There are several stages of Parkinson’s disease, which doctors use to track its progression. However, the condition affects individuals differently, and not everyone will experience the same symptoms of Parkinson’s, nor at the same time. Parkinson’s is a progressive condition, meaning symptoms tend to worsen gradually, new symptoms may develop, and disabilities can accumulate over time.

Understanding the stage of Parkinson’s can help you plan care and anticipate future needs for yourself or your loved one diagnosed with the condition.

The Stages of Parkinson’s

The stages of Parkinson’s are measured using the Hoehn and Yahr scale, first introduced in 1967. This scale was later updated to include stages 1.5 and 2.5 to reflect intermediate disease progression. It primarily focuses on motor symptoms, such as tremors, bradykinesia (slowness of movement), and loss of balance.

Another tool some doctors use is the Unified Parkinson’s Disease Rating Scale (UPDRS). This scale considers not only movement symptoms but also nonmotor Parkinson’s symptoms such as changes in mood, cognitive abilities (e.g., thinking, remembering), and social behavior.

Stage 1

At stage 1, motor symptoms typically affect only one side of the body. These symptoms are mild and generally do not interfere with daily activities. People may notice subtle changes in posture, walking, or facial expressions. Disability is minimal or absent, and most people can continue their regular routines.

Stage 1.5

In stage 1.5, motor symptoms still primarily affect one side of the body. However, there may also be involvement of the midline — parts of the body between the head and pelvis — leading to issues with posture or balance. These changes are still mild and may not significantly impact daily activities.

Stage 2

At stage 2, motor symptoms start affecting both sides of the body or the midline. People may experience more noticeable changes in posture, facial expressions, or voice, and walking may become more difficult. While daily tasks like dressing or eating take longer, balance is generally maintained. People in stage 2 can still live independently, but activities become increasingly challenging.

Stage 2.5

In stage 2.5, motor symptoms affect both sides of the body. Balance may begin to be affected, but individuals can still recover normally during a pull test (where a doctor pulls back on the person's shoulders to assess stability). Although mild issues with stability may start to emerge, many people at this stage remain able to manage daily tasks independently with minimal assistance.

Stage 3

Stage 3 is the middle stage of Parkinson’s. Loss of balance becomes a key concern, making falls more common, particularly during activities such as turning or standing. Motor symptoms significantly interfere with daily tasks such as eating, dressing, and personal care. While disability is considered mild to moderate, most people can still live independently, although they may require occasional assistance.

Stage 4

By stage 4, symptoms are more severe and disabling. People may still be able to stand and walk, but they often need a cane or walker for support. Significant help is needed for personal care and most daily activities, making it difficult or unsafe for people to live alone without assistance.

Stage 5

Stage 5 is the most advanced and debilitating stage of Parkinson’s. Stiffness in the legs may make standing or walking without help impossible, and individuals are often bedridden or require a wheelchair. Round-the-clock care is necessary for all activities, and some individuals may experience additional symptoms, such as hallucinations or delusions.

Another View of Parkinson’s Progression

A newer theory called Braak’s hypothesis suggests that Parkinson’s disease may begin years before motor symptoms appear, with the spread of alpha-synuclein protein playing a key role in disease progression. Early signs, such as loss of smell or digestive issues like constipation, may emerge long before movement problems. While these early symptoms are not yet part of the official staging system, ongoing research is focused on understanding and detecting them earlier. This may help enable earlier intervention, even before stage 1.

Are There Ways To Slow Parkinson’s Progression?

While Parkinson’s disease cannot be cured, certain lifestyle changes may help improve both motor and nonmotor symptoms, contributing to better overall well-being. Regular physical exercise has been shown to benefit symptom management and improve quality of life. Although exercise does not directly slow disease progression, it can help delay the onset of disability.

A healthy diet, like the Mediterranean diet or Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet, can support brain health and help manage symptoms like constipation, though its role in slowing disease progression remains under study. Eating nutrient-rich foods may help address some nonmotor symptoms, such as fatigue or digestive issues.

Medications like levodopa and dopamine agonists are essential for managing motor symptoms, but they do not alter the underlying progression of the disease. However, combining medication with lifestyle changes provides a holistic approach to maintaining quality of life. Regular doctor visits are crucial for monitoring symptoms and adjusting treatment plans as needed​​​.

Talk to Your Doctor

Parkinson’s is a progressive disease, and while it affects each person differently, regular communication with you or your loved one’s doctor is essential. Tracking the progression of symptoms and discussing any new or worsening signs can help your health care team adjust treatments to provide the best possible care.

By staying proactive and addressing changes early, you can manage symptoms more effectively and maintain a higher quality of life. Don’t hesitate to share all symptoms, even those that may seem unrelated, as they can provide valuable insights into your overall well-being.

Find Your Team

MyParkinsonsTeam is the social network for people with Parkinson’s disease and their loved ones. On MyParkinsonsTeam, more than 105,000 members come together to ask questions, give advice, and share their stories with others who understand life with Parkinson’s disease.

How has your or your loved one’s condition progressed? Share your experience in the comments below, or start a conversation by posting on your Activities page.