The progression of Parkinson’s disease can be divided into five stages. The description of each stage is commonly used to explain the development of the disease and the symptoms a patient is experiencing. These stages increase in number as the disease increases in severity. The most commonly used staging system, the Hoehn and Yahr system, focuses almost entirely on motor symptoms of Parkinson’s disease. However, patients experience both motor and non-motor symptoms. 

People with Parkinson’s disease experience the disorder in different ways. Symptoms can range from mild to debilitating. Some individuals may transition smoothly between the five stages of the disease, and others may skip stages entirely. Some patients will spend years in Stage One with very few symptoms, while others may experience a faster progression to the end stages of the neurological disorder.

The five stages of Parkinson’s disease are:

Stage One

Parkinson’s disease affects only one side of your body.

The initial phase of Parkinson’s disease typically presents with mild symptoms. Some patients will not even detect their symptoms in the earliest phases of this stage. Typical motor symptoms experienced in Stage One include tremors and shaking limbs. Family members and friends may begin to notice some other symptoms of Parkinson’s disease including tremor, poor posture, and mask face (loss of facial expression). 

Stage Two

Symptoms of Parkinson’s disease begin affecting movement on both sides of your body.

Once the motor symptoms of Parkinson’s disease are affecting both sides of the body, you have progressed to Stage Two Parkinson’s disease. You may begin having trouble walking and maintaining your balance while standing. You may also begin noticing increasing difficulty with performing once-easy physical tasks, such as cleaning, dressing, or bathing. Still, most patients in this stage lead normal lives with little interference as a result of the disease.

During this stage of the disease, you may begin taking medication. The most common first treatment for Parkinson’s disease is dopamine agonists. This medication activates dopamine receptors, which make the neurotransmitters move more easily.

Stage Three

Symptoms are more pronounced, but you can still function without assistance.

This stage is considered moderate Parkinson’s disease. In Stage Three Parkinson’s disease, you will experience obvious difficulty with walking, standing, and other physical movements. The symptoms can interfere with daily life. You are more likely to fall, and your physical movements become much more difficult. However, most patients at this stage are still able to maintain independence and need little outside assistance.

Stage Four

The symptoms of Parkinson’s disease you experience are severe and disabling. You often need assistance to walk, stand, and move.

Stage Four Parkinson’s disease is often called Advanced Parkinson’s disease. Patients in this stage experience severe and debilitating symptoms. Motor symptoms, such as rigidity and bradykinesia, are visible and difficult to overcome. Most people in Stage Four are not able to live alone. They need the assistance of a caregiver or home health aide to perform normal tasks.

Stage Five

You are wheelchair-bound or bedridden.

The final stage of Parkinson’s disease is the most severe. You may not be able to perform any physical movements without assistance. For that reason, you must live with a caregiver or in a facility that can provide one-on-one care.

Quality of life declines rapidly in the final stages of Parkinson’s disease. In addition to advanced motor symptoms, you may also begin experiencing greater speaking and memory issues, such as Parkinson’s disease dementia. Incontinence issues become more common, and frequent infections may require hospitalizations. At this point, treatments and medicines provide little to no symptom relief.

What is the life expectancy of a person with Parkinson’s disease?

Parkinson’s disease can rob you of your ability to move, take care of yourself, and live a full life, but it is not considered a fatal illness. Parkinson’s disease patients often live just as long as people without the disease. However, older individuals with advanced-stage Parkinson’s disease may experience complications of the disease that can be deadly. These complications include infections, pneumonia, falls, and choking.