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What are the 5 stages of Parkinson’s disease?

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Stage 1Stage 2Stage 3Stage 4Stage 5How quickly does it progress?Is it fatal?Summary
As Parkinson’s disease progresses through its five stages, people often experience significant changes in their physical abilities, mental well-being, and overall quality of life.
Medically reviewed by Nancy Hammond, M.D.
Written by Rashida Ruwa, RN
Updated on

Parkinson’s disease is a neurological disorder caused by the breakdown of nerve cells in the brain that produce dopamine. This lack of dopamine can lead to symptoms such as involuntary and uncontrollable movement.

Other symptoms of Parkinson’s can include:

While each person’s experience with the disease is unique, doctors often use the Hoehn and Yahr scale to classify Parkinson’s symptoms. This scale has five stages to describe how the disease progresses.

Stage 1

An image of someone grasping the wrist of their right hand to steady a tremor, whilst also holding on to a glass of water.
Daria Kulkova/Getty Images

Stage 1 is the mildest form of Parkinson’s disease, where symptoms will generally not interfere with daily activities.

The symptoms in stage 1 affect only one side of the body and may include:

  • a slight tremor
  • stiffness
  • difficulties with posture and movement

This stage may last several years, and treatment typically involves medications to manage symptoms. Examples of drugs include MAO-B inhibitors like rasagiline (Azilect) and dopamine agonists like levodopa (Sinemet) and pramipexole (Mirapex).

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Stage 2

Stage 2 is considered a moderate form of Parkinson’s. At this point, symptoms become more noticeable, and people can feel the effects on both sides of the body.

Symptoms such as tremors, stiffness, and rigidity may become more pronounced, affecting balance and coordination. Most people in this stage can still live alone, although they may find that some daily tasks are now challenging to complete.

During this stage, treatment may involve a combination of prescribed medication to improve symptoms, as well as physical therapy and speech therapy to improve mobility and communication skills.

Stage 3

At this stage, most symptoms are similar to those of stage 2. However, they become even more pronounced and may significantly affect daily activities. Symptoms such as losing balance and coordination may make walking or standing difficult, and falls may become more common. 

Some people may be able to complete their daily activities, while others may require assistance. Treatment options can include the same medications as in previous stages and occupational therapy to help with daily activities.

Stage 4

During stage 4, the symptoms of Parkinson’s disease can be severely limiting and may include the inability to walk or stand without assistance. 

Walking may be possible, but it is often very difficult, and a person may require a wheelchair, walker, or other assistive devices. Most people in this stage are unable to live alone because of a marked decrease in movement. 

Treatment options can include:

  • medications
  • occupational therapy
  • speech therapy
  • nursing care to manage symptoms and improve the quality of life

Stage 5

This is the most advanced stage of Parkinson’s disease. The person with Parkinson’s may be unable to stand or walk and may require round-the-clock care to prevent falls.

The following symptoms may be present:

Some people may experience difficulty swallowing and speaking, increasing their risk of infections such as aspiration pneumonia — inflammation or swelling of the lungs and airways.

The duration of this stage can vary widely. Treatment at this stage is focused on managing symptoms and providing palliative care to improve the quality of life and prevent complications.

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How quickly does Parkinson’s progress? 

The progression of Parkinson’s disease can vary significantly from person to person, and it is difficult to predict the exact rate of progression in each case. 

In the early stages of Parkinson’s, symptoms such as tremors, stiffness, and slow movements may be mild and not interfere significantly with daily activities. However, as the disease progresses, symptoms can become more severe and affect the person’s ability to perform daily activities.

A potential complication of Parkinson’s disease is dementia, but not every person with Parkinson’s will develop the condition. The risk of developing dementia increases as the disease progresses.

Some studies have shown that 24–50% of individuals with Parkinson’s disease will eventually develop some form of cognitive impairment.

Dementia symptoms tend to appear in the later stages of Parkinson’s disease, typically when the disease has progressed to stage 4 or 5. However, individuals may experience cognitive impairment at any point in the disease course.

Can Parkinson’s disease be fatal? 

Parkinson’s disease itself is not typically considered a fatal condition. However, some symptoms of Parkinson’s disease can lead to conditions that may be fatal.

For example, difficulty swallowing can lead to aspiration pneumonia. This can occur when the muscles used to swallow become weak or when there is difficulty coordinating swallowing movements. Aspiration pneumonia can be fatal if not promptly treated.

Additionally, falls can occur due to balance and coordination problems and can result in serious injuries such as fractures or head trauma. These injuries can be life threatening, especially in older adults.


Parkinson’s disease is a progressive neurological disorder that affects movement and can cause a wide range of symptoms. Doctors typically classify the disease into five stages, with stage 1 being the mildest and stage 5 being the most advanced.

Treatment options can include:

  • medications
  • physical therapy
  • speech therapy
  • occupational therapy

While there is currently no cure for Parkinson’s disease, ongoing research is helping to develop new treatment options and improve our understanding of the condition.

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