The stages of Parkinson correspond to the severity of
movement symptoms and how much a person’s daily activities
are affected. The most commonly used rating scales are
focused on the motor symptoms, but new scales include
information on non-motor symptoms (such as cognitive
problems or sense of smell).
The Hoehn and Yahr scale rates symptoms on a scale of 1 to
5. On this scale, depending on a person’s difficulties, 1
and 2 represent early-stage, 2 and 3 mid-stage, and 4 and 5
Another scale commonly used to assess the progression of
Parkinson is the United Parkinson’s Disease Rating Scale
(UPDRS). It focuses on movement symptoms. In addition to
these, the UPDRS takes into account cognitive difficulties,
ability to carry out daily activities, and treatment
MILD PARKINSON’S DISEASE
Movement symptoms may be inconvenient, but do not affect
MODERATE PARKINSON’S DISEASE
Movement symptoms occur on both sides of the body and
movements are more slowly. Trouble with balance and
coordination may develop. Movements may become stuck
("freezing" episodes). Symptoms can reappear quickly and
unexpectedly, which could be described as being like a
light switch being turned on and off ("on/off" syndrome).
Parkinson medications may "wear off" between doses.
ADVANCED PARKINSON’S DISEASE
This stage corresponds to great difficulty with the
ability to get up or walk. The patients might not be able
to live alone and assistance is needed with all daily
activities. Cognitive problems may be prominent, including
hallucinations and delusions.
The beneficial effects of oral medication becomes
unpredictable and is failing to control motor
fluctuations. Other therapy strategies such as continuous
drug delivery or stimulation have to be considered.