The five stages of Parkinson’s disease

Parkinson’s disease (PD) affects everyone differently. The disease doesn’t always move in a straight line and it can be tricky to predict exactly how it will progress. Symptoms can vary significantly from person to person, as can the severity of symptoms and the rate of progression. 

Nevertheless, there are some general patterns of progression that PD tends to follow. The progression of the disease can be loosely broken down into the following five stages [1]

Stage One

Tremors and other movement symptoms start to develop during the early stages of PD, typically affecting just one side of the body. Symptoms tend to be mild and generally have little impact on day-to-day life, although close family and friends may notice some changes in posture, walking behavior and facial expressions. 

Stage Two

Symptoms begin to worsen. Tremors, stiffness and other movement symptoms may become more noticeable as they start to affect both sides of the body. Walking gets more difficult and posture changes can become more apparent. Completing daily routines may take more time than usual.

Stage Three

Stage Three is characterized by slowness of movement and loss of balance, both of which can increase the risk of falls. The intensity of symptoms may make it significantly more difficult to complete the activities of daily living, such as dressing and eating. 

Stage Four

Symptoms continue to get more severe. It’s possible to stand without assistance, but a helping hand or assistive device may be required to move around. Assistance is required for many of the activities of daily living and, consequently, independent living can be a challenge. 

Stage Five

The most advanced stage of PD is associated with a variety of both motor and non-motor symptoms. Severe rigidity in the legs may make it impossible to stand or walk and full-time care is required for daily activities. Psychotic symptoms such as hallucinations may develop; these symptoms are present in up to 50% of patients with PD [2]. Dementia is also common and affects about 30% of people with PD [3]


Can PD progression be stopped?

PD is a neurodegenerative disease. It causes the neurons that produce dopamine in the brain to progressively degenerate [4], this leads to reduced dopamine production. Dopamine is a chemical in the brain that affects a person’s movement (among many other things). While everyone’s timeline is different, it is a progressive disease and although there is currently no treatment to cure or halt the progression, there are effective treatments to manage the symptoms. 

Some types of medication, for example, increase or substitute dopamine to help manage symptoms related to walking, movement and tremors. In addition to medication, some lifestyle factors may also play a role in managing the symptoms of PD, including:


A balanced, nutritious diet is good for your general health and may also help alleviate some of the non-movement-related symptoms of PD. For example, eating more dietary fiber and drinking more fluids may assist in easing constipation and help counteract the dehydrating effects of some PD medications. 


Regular exercise improves muscle strength, coordination, balance and flexibility – all of which may help in reducing the risk of falling. An estimated 45% to 68% of people with PD will fall each year [5]

Researchers are still exploring whether regular exercise can potentially change the progression of PD over the long term. In a 2022 study published in Neurology [6], researchers found that patients with early-stage PD who engaged in four hours of moderate to vigorous exercise each week had a slower decline in balancing and walking compared to those who exercised less frequently. 

More research is needed to better understand the link between exercise and PD symptom management. 


How does Neptune help?

PD is unpredictable and individualistic. The disease does not progress linearly, not everyone will experience the same symptoms or the same intensity of symptoms, and a treatment plan that works well for one person may not necessarily yield the same results for another. However, tracking the progression of PD and continuously delivering the level of personalized treatment needed to optimize symptom control can be challenging – particularly with the limited visibility physicians have of patients between consultations.

That’s where Neptune comes in. Neptune uses the power of sensor and AI technologies to offer continuous and objective motor state insights to enable treatment personalization. Neptune additionally offers medication reminders and a means to track subjective feedback and diary entries. Altogether, people living with Parkinson’s and their loved ones can leverage both the objective and subjective insights to create better dialogue between doctor visits. Doctors, on the other hand, can use these insights to gain better visibility of a patient in-between appointments and be empowered to personalize treatment regimens. 

Ultimately, people living with Parkinson’s can receive the right treatment regime to better manage their symptoms and enjoy a better quality of life. To see how Neptune works, click the link here. To keep up to date with the latest developments, sign up to the Orbit newsletter.




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