Written by Cherilyn Cecchini, MD | Reviewed by Katie E. Golden, MDPublished on August 25, 2022
Key takeaways:
- Parkinson’s disease symptoms can be subtle in the early stages of the condition. They include stiffness, loss of smell, trouble sleeping, and constipation.
- As Parkinson’s disease progresses, many of the movement symptoms become more apparent. This includes an uncontrollable tremor, difficulty walking, and loss of facial expression.
- Some people are more likely to develop Parkinson’s disease based on their genes and their environment. But it tends to affect people older than 65 years of age.
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Parkinson’s disease (PD) is a type of movement disorder that is caused by a lack of dopamine in the brain. PD develops when a special type of brain cell that produces dopamine starts to die.
PD is a progressive disorder, meaning that it steadily gets worse as the number of these brain cells decreases. This also means that the earliest symptoms can be subtle. And so many people are not diagnosed with PD until their symptoms get worse with time.
If you’re worried that you or someone you know has PD — you’re not alone. It can be hard to know if someone’s symptoms are truly PD or if they’re something else. We’ll discuss 11 early signs and symptoms of PD. This way you know when to see a provider to find out what’s going on.
Who is at risk for Parkinson’s disease?
Scientists are still trying to understand what puts someone at higher risk for PD. But they know that the following factors play a role:
- Age: This is the biggest risk factor for developing PD. In most cases, PD is diagnosed when someone is over 65 years old. But people younger than 50 can still develop PD. Experts think that when a younger person develops PD, it’s more likely because of their genetics.
- Genetics: Scientists believe that genes that someone inherits from their parents cause up to 15% of PD cases. And a smaller number of those are due to specific genetic mutations. But the data is still limited. Even though genetics plays a role, most cases of PD do not run in the family. And even when they do, genetics probably isn’t the only reason that someone gets PD.
- Environment: Exposure to toxins in the environment may also play a role in PD risk. These include pesticides, cyanide, herbicides, methanol, and carbon disulfide. People are more likely to be exposed to these chemicals if they live in a rural area, drink well water, or work in agriculture. But just like genetics, exposure to these toxins is likely not the only reason a person develops PD.
- Lifestyle: Research shows that cigarette smoking and caffeine intake may actually protect someone against developing PD. But other health risks associated with these may outweigh the potential benefits.
Researchers are not sure how these risk factors interact with each other. But it’s clear that no one develops PD from one factor alone. Instead, a combination of these factors likely increases or decreases the likelihood that a person gets PD.
11 early signs and symptoms of Parkinson’s disease
Early symptoms of Parkinson’s disease aren’t always noticeable — even for the person with the condition. And what PD looks like for one person may be different from what it looks like for another person.
It’s also helpful to remember that if someone develops these signs, it does not necessarily mean they have PD. Some of these are very common symptoms, with much more likely causes than PD. PD symptoms start slowly and progressively get worse over long periods of time. But this can take months or even years. So, in many cases, the diagnosis takes time.
Here are 11 of the most common early signs and symptoms of PD.
1. Tremor
Shaking in the hand, arm, foot, or leg is a common PD symptom. It’s usually more noticeable when someone is at rest, and it gets better with movement. And it usually starts on just one side of the body, but over time it can affect both sides.
2. Small handwriting
A person with PD may notice that their handwriting looks different. The letters may seem smaller than usual, and the words may seem closer together.
3. Stiffness and difficulty walking
Muscle and joint stiffness can be early signs of PD. Some people may swing their arms less than usual when walking. Over time they may develop a “shuffling gait.” That means they have trouble lifting their foot off the ground and taking a full step.
4. Trouble sleeping
PD can cause sudden movements, like jerking, when a person is in deep sleep. And difficulty staying asleep may also be a sign. They may get up frequently to use the bathroom. Or they may have pain or restlessness in their legs that improves only if they move around. These sleep symptoms may also lead to falling asleep in the middle of the day without meaning to.
5. Changes in voice
Someone with PD may start to speak in a softer or lower voice. They may also mumble, stutter, or have trouble articulating their words.
6. Constipation
Constipation is a very common symptom that many Americans experience. But one of the early symptoms of PD is difficulty moving your bowel or having to strain to pass a bowel movement.
7. Bladder problems
This is another common symptom with more likely causes than PD. But people with PD can feel like they have an overactive bladder. They may have to get up frequently to pee or experience unexpected urgency.
8. Loss of smell
Experts believe the loss of smell may be one of the earliest signs of PD. And it can start years before any of the movement symptoms start.
9. Inability to make facial expressions
Another term for the inability to make facial expressions is a “masked face.” It describes the way some people with PD have a harder time expressing joy or laughter with their facial expressions. They may look like they are upset, mad, or serious even when they’re in a good mood.
10. Hunching over
Stooping, slouching, or leaning when standing can all be early signs of PD. Someone may also have trouble balancing and maintaining their posture.
11. Rigidity or slow movements
Someone with PD may start to slow down their everyday movements. For example, it may take someone much longer to button their shirt or tie their shoes.
How long can you have Parkinson’s without knowing?
Since PD symptoms are different from person to person, it’s possible that someone can live for several years before realizing they have the disease. Many people are not diagnosed until the later stages of the condition.
When should you see a doctor about possible Parkinson’s?
If you or a loved one is experiencing one or more of the above symptoms, it’s never too early to talk to your doctor. That’s especially true if a symptom is worrying you or interfering with your day-to-day life.
It can be scary to address these concerns or face the possibility of PD. But remember, there are many different explanations for the symptoms above. So whether or not PD is causing them, your provider can help you figure out what’s going on.
Can you cure PD if you catch it early?
There’s no cure for PD. But that doesn’t mean there’s no treatment. There are many medications and treatments that can help people with PD live a long and healthy life.
The bottom line
It can be difficult to know if someone’s symptoms are the early signs of Parkinson’s disease. But if you or someone you know feels “off,” and the symptoms do not seem to be getting any better, don’t let your worry get the best of you. Talk to your provider about your concerns. They can guide you through the next steps in diagnosis to help you figure out what it’s going on.
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