Connect with others who understand.

sign up log in
About MyParkinsonsTeam

Stages of Parkinson’s

Updated on August 13, 2018

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 One

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

Stage Two

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 Three

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 Four

At stage four, the 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 Five

During stage five, 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 one.

Condition Guide

Resources

External resources

MyParkinsonsTeam resources

Kelly leads the creation of content that educates and empowers people with chronic illnesses. Learn more about her here.

A MyParkinsonsTeam Member said:

Hubby has pd and has had for many years, even before we realized what was going on. It started with dragging feet and me getting on to him for not… read more

posted 6 days ago

hug

Recent articles

Bsp af 6
Thousands of members of MyParkinsonsTeam connect with one another and read each other's stories...

Four Books About Parkinson's Disease You Should Read

Thousands of members of MyParkinsonsTeam connect with one another and read each other's stories...
Mht myparkinsonsteam article carousel managing parkinsons disease motor fluctuations
Article written by Mary K. Talbot Dopamine is a neurotransmitter that sends signals between nerve...

Managing Parkinson's Disease Motor Fluctuations

Article written by Mary K. Talbot Dopamine is a neurotransmitter that sends signals between nerve...
Mht myparkinsonsteam article carousel tips and lifestyle changes
Article written by Kelly Crumrin Most people who begin Levodopa treatment for Parkinson’s can get...

Tips and Lifestyle Changes to Improve "Off" Time in Parkinson's

Article written by Kelly Crumrin Most people who begin Levodopa treatment for Parkinson’s can get...
Mht myparkinsonsteam carousel what is dyskinesia like
Article written by Laurie Berger If you’re experiencing dyskinesia — jerky, involuntary movements...

What Is Dyskinesia Like?

Article written by Laurie Berger If you’re experiencing dyskinesia — jerky, involuntary movements...
Mht ad treatments thumb
Article written by Kelly Crumrin Parkinson’s disease is a movement disorder that causes motor...

Treatments for Parkinson’s and Parkinsonism

Article written by Kelly Crumrin Parkinson’s disease is a movement disorder that causes motor...
Coronavirus
Article written by Kelly Crumrin According to the Centers for Disease Control and Prevention...

Canceling Is Kindness: Keeping Safe From COVID-19 With Parkinson's

Article written by Kelly Crumrin According to the Centers for Disease Control and Prevention...
Mht ad thepathtodiagnosis2 thumb
Article written by Kelly Crumrin The path to a diagnosis of Parkinson’s can be a long and...

Parkinson’s – The Path to Diagnosis

Article written by Kelly Crumrin The path to a diagnosis of Parkinson’s can be a long and...
Mht ad cause thumb
Article written by Kelly Crumrin The cause of most cases of Parkinson’s disease is unknown. While...

What Causes Parkinson’s?

Article written by Kelly Crumrin The cause of most cases of Parkinson’s disease is unknown. While...
Mht ad types thumb
Article written by Kelly Crumrin Parkinsonism is a syndrome, or collection of symptoms,...

Types of Parkinson’s

Article written by Kelly Crumrin Parkinsonism is a syndrome, or collection of symptoms,...
Mht ad sideeffectsandparkinsons thumb
Article written by Kelly Crumrin On MyParkinsonsTeam, the social network and online support group...

Side Effects and Parkinson's

Article written by Kelly Crumrin On MyParkinsonsTeam, the social network and online support group...
MyParkinsonsTeam My Parkinson's disease Team

Two Ways to Get Started with MyParkinsonsTeam

Become a Member

Connect with others who are living with Parkinson's disease. Get members only access to emotional support, advice, treatment insights, and more.

sign up

Become a Subscriber

Get the latest articles about Parkinson's disease sent to your inbox.

Not now, thanks

Privacy policy
MyParkinsonsTeam My Parkinson's disease Team

Thank you for signing up.

close