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Some symptoms of Parkinson’s disease occur a decade or more before most people are diagnosed with the condition. These lesser-known signs can be helpful early clues to bring to your doctor’s attention. Other symptoms develop later in the disease, representing warning signs of disease progression or complications that may be treatable. If you or a loved one have Parkinson’s or are at risk for developing it, it’s important to never ignore these symptoms:
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1Tremors in your hands
Having tremors (shaking) in your hands, especially when they’re at rest, is one of the most common symptoms of Parkinson’s disease. Women are more likely than men to have tremor as their first symptom of the disease. Usually, tremors start in a hand or fingers, sometimes only on one side of your body. You may develop “pill-rolling tremor,” where you rub your thumb and finger back and forth as if massaging an invisible pill. Hand tremors can progress to tremors of your legs, face and other areas of your body.
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2Loss of smell
COVID-19 is not the only illness that can cause loss of smell (anosmia). This symptom also can be an early sign of Parkinson’s disease. About 90% of people with Parkinson’s lose their sense of smell, often several years before tremors or other movement-related symptoms begin. Just losing your sense of smell does not mean you have Parkinson’s, of course, since other conditions can cause it as well. But persistent loss of smell is worth bringing to the attention of your doctor.
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3Acting out your dreams while sleeping
About two-thirds of Parkinson’s patients have sleep disorders—a common early sign of the condition. One type of sleep problem seen in about half of Parkinson’s disease patients is REM (rapid eye movement) behavior disorder. This can cause you to move around in bed while sleeping, sometimes even kicking or hitting your partner as you act out vivid dreams.
Other sleep problems related to Parkinson’s disease include insomnia (lack of sleep or interrupted sleep), daytime sleepiness, and sleep apnea.
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4Feeling depressed or anxious
Feelings of depression and anxiety can occur early in Parkinson’s, as well as in later stages. Sometimes, mood changes start up to 10 years before the diagnosis of Parkinson’s. Women with Parkinson’s are more likely to experience depression than men who have the disorder. Experts believe Parkinson’s causes chemical changes in brain activity that affect mood and emotion, resulting in such symptoms as fear, anxiety, and loss of motivation. These Parkinson’s complications are treatable with medications.
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5Frequent constipation
Digestive and bowel problems are common for people with Parkinson’s disease due to slowing of the digestive tract. Such problems often start before tremor or other movement dysfunction—sometimes as early as 20 years before Parkinson’s disease is diagnosed. Bladder problems—either incontinence or having difficulty urinating—are another Parkinson’s complication. Whether you have bowel or bladder difficulties associated with Parkinson’s, treatments may be available, so discuss these problems with your healthcare provider.
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6Speaking more softly than usual
Parkinson’s disease often affects the voice. You may start speaking more quietly and monotonously, with less expression, intensity and pitch variation than before. Your voice also may become breathier. If you have a softened voice due to Parkinson’s, you may be able to recover some volume through speech therapy. Singing can also help some people strengthen their vocal cords. Unfortunately, others—such as singer Linda Ronstadt—find that Parkinson’s impairs their ability to hit notes.
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7Having double vision or problems reading
Have you noticed double vision when you are focusing on tasks or trying to see something close up? Is it taking you longer than normal to read because you keep losing your place from one line to the next? Parkinson’s disease can cause eye movement problems, making it difficult to focus.
You may also notice other eye-related Parkinson’s symptoms, such as:
Blinking too little, resulting in dry eyes
Blinking too much
Trouble opening your eyes
Color blindness (especially with blues and yellows).
Talk with your doctor or eye care professional about treatments for these symptoms.
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8Losing facial expressions
As Parkinson’s progresses, one symptom that occurs is “facial masking”—showing less facial expression than before. You may be feeling happy or angry or upset, but your face no longer reveals these emotions. Instead, you may develop a blank expression and smile much less than you used to. This can cause the people you’re with to wonder if you’re bored or annoyed, which can affect your relationships. Make sure your loved ones understand this is a Parkinson’s symptom, and not to take it personally.
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9Dizziness when you stand up
A common Parkinson’s complication is orthostatic hypertension. This means that your blood pressure plunges when you change positions, such as going from sitting to standing. It can cause you to feel dizzy or lightheaded; you may even faint or fall. Orthostatic hypertension can be caused by other conditions besides Parkinson’s, such as low blood sugar. If the symptom persists, report it to your healthcare provider. Several medications are available specifically for the treatment of orthostatic hypertension in Parkinson’s patients.
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10Having hallucinations or delusions
Late-stage Parkinson’s can bring on delusions and visual hallucinations. About 20 to 40% of people with Parkinson’s experience these, sometimes as the result of Parkinson’s medications. They also can be a symptom of Parkinson’s disease dementia. Parkinson’s dementia is caused by changes to Lewy body proteins in the brain, and eventually affects about 50 to 80% of people with Parkinson’s disease, according to Alzheimer’s Association estimates. If Lewy body-associated dementia occurs, it is typically about 10 years after the onset of Parkinson’s.
