What is Parkinson's Disease?
PD is a slowly progressive neurologic condition, which affects 4 main areas of nervous system function.
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Motor control: How we move.
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Mood and cognition: How we feel, think, process the world and behave.
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Autonomic control: Semi-automatic or automatic aspects of nervous system control, such as swallowing, bladder, bowel and blood pressure control.
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Sleep: How we rest.
For more information on how Parkinson’s may affect these areas of neurologic function please click here.
To simplify things, clinicians often compress symptom descriptors into motor and non-motor, where motor symptoms refer to physical changes, and non-motor symptoms refer to changes in mood and cognition, autonomic control and sleep. We’ll use this terminology through the website.
Parkinson’s symptoms change slowly over time, usually over months to years, and different symptoms may emerge at varying times after diagnosis. Whilst every individual’s experience of their Parkinson’s disease is unique, the order in which different kinds of symptoms may emerge is well understood. These ‘milestones’ tend
to be fairly consistent across individuals.
How quickly people travel through these clinical milestones can vary considerably. Some people living with PD will progress faster than others, some people may find specific symptoms more troublesome at different stages than others, so it's important to remember that information provided here is of a general nature only, and is not intended with predictive or prognostic value.
Nevertheless, as clinicians, natural history information helps us to understand when specific interventions may be helpful.
As clients, this can help to know where focusing your mental and physical energies may be most beneficial.
As carers we hope this will make supporting your partner as well as yourself a little easier.
How do Parkinson’s symptoms change over time?
For historical reasons, PD stages have been defined in the medical literature based on motor symptoms, and information on this website has been laid out in keeping with this.
Early PD generally relates to the first 5-10 years. This is when control of motor symptoms are generally fairly reliable on lower dose medication regimens.
Mid-stage PD generally relates to a period somewhere between 5 - 15 years of diagnosis, where control of motor symptoms with medication becomes more inconsistent or unreliable.
Later PD refers to a stage generally beginning somewhere between 10-20+years post diagnosis where motor symptoms emerge that are less responsive to medication.
Different types of non-motor symptoms are more or less prominent in different stages, and these are addressed in the individual sections. We have deliberately chosen overlapping periods when explaining the natural history of PD, firstly to acknowledge that there is variability in progression between individuals, but also to note that progression in different domains of Parkinson’s may vary. For example, at 14 years, motor symptoms will remain the dominant concern for some patients, whereas non-motor concerns may be a major focus for others.
Please remember that information provided on this website is of a general nature only and in no way intended as clinical advice. Optimising and individualising treatment of any individual is exclusively the domain of you and your treating clinicians.
My Exercise Journey
Exercise is one of the cornerstones of therapy for Parkinson’s disease. This is based on strong medical evidence confirming efficacy from both a physical and mental perspective.