Though everyone’s Parkinson’s differs, each person’s condition can be roughly described by one of 5 separate stages, with each possessing its own set of characteristics. These descriptions are by no means exhaustive, but are a good indicator of the severity of someone’s Parkinson’s, and so understanding them can be highly beneficial. We have also included the official Hoen and Yahr scale definitions for further clarification.
Stage One
Unilateral involvement only usually with minimal or no functional disability ↑
Stage One is characterised by the least severe, most mild symptoms. The person with Parkinson’s may experience tremor and movement symptoms, but this will be generally limited to one side of the body, and they do not face huge interference during their day to day life. Other symptoms may include changes in posture and the person’s face, and may seem less noticeable than the other stages.
Stage Two
Bilateral or midline involvement without impairment of balance ↑
Stage Two is characterised by the deterioration of symptoms, with symptoms becoming apparent on both sides of the body. Rigidity (stiffness), posture and movement symptoms are sometimes more apparent than lower stages. While this stage should not see significant restrictions in the day to day life of the person with Parkinson’s, they may experience greater difficulties compared to stage one.
Stage Three
Bilateral disease: mild to moderate disability with impaired postural reflexes; physically independent ↑
Stage three is characterised by more frequent falls, loss of balance and slowing/freezing of gait compared to lower-numbered stages, alongside a general worsening of other symptoms. The person with Parkinson’s may require more care, as basic tasks become more difficult to achieve without aid, though they will likely be able to live with a high degree of independence.
Stage Four
Severely disabling disease; still able to walk or stand unassisted ↑
Stage four is characterised by a greater loss of independence and requiring a walking stick or other aid in order to move around, with the person with Parkinson’s experiencing symptoms that may be highly limiting and have an impact on their overall quality of life. Symptoms will likely be more severe, and the person with Parkinson’s may need greater care and attention than lower-numbered stages.
Stage Five
Confinement to bed or wheelchair unless aided ↑
Stage five is characterised by severe symptoms and a great loss in independence, and will find it difficult to move due to rigidity, necessitating extensive care nearly constantly. The person with Parkinson’s may experience hallucinations alongside their physical symptoms. Walking will not be possible even with an aid, and the person with Parkinson’s will have to remain in a bed or chair.
It’s important to note once again that these descriptions are by no means exhaustive. The person with Parkinson’s might experience some symptoms associated with a certain stage, but not others. and might progress through the stages at an entirely different pace to someone else. This list is intended to help you understand the clinical framework used to define the stages of Parkinson’s; if you are unsure of anything, it is best to consult your GP for further advice and clarification :).
↑ Larsen TA, LeWitt PA, Calne DB. Theoretical and practical issues in assessment of deficits and therapy in parkinsonism. Lisuride and other dopamine agonists. 1983:363-73.