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Understanding the Various Stages of Parkinson's Disease


We often find ourselves asking our medical professionals what stage of a condition we may be in. This can be extra difficult to classify for Parkinson's patients because the symptoms can look so different and unique for each person. It is also important to note that one may fluctuate between stages as medications and therapies improve current situations. Additionally, rarely can stage prediction be made for progression because a person may stay in a certain stage for years and other stages for months. It is also important to remember that every journey with PD is unique. Because a symptom might be listed within a stage, it doesn't necessarily mean a person with PD will experience that symptom.


​Joseph H. Friedman, MD writes, "Staging most disease is important in predicting how long people will live or how well they can function. This is not true for staging in PD. Severity of PD is currently not measurable. As physicians, we currently rate different aspects of PD differently and often use multiple different scales. It affects people in so many ways that it defies methods for comparison, just as it has been impossible to measure what we mean when we say disease progression. We have good methods for measuring the motor symptoms of PD. The severity of your own PD is really a matter of how severely it affects your life. A number can never capture this."


​At the PAA, we recommend not getting too hung up on what stage classification of Parkinson's you may be in. However, for the purposes of education, we are including the breakdown of stages as presented by the Davis Phinney Foundation in their manual, "Every Victory Counts."


Early Stage

  • Symptoms on one side of the body

  • Decreased arm swing on one side when walking

  • Decreased stride length

  • Dragging your foot while walking

  • Scuffing your toes, especially when tired

  • Change in leg coordination when cycling or running

  • Sense of muscle fatigue or heaviness in your arm or leg on one side of the body

  • Difficulty completing repetitive movements due to sense of muscle fatigue

  • Trouble with hand coordination, especially on one side. This is often apparent doing tasks that use both hands.

  • Reduced range of motion in your shoulder, shoulder pain, or frozen shoulder.

  • Mask-like face or change in facial expression.

  • Decreased or small handwriting.

Mid Stage

  • Symptoms on both sides of the body

  • Soft speech

  • Mild swallowing problems, such as difficulty swallowing pills

  • Flexed or bent posture and shuffling gait

  • Motor fluctuations and dyskinesia

Advanced Stage

  • Postural instability with balance

  • Walking problems, with increased shuffling, freezing of gait

  • Significant speech and swallowing problems

  • Drooling

  • Rigidity in the neck and trunk parts of the body

Sources:

Davis Phinney Foundation for Parkinson's. Every Victory Counts, Your Go-To Resource of Essential Information and Inspiration for Living Well with Parkinson's. "Manual." Sixth Edition, 2021


​Friedman, MD. Joseph H. "Making the Connection Between Brain and Behavior: Coping with Parkinson's Disease." Appendix D. Staging Parkinson's Disease. Pages 202-205. Second Edition. DemosHealth 2013


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