11 Symptoms That Could Be Early Signs of Parkinson’s Disease
Key takeaways:
The early signs of Parkinson’s disease can be subtle. These are often called “non-motor” symptoms and may include loss of smell, constipation, trouble sleeping, and change in bladder habits.
Many early symptoms of Parkinson’s start years before the more noticeable “motor” symptoms. Tremors, difficulty walking, and muscle rigidity usually develop later in the disease.
Some people are more likely to develop Parkinson’s disease because of their genes or their environment. But in general, it tends to affect people over the age of 65.
Table of contents
Some of the most recognizable symptoms of Parkinson’s disease are the ones that affect movement. These are referred to as “motor” symptoms and include tremors, slow and rigid movements, and difficulty walking. But these symptoms tend to develop in the later stages of the disease.
Some of the earliest signs can be subtle, and are usually referred to as “non-motor” symptoms. That’s why many people aren’t diagnosed until the later stages of Parkinson’s disease.
The following list starts with some of the earliest symptoms and then walks through a typical progression of some of the later symptoms. Everyone’s experience is different, so later symptoms are included to show how the condition might develop.
1. Loss of smell
Experts believe that loss of smell may be one of the earliest signs of Parkinson’s. It can start years before any of the more recognizable motor symptoms begin. By the time they’re diagnosed, the majority of people with Parkinson’s report a noticeable loss of smell.
2. Constipation
Constipation is a very common issue for many people — and it can happen for many different reasons. But trouble having a bowel movement or needing to strain is also an early symptom of Parkinson’s. That’s because Parkinson’s affects your nervous system, which plays an important role in digestion.
3. Bladder problems
Like constipation, changes in bladder function are also common in adults. The nervous system plays an important role in bladder function, too. People with Parkinson’s often feel like they have an overactive bladder. They may need to pee often, or they may feel a strong, sudden urge to go (urinary urgency).
How is Parkinson’s disease diagnosed? Learn why diagnosing Parkinson’s isn’t always a straightforward process. It can take some time.
Who treats Parkinson’s disease? A treatment team usually includes a few different types of healthcare professionals. But the journey typically starts with a primary care provider.
How quickly does Parkinson’s progress? The progression of Parkinson’s can vary based on several factors. Learn more about the stages and what to expect over time.
4. Trouble sleeping
Parkinson’s can disrupt someone’s sleep for a few different reasons. This can be caused by:
Bladder changes that cause you to use the bathroom more often
Sudden movements, like jerking, during deep sleep
Pain or restlessness in your legs that gets better when you move around
These sleep disruptions may also lead to increased daytime sleepiness or taking more naps in the middle of the day.
5. Dizziness
A condition called orthostatic hypotension can cause dizziness when someone changes position, like standing up. It can happen for many different reasons, but it’s also relatively common in early Parkinson’s disease. This is related to the way Parkinson’s affects the nerves that control blood pressure. When someone with orthostatic hypotension stands up, their blood pressure drops temporarily. This can make them feel dizzy or even pass out.
6. Slow movements
One of the first motor symptoms in Parkinson’s is general slowness. This is called “bradykinesia.” This may be difficult for someone to describe at first. It may just feel like weakness or tiredness. It may also feel harder to start moving.
In the arms, a person might notice it’s hard to coordinate movement in their hands. They may have difficulty with:
Buttoning shirts or zippering jackets
Tying shoelaces
Typing on a phone or computer
Writing by hand, including handwriting that may start to appear smaller
In the legs, a person might notice:
Difficulty getting out of a chair
A shorter stride when walking
A feeling of unsteadiness
7. Stiffness and rigidity
Muscle and joint stiffness can also be early motor signs of Parkinson’s. Some people may feel this as inflexibility, tightness, or even muscle cramps. But these motor symptoms will become more noticeable with time. This may be even more noticeable while walking.
For example, it can lead to:
Decreased arm swing when walking
A “shuffling gait,” where it’s hard to lift your feet off the ground or take full steps
A stooped-over appearance when walking
As Parkinson’s progresses, changes in posture become easier to see. It can look like stooping, slouching, or leaning when standing. This may also lead to problems with balance and increased falls.
8. Tremor
Shaking is one of the hallmark motor symptoms of Parkinson’s. Tremors often affect your:
Hand
Arm
Foot
Leg
The classic Parkinson’s tremor is described as a “pill-rolling” tremor in the hand. It’s a small, circular tremor that looks like someone is drawing small circles with their hand. This tremor is usually more noticeable when the person is resting and is less noticeable with movement.
Most Parkinson’s tremors start on just one side of your body, but over time they may affect both sides. Not everyone with Parkinson’s will develop the classic pill-rolling tremor. While most people with Parkinson’s have some type of tremor, it can look different from person to person.
9. Changes in voice
Parkinson’s disease affects many different muscles in your body, including ones that help you speak. A person with Parkinson’s may begin to speak more softly or in a lower voice. They may also mumble, stutter, or have trouble saying their words clearly.
10. Masked face or inability to make facial expressions
Parkinson’s also affects the muscles in your face. This can make it harder to form facial expressions, sometimes referred to as “masked face.” It means that someone with Parkinson’s may have a harder time expressing joy or laughter on their face. They may look like they’re upset, mad, or serious — even when they’re in a good mood.
11. Depression and anxiety
Changes in mood can happen in both early and late stages of Parkinson’s. In particular, depression can be underdiagnosed and undertreated in people with the condition. But about one in three people with Parkinson’s experience depression.
Other common mental health symptoms include:
Decreased interest in activities
Decreased motivation
Low mood
Anxiety
Trouble concentrating
Difficulty with planning
In the later stages of Parkinson’s, people can also develop hallucinations (seeing or hearing things that aren’t there) or delusions (believing things that aren’t true). Others can start to develop dementia, but memory changes tend to come later in the disease.
Who is at risk for Parkinson’s disease?
Scientists are still trying to understand what raises a person’s risk for Parkinson’s disease. But they know that the following factors play a role:
Age: In most cases, Parkinson’s is diagnosed when someone is over 65 years old. But it can still develop in people younger than 50. Experts think that when someone develops Parkinson’s at a younger age, it’s more likely because of their genetics.
Genetics: Scientists believe that up to 15% of Parkinson’s cases are caused by genes passed down from parents. But even though genetics plays a role, most people with Parkinson’s don’t have a family history of the disease. Even when it does run in families, genetics are probably only part of the reason.
Environment: Exposure to toxins in the environment may also play a role in Parkinson’s risk. These include pesticides, cyanide, herbicides, methanol, and carbon disulfide. People who live in rural areas, drink well water, or work in agriculture are more likely to be exposed to these chemicals. But like genetics, toxin exposure is likely a contributor rather than the main cause.
Lifestyle: Research shows that cigarette smoking and caffeine intake may actually protect someone against developing Parkinson’s. But smoking and too much caffeine can lead to other health risks that may outweigh any potential benefits.
Researchers are still studying how all these risk factors interact with each other. But it’s clear that no one develops Parkinson’s from one factor alone. Instead, it’s likely that a mix of these factors all play a role in raising — or lowering — the risk.
Diagnosing Parkinson’s disease
Many people live with Parkinson’s symptoms for several years before they see a healthcare professional. But getting diagnosed earlier can help get you on the right treatment sooner.
If you or a loved one is experiencing one or more of the above symptoms, it’s never too early to talk to a healthcare professional. This is especially true if your symptoms are causing worry or interfering with your daily life.
If you do have Parkinson’s disease, the diagnosis can take time. This is because there isn’t one single test for the condition. The diagnosis is based on your symptoms and a physical exam. If Parkinson’s is likely, your primary care provider will likely:
Recommend blood tests and imaging tests: These tests will rule out other potential causes of your symptoms. This is because many other conditions can cause symptoms that look like Parkinson’s disease.
Refer you to a neurologist for evaluation: This is a healthcare professional who specializes in the brain and nerves. Neurologists have experience in diagnosing and treating conditions like Parkinson’s.
Is there a cure for Parkinson’s disease?
There’s no cure for Parkinson’s. But there are many treatments that can help improve symptoms and decrease the risk of complications from the disease. These can include:
Medications that reduce the motor symptoms
Medications to help with the other symptoms, like depression or constipation
Physical therapy to improve strength, coordination, and balance
Occupational therapy to help you stay independent and perform daily activities
Certain medical procedures that can help with Parkinson’s symptoms
It may feel scary to talk to someone about the possibility of having Parkinson’s. But getting diagnosed earlier can help get you the right support and treatment for your symptoms.
Frequently asked questions
Yes, Parkinson’s symptoms are different between men and women. Since Parkinson’s is more common in men, researchers still have a lot to learn about how it affects women. Based on current understanding, women are more likely to experience:
Tremors
Restless leg syndrome
Sleep Disturbances
Depression
A lower quality of life
Parkinson’s disease isn’t curable, and it gets worse over time. This is called a progressive condition. That being said, treatment and lifestyle changes can slow down the progression of symptoms.
The progression of Parkinson’s disease can be very different from person to person. Some people will have symptoms that noticeably worsen over the span of just a few years. For others, it may take decades. In general, people who develop symptoms before the age of 50 tend to have a slower progression than those diagnosed later in life.
The bottom line
It can be difficult to know if early symptoms are caused by Parkinson’s disease. But if you or someone you know feels “off” and the symptoms don’t seem to get any better, don’t let your worry get the best of you. Talk to a healthcare professional about your concerns. They can help you figure out what’s going on and guide you through the next steps in diagnosis.
Why trust our experts?
References
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Haehner, A., et al. (2011). Olfactory loss in Parkinson’s disease. Parkinson’s Disease.
Hiorth, Y. H., et al. (2019). Orthostatic hypotension in Parkinson disease. Neurology.
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