The stages of Parkinson’s disease will vary from person to person. Although various tables and charts exist, it’s important to keep in mind a progressive disease like Parkinson’s will be unique to the individual. With that being said, before an individual is diagnosed with Parkinson’s and begins stage one, it’s important to know the early signs and symptoms to look out for.

Signs and symptoms include:

• Resting and action tremors
• Rigidity
• Bradykinesia (slow movement)
• Standing kyphosis with flexed extremities
• Start hesitation with festinating gait (shuffling of the feet)
• Dynamic postural instability

As the disease progresses symptoms may become worse. Parkinson’s occurs in seven various stages, each with unique characteristics.

Stage of Parkinson’s	Physical Limitations	Everyday Limitations
0	No signs of disease
1	Unilateral disease	The symptom of PD at stage one may be so mild that the person doesn’t seek medical attention or the physician is unable to make a diagnosis. Symptoms at stage one may include tremor, rigidity, or slowness of movement in the arm or leg on one side of the body, or one side of the face may be affected, impacting the expression
1.5	Unilateral plus axial involvement	Movements that occur around the spine may be affected.
2	Bilateral disease, without impairment of balance	Still considered early in the disease, but now symptoms have become bilateral, or may include the midline without impairment to balance. Symptoms may include loss of facial expression on both sides of the face, decreased blinking. Speech abnormalities may be present, such as a soft voice, monotone voice or slurring speech. There may also be stiffness or rigidity in the muscles of the runk that may result in neck or back pain, stooped posture and general slowness in all ADLs.
2.5	Mild bilateral disease, with recovery on pull test	The disease affects both sides of the body but individual is able to recover with specific tests.
3	Mild to moderate bilateral disease, some postural instability, physical independent	This is considered mid stage and is characterized by a loss of balance and slowness of movement. Balance is compromised and the inability to make the rapid, automatic, and involuntary adjustments necessary to prevent falling, and falls are common at this stage. Those in stage three are still fully independent in their ADLs, such as dressing, hygiene and eating.
4	Severe disability; still able to walk or stand unassisted	The disease has progressed to a severely disabling disease. Patients with stage 4 may be able to walk and stand unassisted but they are noticeably incapacitated. Many use a walker, and the patient is unable to live an independent life and needs assistance with some activities of daily living.
5	Wheelchair bound or bedridden unless aided	This stage is characterized by confinement to a bed or wheelchair. Individuals may be unable to rise from a chair or get out of bed without help, they may have a tendency to fall when standing or turning, and they may freeze or stumble when walking. Around the clock assistance is required at this stage to reduce the risk of falling and help with all daily activities. The individual may also experience hallucinations or delusions.