Connect with others who understand.

sign up log in
About MyParkinsonsTeam

Stages of Parkinson’s

Updated on May 03, 2021
Medically reviewed by
Evelyn O. Berman, M.D.
Article written by
Kelly Crumrin

There are five commonly recognized stages of Parkinson’s. Neurologists stage Parkinson’s based on the way the condition typically progresses. However, symptoms of Parkinson’s vary by the type of parkinsonism and between individuals. An individual with Parkinson’s will not necessarily experience all or even most symptoms and may not experience them at the same stage in which others experience them. Parkinson’s is a progressive disease, which means that symptoms worsen gradually over time, new symptoms appear, and disability accumulates.

Assessing the stage of Parkinson’s helps anticipate disabilities and plan accordingly for care.

The Five Stages of Parkinson’s

The stages of Parkinson’s are based on the Hoehn and Yahr scale introduced in 1967. The Hoehn and Yahr staging system focuses on disability caused by motor symptoms such as bradykinesia (slowed movements), tremor, and loss of balance. Some neurologists also use a newer scale called the Unified Parkinson’s Disease Rating Scale (UPDRS). The UPDRS scale takes into account changes in mood, cognitive function such as thinking and remembering, and social behavior.

Stage 1

Motor symptoms occur on one side of the body only. There is minimal or no disability.

Stage 2

Motor symptoms worsen and begin to affect both sides of the body. There may be difficulty walking and changes in posture, facial expression, and voice. Daily activities become harder and take longer.

Stage 3

In the middle stage of Parkinson’s, loss of balance becomes apparent and falls are more common. Motor symptoms make it difficult to eat, dress, and perform self-care, but the person is still capable of living alone.

Stage 4

At stage 4, a person is no longer able to live alone. Disability is severe, and the person requires help with many daily tasks. They may or may not be able to stand and walk without assistance. Many people begin using walkers at this stage.

Stage 5

During stage 5, the person cannot rise from a chair or bed without help. Motor symptoms include stumbling and freezing. They may lose the ability to stand or walk, and a wheelchair becomes necessary. Assistance is required around the clock for all activities. Some people begin to experience psychotic symptoms such as hallucinations or delusions.

Another View of Parkinson’s Progression

A newer theory of Parkinson’s progression called Braak's hypothesis suggests that Parkinson’s may begin years before motor symptoms develop. According to Braak’s hypothesis, loss of smell and digestive symptoms such as constipation are the earliest signs of Parkinson’s, showing up many years before motor issues. While these early symptoms do not show up on an official Parkinson’s stage yet, many researchers are working on ways to identify and treat Parkinson’s earlier, even before stage 1.

Condition Guide

References

  1. Stages of Parkinson’s – Parkinson’s Foundation
  2. What Are the Stages of Parkinson’s Disease? – ParkinsonsDisease.net
All updates must be accompanied by text or a picture.
Evelyn O. Berman, M.D. is a neurology and pediatric specialist and treats disorders of the brain in children. Review provided by VeriMed Healthcare Network. Learn more about her here.
Kelly Crumrin is a senior editor at MyHealthTeam and leads the creation of content that educates and empowers people with chronic illnesses. Learn more about her here.

Related articles

Dopamine is a neurotransmitter responsible for sending signals in the brain to coordinate...

Understanding Dopamine and Parkinson’s Disease

Dopamine is a neurotransmitter responsible for sending signals in the brain to coordinate...
Despite advancements made in understanding Parkinson’s disease (PD) and the development of...

End-Stage Parkinson’s Disease: What To Know

Despite advancements made in understanding Parkinson’s disease (PD) and the development of...
The Parkinson’s disease (PD) staging system is a helpful tool to track movement-related symptoms...

Understanding the Progression of Parkinson’s Disease

The Parkinson’s disease (PD) staging system is a helpful tool to track movement-related symptoms...
Parkinson’s disease (PD) is associated with genetic and environmental risk factors. Among these...

Traumatic Brain Injuries and the Risk for Parkinson’s

Parkinson’s disease (PD) is associated with genetic and environmental risk factors. Among these...
Early onset Parkinson’s disease (also known as young onset Parkinson’s disease) is a form of...

Early Onset Parkinson’s Disease: Your Guide

Early onset Parkinson’s disease (also known as young onset Parkinson’s disease) is a form of...
The Centers for Disease Control and Prevention (CDC) recommended Pfizer COVID-19 vaccine booster...

COVID-19 Vaccine Boosters and Additional Doses for People With Parkinson's: Current Guidelines

The Centers for Disease Control and Prevention (CDC) recommended Pfizer COVID-19 vaccine booster...

Recent articles

Many symptoms of Parkinson’s disease and parkinsonism can interfere with daily life. Parkinson’s...

Micrographia (Handwriting Difficulties) and Parkinson’s Disease

Many symptoms of Parkinson’s disease and parkinsonism can interfere with daily life. Parkinson’s...
Many people with Parkinson’s disease (PD) worry whether they’ll be able to continue driving with...

Driving and Parkinson’s: Your Guide

Many people with Parkinson’s disease (PD) worry whether they’ll be able to continue driving with...
Parkinson’s disease (PD) psychosis most commonly involves hallucinations and delusions. It...

Treatment Options for Parkinson’s Psychosis

Parkinson’s disease (PD) psychosis most commonly involves hallucinations and delusions. It...
Hallucinations and delusions occur for 20 percent to 40 percent of people with Parkinson’s...

How To Recognize Hallucinations and Delusions

Hallucinations and delusions occur for 20 percent to 40 percent of people with Parkinson’s...
Hallucinations and delusions can be a major source of stress for caregivers caring for people...

How To Manage Hallucinations and Delusions: Tips for Caregivers

Hallucinations and delusions can be a major source of stress for caregivers caring for people...
Dyskinesias are involuntary, erratic movements of the face, limbs, or torso that occur as a side...

Poll: What Have You Done To Manage Dyskinesia?

Dyskinesias are involuntary, erratic movements of the face, limbs, or torso that occur as a side...
MyParkinsonsTeam My Parkinson's disease Team

Thank you for subscribing!

Become a member to get even more:

sign up for free

close
MyParkinsonsTeam My Parkinson's disease Team

Want to stay up to date on the latest news and articles about Parkinson's disease?