What are the Stages of Parkinson's Disease?

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  • Written By: Marjorie McAtee
  • Edited By: W. Everett
  • Last Modified Date: 07 October 2019
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Parkinson's disease is a progressive neurological disorder. There are five generally recognized stages of Parkinson's disease. The progression of the disease may vary from one patient to the next, and not all patients will experience all five stages of Parkinson's disease in their generally accepted order. Symptoms may also vary throughout the progression of Parkinson's disease.

While doctors have currently identified five distinct stages of Parkinson's disease, not all patients will experience a straightforward disease progression that passes through all five stages, one after the other. Nor will all patients remain in all stages for the same length of time. The five stages of Parkinson's often vary in duration from patient to patient. Disease progression is generally considered impossible to predict, with some patients experiencing all stages while other patients skipping from an early stage to an advanced stage without passing through the stages in between.

The neurological symptoms of Parkinson's disease typically appear during the first stage of the illness. Patients in the first stage of Parkinson's disease may experience mild shaking and tremors. These tremors usually affect only one limb, or one side of the body. Poor posture, reduced ability to maintain balance, and strange facial expressions may also occur during this stage of the disease. Patients are, however, typically able to continue with ordinary activities and care for themselves without help.


In the second stage of Parkinson's disease, symptoms begin to appear in more than one limb and on both sides of the body. Symptoms may begin to impair a patient's ability to walk or care for themselves. Problems with balance generally become more apparent during this stage of the illness. Patients in the first or second stages of Parkinson's disease may be prescribed selegiline, pramipexole, or ropinirole to manage their symptoms.

Parkinson's disease does not generally lead to significant impairment in functioning until the fourth and fifth stages of the disease. Patients in the fourth stage of Parkinson's may experience bradykinesia, or slowed body movements, as well as a greatly reduced ability to walk. Tremor symptoms may ease or disappear during the fourth stage of the disease. The patient will probably no longer be able to care for himself, however, and may need live-in help to accomplish daily tasks. Patients in the fourth and fifth stages of Parkinson's disease are usually treated with levodopa.

Patients in the fifth and final stage of Parkinson's generally lose the ability to stand or walk and are considered total invalids. Mental and physical vitality can deteriorate during this final stage of the disease. Patients in this stage of the disease usually need nursing care on a constant basis, generally in a hospice setting.


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