and facial expressions.

Stage two

Symptoms worsen, including tremor, rigidity and other movement symptoms, and affect both sides of the body. The person is still able to live alone, but daily tasks are more difficult and lengthier.

Stage three

This is considered mid-stage. Individuals experience loss of balance and slowness of movements. While still fully independent, these symptoms significantly impair activities such as dressing and eating. Falls are also more common by stage three.

Stage four

Symptoms are severe and limiting. Individuals may stand without help, but movement likely requires a walker. People in stage four require help with daily activities and are unable to live alone.

Stage five

Stiffness in the legs may make it impossible to stand or walk. The person requires a wheelchair or is bedridden. Around-the-clock nursing care is needed for all activities. The person may experience hallucinations and delusions.

Signs of Parkinson’s disease

In 1817, Dr. James Parkinson published “An Essay on the Shaking Palsy” describing non-motor, as well as, motor symptoms of the illness that bears his name. “Parkinson’s is not just a movement disorder,” explained Dr. Shprecher. “Constipation, impaired sense of smell, and dream enactment can occur years before motor symptoms of Parkinson’s. The latter, caused by a condition called REM sleep behavior disorder, is a very strong risk factor for both Parkinson’s and dementia (with a greater than 70% lifetime risk). This has prompted us to join a consortium of centers studying REM sleep behavior disorder.”

Living with Parkinson’s disease

Depending on severity, life can look very different for a person coping with Parkinson’s disease. As a loved one, your top priority will be their comfort, peace of mind and safety. Dr. Shprecher offered some advice, regardless of the disease’s progression.“Besides movement issues Parkinson’s disease can cause a wide variety of symptoms including drooling, constipation, low blood pressure when standing up, voice problems, depression, anxiety, sleep problems, hallucinations and dementia. Therefore, regular visits with a neurologist experienced with Parkinson’s are important to make sure the diagnosis is on target, and the symptoms are monitored and addressed. Because changes in and side effects of your other medications can affect your Parkinson’s symptoms, you should remind each member of your health care team to send a copy of your clinic note after every appointment.”

Dr. Shprecher also added that maintaining a healthy diet and getting regular exercise can help improve quality of life. Physical and speech therapists are welcome additions to any caregiving team.

You are not alone

Caring for a loved one or coping with Parkinson’s disease yourself can be scary, confusing and isolating. Banner Health specialists are experienced and ready to help in whatever capacity you need. Set up your appointment today.

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