Understanding the Five Stages of Parkinson’s Disease in the Elderly

Parkinsonism or Parkinson’s disease is a neurodegenerative disorder that manipulates how the nerve cells in the brain produce dopamine. It is marked by the presence of certain recognizable symptoms. It is more common in men and more widespread than Lou Gehrig’s disease, multiple sclerosis, and muscular dystrophy combined. Parkinson’s disease influences people in different ways. It is commonly referred to as movement disorder where the affected suffer from tremors and balance. Although the disorder typically affects older people, Parkinson’s disease has been diagnosed in younger adults as well (rare).

While each individual’s experience with the disorder differs in severity, five stages of progression are typical for all. As Parkinson’s impact as many as 10 million people worldwide, Halo Health Care shares the following information.

The main symptoms of Parkinson’s include:

• Stiffness in limbs
• Balance difficulties and problems when standing up
• Bradykinesia (slowed movement)
• Uncontrollable tremors and shaking

Parkinson’s Disease: Stage 1

In stage one of Parkinson’s disease, the symptoms are mild and seen only on one side of the body, that is; unilateral involvement and there is no to minimal functional impairment. The symptoms can be so mild that the affected doesn’t seek medical attention or the doctor is unable to make a diagnosis. The stage one symptoms may include intermittent tremor of one hand, one leg or hand may feel lumbering than another, or paralysis of one side of the face, affecting the expression. Stage one of Parkinson’s disease is very difficult to diagnose, therefore, before making a formal diagnosis, the doctor may wait to see if the symptoms get worse over time.

Parkinson’s Disease: Stage 2

In Parkinson’s disease, stage two is still considered early for making a diagnosis and is described by symptoms based on bilateral involvement (both sides of the body) of the body, or at midline without loss to balance. Stage two of Parkinson’s disease may develop months or years after stage one and the symptoms may include:

• General slowness in all activities of daily living
• Stooped posture
• Rigidity or stiffness of the muscles in the trunk that may result in back or neck pain
• Slurring speech
• Fading volume after starting to speak loudly
• Monotone voice
• Soft voice
• Speech abnormalities
• Decreased blinking
• Loss of facial expression on both sides of the face

However, these symptoms may not affect the individual while performing the tasks of daily living. Diagnosis may be easy at stage two if the person has a tremor; but, if one was missed and the only symptom of stage two is lack of spontaneous movement or slowness, Parkinson’s disease could be misunderstood as only advancing age.

Parkinson’s Disease: Stage 3

Stage three of Parkinson’s disease is considered mid-stage and is characterized by slowness of movement and loss of balance. Falls are common at this stage as the balance is compromised by the helplessness to make involuntary, automatic, and rapid adjustments necessary to prevent falling. Diagnosis is not in doubt at this stage as all other symptoms of Parkinson’s disease are also present at this stage. In most cases, the doctor diagnoses impairments in reflexes by standing behind the patient and pulling the shoulders gently to determine if the patient has trouble keeping the balance. An essential clarifying factor of this stage is that the affected are still fully independent in their daily living activities such as eating, hygiene, and dressing.

Parkinson’s Disease: Stage 4

Stage 4 is when Parkinson’s disease has progressed to severely disabling disease. While the patients may be able to stand and walk unassisted, they are noticeably debilitated. Many use a walker for assistance. At this stage, the individual is unable to live an independent life and requires assistance at some point of daily living. Stage four is defined based on the necessity for help with daily living and if the individual is able to live alone, it is defined as stage three.

Parkinson’s Disease: Stage 5

This is the most advanced stage of Parkinson’s disease and is characterized by the patient’s inability to get out of bed or a chair without help. The patients may have the tendency to fall or disbalance when turning or standing. Moreover, they stumble or even freeze when walking. For patients with stage five Parkinson’s disease, around-the-clock assistance is required to reduce the risk of falling and help them with daily activities. Another symptom of stage five Parkinson’s disease is that the patients may also experience delusions or hallucinations.

Final Words

Although there is no ‘one way’ for diagnosing Parkinson’s disease, the diagnostic tests can be carried out based on the symptoms and how it is affecting the patient. Moreover, there is no standard treatment for Parkinson’s and the treatments are based on the patient’s symptoms. It may include surgical therapy or medication. In addition, if the disorder is not spread to further stages and still can be controlled, then the physician may suggest exercise and rest.