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.
- 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