The 5 Stages Of Parkinson’s Disease


There are five Parkinson’s disease stages.  This helps healthcare providers decide what treatment to recommend and to help families better understand how the condition progresses.  These categories include stages I through V, and can also be described as early, moderate, and advanced Parkinson’s disease.  The effects and severity of symptoms increases with each of these five stages.

Stage I (Beginning or Early Stage of Parkinson’s)

  • Signs and symptoms are only on one side of the body
  • Symptoms are mild
  • Symptoms are inconvenient but not disabling
  • Usually has tremors in one limb
  • Friends have noticed changes in posture, locomotion, and facial expression.

Stage II

  • Symptoms occur on both sides of the body
  • Minimal disability
  • Posture and gait are affected.
  • Medication may be started during stage I or II and typically involves one of the less powerful Parkinson’s disease medications.  This includes such drugs as:  Selegiline (Eldepryl, Zelapar, Emsam); an anticholinergic;  or a dopamine agonist, such as pramipexoleMirapex®) or ropinirole (Requip®).

Using these medicines first allows the healthcare provider to save the most powerful treatment (specifically, levodopa) for the time when people need it most.

Stage III (Moderate Parkinson’s Disease)

  • Significant slowing of body movements
  • Early impairment of equilibrium when walking or standing
  • Generalized dysfunction that is moderately severe

Stage III is when levodopa is usually first prescribed.  Stages III, IV, and V are when a person develops significant disability from Parkinson’s disease.  A person in stage III is considered to have moderate Parkinson’s disease.

Stage IV (Advanced Parkinson’s Disease)

  • Severe symptoms
  • The person can still walk to a limited extent
  • Rigidity and bradykinesia are present
  • Person is no longer able to live alone
  • Tremor may be less than earlier stagesStage V
    • Cachectic stage (general reduction in vitality and strength of body and mind)
    • Invalidism complete
    • Person cannot stand or walk
    • Requires constant nursing care

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