Nearly 1 million Americans have Parkinson’s disease, a chronic neurodegenerative disorder that can cause a variety of symptoms and, in its later stages, be debilitating. But newer medications, therapies, and lifestyle changes have such a significant impact on how the illness progresses that some people with Parkinson’s disease (PD) have a normal to near-normal life expectancy compared to someone without PD. Your Parkinson’s prognosis and life expectancy depends on individual factors, such as your specific treatment plan and medical history. Early diagnosis and prompt treatment can also make a difference.
Experts have identified a general Parkinson’s progression and created a set of Parkinson’s stages, which can help determine where you are at in the disease and what your prognosis might be. However, not everybody progresses through Parkinson’s disease in the same way or on the same time frame. Some people skip stages or rapidly progress to later stages. Others live for many years with mild or moderate Parkinson’s and never reach the more advanced stage of the illness.
Here are five commonly recognized stages of Parkinson’s, including what symptoms you might expect. Treatment also can occur during these stages to help prevent or delay later stages of the illness. This can include medication, physical therapy, and lifestyle changes, such as a healthy diet and exercise program.
Stage One
Symptoms at this early stage are usually mild, sometimes so subtle that you don’t detect them, or consider them signs of normal aging, such as fatigue. You can generally keep up with all your normal activities. However, family members may notice subtle changes before you are aware of them. Some of these signs include body stiffness; changes in posture or in walking (for example, walking more slowly or walking with your arms not swinging); handwriting that has become tiny and cramped; or your face becoming more expressionless.
Stage Two
Symptoms worsen in stage two. If you had a tremor, muscle stiffness, or other movement problem on one side of your body before, now it’s on both sides. You may start having trouble with your balance and begin to experience falls. You can still perform your “activities of daily living”—like eating, bathing and dressing—on your own, but these are becoming more difficult and take longer to perform.
Stage Three
At this mid-stage point in Parkinson’s progression, you’re likely to increasingly experience loss of balance and slowness of movements (bradykinesia), such as walking more slowly. Falls are becoming more common. Your symptoms make it difficult to do things like eat or get dressed on your own, though you can still live independently at this point.
Stage Four
People with middle-to-late, or stage four Parkinson’s aren’t able to live alone. You may need to move into some form of supportive care or else have someone living with you who can help you. You can usually still stand without assistance at this stage. However, if you want to walk, you may need a walker.
Stage Five
Late-stage Parkinson’s is the most advanced form of this chronic neurodegenerative disease. Symptoms at this point will have become disabling. The stiffness in your legs makes it very difficult or impossible to stand or walk. You likely will require a wheelchair or may be bedridden. Around-the-clock nursing (skilled care) is necessary. You may have hallucinations or delusions along with the physical symptoms of Parkinson’s disease.
Most people with Parkinson’s can have a normal—or close to normal—life expectancy today, thanks to new medications, therapies, and other treatments. Survival rates for those with typical Parkinson’s disease are either the same as for the general population or shortened by about a year, studies show.
Risk factors for earlier mortality with Parkinson’s include:
Being diagnosed before age 70
Having cognitive impairment early in the disease
Developing Parkinson’s dementia
People with Parkinson’s don’t die from the disease itself, but from associated complications, such as infections (especially pneumonia) or injuries (often related to falls). Cardiovascular disease is another common cause of death.
Treatments and lifestyle improvements, can help forestall cognitive decline, lower your risk of falls and strengthen your cardiovascular system. These can help improve your quality of life and, by slowing progression of the illness, potentially keep you living longer.
Researchers are continuing to explore new treatments that they hope will one day lead to better therapies for Parkinson’s, which will result in an improved prognosis.
