An Overview of Parkinson's Stages
There are several rating systems in place to stage Parkinson's disease. A widely used scale developed by Hoehn and Yahr categorizes people with the disease into one of five stages. These stages can help healthcare providers decide what treatment to recommend. They can also help families gain a better understanding of how Parkinson's disease progresses. The overall effect and severity of Parkinson's disease symptoms increases with each of these stages.
Healthcare providers may also describe Parkinson's disease stages as early, moderate, and advanced.
Stage I (Beginning Stage of Parkinson's)
Stage I is considered the beginning stage of the disease. A person is categorized with stage I if the following are present:
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 I is also known as early-stage Parkinson's disease.
Parkinson's Disease Stage II
A person is categorized as stage II if the following are present:
Symptoms occur on both sides of the body
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®)
A dopamine agonist, such as pramipexole (Mirapex®) 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.
Parkinson's Disease Stage III (Moderate Parkinson's Disease)
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.
A person is categorized with stage III if the following are present:
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 (see Parkinson's Disease Medications).
Stage IV (Advanced Parkinson's Disease)
A person is categorized with stage IV of the disease if the following are present:
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 stages.
This stage is considered advanced Parkinson's disease.
Stage V Parkinson's Disease
A person is said to be in stage V if the following are present:
Cachectic stage (general reduction in vitality and strength of body and mind)
Person cannot stand or walk
Requires constant nursing care.