In 1967, Hoehn & Yahr defined five stages of PD based on the level of clinical disability. The grading does justice to the motor symptoms but does not consider the non-motor symptoms of PD. This scale can be used for clinical purposes.
Patients mostly get diagnosed in Stage 1 or Stage 2
Stage 1:
Minimum symptoms are visible in this stage. The patients and family members start noticing some minor changes. But the patient is independent with minor difficulties.
- Tremors on one side of the body.
- Mild clumsiness.
- Stiffness of posture and mask like face.
- Slowed facial expression movement.
Stage 2:
- Tremor, rigidity and other movement symptoms affect both sides of the body.
- Walking, bathing and changing clothes take a longer time to complete.
- The back muscles become stiff.
Stage 3:
- Loss of balance and slowed movement.
- Falls become more common.
- Daily activities of living are hindered, but the patient is mostly still independent or needs mild supervision.
Stage 4:
- Movement is limited.
- Patients require assistive devices like walking cane or wheelchairs.
- They need help with daily activities of living.
Stage 5:
- Difficult or unable to stand.
- Bed-ridden or requires a wheelchair to move about.
- Difficulty Swallowing.
- Continuous nursing care is required.