Understanding the 5 Stages of Parkinson’s Disease

Michael J. Fox and Ozzy Osbourne are some of the most famous Hollywood stars to date. Their names will forever be etched in the Hollywood Walk of Fame for their iconic works, including the “Back to the Future” series starring Michael J. Fox and just one of the many classic rock hits, “Crazy Train” by Ozzy Osbourne.

However, these two icons shared more than just an embedded terrazzo and brass star in Hollywood; they both were diagnosed with Parkinson’s disease (PD). Keep reading to learn more about Parkinson’s disease, including a look at its five stages and what treatment options are available.

Defining Parkinson’s Disease

Parkinson’s disease is a progressive movement disorder of the nervous system that causes nerve cells in parts of the brain to weaken, become damaged and eventually die, causing various symptoms, including:

• Bradykinesia (a slowing down of spontaneous and some automatic movements)
• Cognitive impairments
• Impaired balance
• Stiffness
• Tremors

Even though PD affects many parts of the brain, the most common symptoms are from the loss of neurons near the base of the brain, called the substantia nigra. This region of the brain produces dopamine, a chemical messenger that sends signals to the brain to carry out intentional movement. According to the National Institute of Neurological Disorders and Stroke, patients with PD have lost 60 to 80% of the dopamine-producing cells in the substantia nigra by the time symptoms appear.

Stage 1: Early Symptoms

While the symptoms of Parkinson’s disease and the rate of progression can be unique to each person, stage 1 almost always involves mild symptoms, like tremors and other movement symptoms, on one side of the body. Some may notice changes in their posture, walking and facial expressions. During this stage, symptoms typically don’t interfere with everyday activities, making them easy to overlook and misattribute to something else.

Stage 2: Progression of Symptoms

Stage 2 is when mild PD symptoms worsen. Tremors, rigidity and other movement symptoms begin spreading to the other side of the body or the midline (the neck and trunk). Walking difficulties, poor posture and speech difficulties become more apparent, making everyday tasks a greater challenge. However, people in stage 2 can still live independently.

Stage 3: Balance and Mobility Issues

Balance and mobility symptoms transition from mild to more moderate as the disease progresses to mid-stage. Loss of balance and the risk of falling increase significantly in stage 3. The patients’ reflexes and overall movement begin to slow, and everyday tasks take them much longer. At this point, certain home adjustments or living assistance become necessary.

Stage 4: Advanced Limitations

Once PD reaches stage 4, symptoms are fully developed and severely disabling. Although they’re able to stand and walk on their own, people in stage 4 will likely need to use a cane or a walker to assist themselves. Stage 4 is also when patients are unable to do everyday activities alone, and they need assistance at all hours.

Stage 5: Severe Symptoms and Care Needs

Stage 5 is the most debilitating stage of PD. Leg stiffness becomes so severe that patients are unable to stand or walk, and they’re often bedridden or in a wheelchair and need assistance for everything they do. Their cognitive health also begins to decline in stage 5 through hallucinations, delusions or dementia.

Treating Parkinson’s Disease

Although PD isn’t curable, it’s highly treatable, especially if it’s caught early. The typical first line of defense against PD is a medication called levodopa. This medication, in combination with carbidopa, is considered the gold standard for treating PD symptoms. It works by crossing the blood-brain barrier and converting into dopamine to replace those that were eliminated. This medication alleviates several motor symptoms, including tremors, slowness and stiffness.

Another common treatment method for patients with early-stage PD is regular exercise and physical therapy. Physical movement can potentially prevent the disease from progressing by increasing your strength, flexibility and balance. While it won’t cure PD, it may prevent progression to the next stage.

Once PD reaches its final stages, medication and physical therapy typically don’t alleviate symptoms. For certain individuals, a surgical approach called deep brain stimulation is available. This procedure involves placing electrodes in the brain that are connected to a pacemaker-like device under the skin on the chest. The electrodes are also connected to a generator within the chest, typically near the collarbone, which sends electrical pulses to the brain that may reduce PD symptoms.

Navigating life with Parkinson’s disease can be challenging, but rest assured, our team of expert neurologists is committed to providing the world-class care you need so you can live the life you deserve.

Helping You Live Well With Parkinson’s Disease

We know that getting a Parkinson’s disease diagnosis can feel overwhelming, but you aren’t alone. At AdventHealth, our team of specialized neurologists and senior health experts is here to care for you with life-improving medications, exercises and minimally invasive surgical techniques to help you manage your symptoms well and support your body, mind and spirit.

Learn more about Parkinson’s disease or schedule an appointment with one of our specialists. We’re committed to delivering the expert care and support you need to live a fulfilling life.