Stages of Parkinson’s disease
2/14/24, 6 mins reading
Hoehn & Yahr staging.
Parkinson’s disease is a chronic, progressive neurodegenerative disorder. Its patients present motor symptoms and non-motor symptoms in clinics. Based on motor dysfunctions, Dr. Margaret M. Hoehn and Dr. Melvin D. Yahr in 1967 defined 5 stages of Parkinson’s disease. Overall the extent of motor disability deteriorates as the stage advances with stage 1 being mildest and stage 5 most advanced.
Parkinson’s disease stages
Although the Hoehn and Yahr staging method has been used for decades, some flaws concerning this method need to be pointed out
The stage number is not always a real indicator of disease severity. In other words, the advanced stage doesn’t necessarily mean it is more severe than the lower stage. For example, some patients are diagnosed and defined with stage 1 Parkinson’s disease since tremors and rigidity are observed and assessed on only one hand. However, tremor and rigidity symptoms on one hand may be rather severe and way worse than stage 2 with both hands affected. In this case, it would be wise to take into consideration of overall medical condition and make an assessment based on the entirety of motor symptoms.
This method only looks into motor symptoms and omits non-motor symptoms. As a fact of the matter, non-motor symptoms such as loss of smell, and constipation occur even before motor symptoms in some cases. Assessing motor symptoms only doesn’t present a whole picture of this disorder and would provide clinicians with an incomplete evaluation of patients in terms of management. Managing non-motor symptoms such as depression, anxiety, and mood disorders has been virtually becoming a huge focus and priority for clinicians, the exclusion of non-motor symptoms would make the managing work impossible to accomplish.
Rating Scales To better assess Parkinson’s disease, clinicians are now using rating systems such as MDS-UPDRS(Movement Disorder Society-Unified Parkinson's Disease Rating Scale) to scale. MDS-UPDRS includes 4 key parts:
Movement evaluation of daily living
Movement examination
Movement complication
non-movement evaluation of daily living
Rating scales have taken into consideration of multiple factors in addition to motor disabilities including non-motor evaluation, and treatment complications. With a multitude of facets on patients with the rating scales, clinicians would be able to better evaluate the severity of PD patients and implement better managing solutions including treatments, lifestyle improvement, and patient education.