Parkinson’s progression: Signs, symptoms, and management
Last updated Aug. 1, 2025, by Marisa Wexler, MS
Fact-checked by Ana de Barros, PhD
Parkinson’s disease is a progressive brain disorder. Parkinson’s symptoms usually begin gradually and worsen over time. While everyone with the disease experiences decline, Parkinson’s progression varies greatly.
How Parkinson’s progresses
Parkinson’s is caused by the death and dysfunction of brain cells that are responsible for making dopamine. Dopamine is a chemical messenger that helps to control movement, cognition, and other bodily processes. Over time, more brain cells become damaged and die, disrupting dopamine signaling and driving Parkinson’s symptom progression.
The progression of Parkinson’s disease is often divided into five stages.
- Stage 1, the earliest stage, is marked by mild symptoms that don’t usually cause disruptive problems in day-to-day life; motor symptoms usually affect only one side of the body.
- Stage 2 is marked by symptoms that can make some day-to-day tasks more difficult, but that usually don’t interfere with most aspects of life; motor symptoms affect both sides of the body and/or the middle of the body.
- Stage 3, the middle stage, is defined by problems with balance; generally there is mild-to-moderate disability that can make daily activities difficult or impossible to do without help, though people can usually still live independently.
- Stage 4 is marked by severe disability that makes it unsafe to live alone and requires considerable day-to-day help; walking may be possible, but a mobility device like a cane or walker may be needed.
- Stage 5, the last stage, is marked by a need for around-the-clock care and severe mobility impairment to the point of being bedridden or needing to use a wheelchair to get around.
Although these five stages are a general explanation of Parkinson’s progression, everyone’s experience is unique. How long each stage lasts and what it involves can vary substantially.
How fast does Parkinson’s progress?
Because there is so much variability in Parkinson’s progression, it is difficult to predict how fast Parkinson’s progresses as the rate is influenced by age, additional health issues, and other factors, many of which still aren’t fully understood.
While there’s considerable variability in Parkinson’s progression, a general rule of thumb is that someone diagnosed with Parkinson’s disease is in the middle stage of the disease, which is characterized by trouble with balance and falls, about 10 years after diagnosis, and in the late-stage Parkinson’s about 20 years after a diagnosis.
Signs and symptoms of Parkinson’s progression
Parkinson’s is marked by motor symptoms, as well as nonmotor symptoms and cognitive changes. As the disease progresses, all of these symptoms may worsen, though the specifics of Parkinson’s symptom progression vary significantly from person to person.
Motor symptoms
Parkinson’s is defined by motor symptoms including:
- tremor
- slowed movements (bradykinesia)
- rigidity
- problems with balance.
Parkinson’s disease is only diagnosed when disease-typical motor symptoms are present. This is why the earliest stages of Parkinson’s disease coincide with the first appearance of motor symptoms.
Usually symptoms start off mild and affect only one side of the body. They gradually become more severe and spread to affect the whole body.
Early symptoms of Parkinson’s may include tremor, rigidity, and bradykinesia. Balance issues affect almost everyone with Parkinson’s, but they usually don’t develop until later on toward the middle stage of the disease.
In the later stages of Parkinson’s, motor symptoms become significantly disabling, making it difficult or impossible for people with the disease to get around and do day-to-day tasks on their own.
Nonmotor symptoms
Although a diagnosis of Parkinson’s is not made until there are noticeable motor symptoms, it’s very common for nonmotor symptoms to develop before then.
Early signs of Parkinson’s such as constipation, sleep disturbances, loss of smell, and depression can be present years or even decades before motor symptoms.
As motor symptoms start and progress, existing nonmotor symptoms tend to worsen and new ones often appear. It’s common for problems like fatigue, urinary issues, and orthostatic hypotension (a drop in blood pressure upon standing) to develop and then worsen in the years after the first motor symptoms .
Cognitive changes
Most people with Parkinson’s disease experience issues with cognition such as trouble with memory. Commonly, mild cognitive impairment will start a few years after motor symptoms.
Over time, cognitive symptoms tend to worsen. After a decade or two, most people with Parkinson’s develop dementia, which causes serious problems with memory and daily functioning.
Self-tracking and monitoring
It is often helpful to monitor the severity of your Parkinson’s symptoms and changes in symptoms as the disease progresses. This can help facilitate productive discussions with your healthcare providers and make it easier to identify when more support may be needed.
Monitoring how symptoms change when taking specific Parkinson’s treatments can also be helpful.
A common way to track and monitor symptoms is by keeping a diary to record your daily experiences. In recent years, there has also been an increasing use of tools like smartphone apps to help with monitoring Parkinson’s symptoms.
Tips for managing Parkinson’s at home
Living with Parkinson’s can pose challenges, including often needing to make adaptations to help with navigating daily life with the disease. Some tips for managing Parkinson’s include:
- taking all medications as directed by your healthcare providers
- eating a well-balanced diet, staying hydrated, and getting regular exercise
- making adaptations to your home, such as removing tripping hazards, improving lighting, and installing grab bars and handrails
- taking advantage of aids to make tasks easier; this can include everything from dressing aids and adaptive utensils to raised toilet seats and shower chairs
- doing mentally engaging activities like puzzles, reading, and learning new skills to support cognitive well-being
- following a consistent sleep schedule
- communicating clearly with your healthcare providers, friends, and family members about what is and isn’t working
- asking for help whenever it’s needed.
When to seek medical help
It’s important that you stay in regular contact with your healthcare providers who specialize in Parkinson’s, and to reach out promptly if you or a loved one notice new symptoms, worsening of existing problems, or difficulties that interfere with daily life.
Timely communication helps ensure that your treatment is adjusted as soon as possible and that you’re given access to additional support when needed.
Parkinson’s News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.
