How Parkinson’s Disease Progresses

If you have Parkinson’s disease (PD), you may wonder how your condition will unfold. You might want to know what symptoms you might have, when they’ll start, and how they’ll affect your life.

These are basic questions. But Parkinson’s is not a basic disease. It doesn’t move in a straight line, and it’s hard to pin down exactly how it’ll progress.

What Makes PD Hard to Predict

Parkinson’s comes with two main buckets of possible symptoms. One affects your ability to move and leads to motor issues like tremors and rigid muscles. The other bucket has non-motor symptoms, like pain, loss of smell, and dementia.

You may not get all the symptoms. And you can’t predict how bad they’ll be, or how fast they’ll get worse. One person may have slight tremors but severe dementia. Another might have major tremors but no issues with thinking or memory. And someone else may have severe symptoms all around.

On top of that, the drugs that treat Parkinson’s work better for some people than others. All that adds up to a disease that’s very hard to predict.

What You Can Expect

Parkinson does follow a broad pattern. While it moves at different paces for different people, changes tend to come on slowly. Symptoms usually get worse over time, and new ones probably will pop up along the way.

Parkinson’s doesn’t always affect how long you live. But it can change your quality of life in a major way. After about 10 years, most people will have at least one major issue, like dementia or a physical disability.

Motor Symptoms

You might break these into mild, moderate, and advanced stages. But any stage can have lots of gray areas. A tremor in your right arm may sound mild, but if you’re right-handed and it’s severe, it can affect your quality of life.

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Mild stage. Symptoms are a bother, but they usually don’t stop you from doing most tasks. And drugs usually work well to keep them in check.

You might notice:

  • Your arms don’t swing as freely when you walk
  • You can’t make facial expressions
  • Your legs feel heavy
  • Posture becomes a little stooped
  • Handwriting gets smaller
  • Your arms or legs get stiff
  • You have symptoms only on one side of your body, like a tremor in one arm

Moderate stage. Often within 3 to 7 years, you’ll see more changes. Early on, you might have a little trouble with something like buttoning a shirt. At this point, you may not be able to do it at all.

You might also find that the medicine you take starts to wear off between doses.

You can expect:

  • Changes in how you speak, like a softer voice or one that starts strong, but trails off
  • Freezing when you first start to walk or change direction, as if your feet are glued to the ground
  • Trouble swallowing
  • Falls to be more likely
  • Trouble with balance and coordination
  • Slower movements
  • Small, shuffling steps

Advanced stage. Some people never reach this stage. This is when medication doesn’t help as much and serious disabilities set in.

At this point, you likely:

  • Are limited to bed or a wheelchair
  • Can’t live on your own
  • Have severe posture issues in your neck, back, and hips
  • Need help with daily tasks

Non-Motor Symptoms

Almost everyone with Parkinson’s gets at least one of these. When severe, they’re more likely than motor issues to lead to a disability or make you move into a nursing home. These symptoms can show up almost any time, but they follow a general trend.

What may show up early. You may have these issues years before any classic motor symptoms like tremors:

You also might get these symptoms later in the disease. And even if you have them, it doesn’t mean you have Parkinson’s. Scientists are still trying to understand the link.

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You might also have mild issues with thinking and planning, like forgetfulness, a shorter attention span, and a hard time staying organized. Drooling and a more urgent need to pee are also common.

What may show up later. Dementia and psychosis are two serious mental health issues that usually take a while to show up. Psychosis is a serious condition where you see or hear things that aren’t there, or believe in things that aren’t based in reality. Dementia means you can no longer think, remember, and reason well enough to carry on your normal life.

As you age, you’re more likely to have both conditions the longer you have Parkinson’s.

WebMD Medical Reference Reviewed by Melinda Ratini, DO, MS on September 13, 2017

Sources

SOURCES:

UpToDate: “Clinical Manifestations of PD.”

Parkinson’s Disease Foundation: “What Is Parkinson’s Disease?” “Understanding the Progression of Parkinson's Disease.”

U.S. National Library of Medicine: “Non-motor Symptoms of Parkinson Disease: Update on the Diagnosis and Treatment,” “Premotor and non-motor features of Parkinson’s disease,” “The progression of non-motor symptoms in Parkinson's disease and their contribution to motor disability and quality of life.”

European Parkinson’s Disease Association: “Parkinson’s Progression.”

Parkinson Canada: “Progression of Parkinson’s Disease.”

Partners in Parkinson’s: “What Are the Stages of Parkinson’s Disease?”

Northwest Parkinson’s Foundation: “Stages of PD,” “Disease Progression,” “About Parkinson’s.”

American Parkinson Disease Association: “Common Symptoms of Parkinson’s Disease.”

National Parkinson Foundation: “Non-Motor Symptoms.”

National Institute of Mental Health: “What Is Psychosis?”

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