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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