Johns Hopkins Medicine defines Parkinson's disease as a chronic brain disorder in which the brain's nerve cells slow down the production of the chemical dopamine. Dopamine is a neurotransmitter responsible for movement and balance. Hence, a decrease in the production of dopamine greatly affects a patient's movements. During the final stages of Parkinson's disease, the symptoms become more severe, and the patient may become disabled and completely dependent on a caregiver.
Tremors
According to MayoClinic.com, tremors are the characteristic sign of Parkinson's disease. The hands perform a type of pill-rolling movement in which the thumb and forefinger performs a back-and-forth rubbing against each other. Johns Hopkins Medicine further states that these tremors occur when the person is at rest. It starts with the upper extremities, but may spread to the lower extremities and even the jaw. These tremors may lessen during the middle stages of Parkinson's disease. However, Parkinson's Disease Guide reports that these tremors gradually return during the latter part of the disease in the form of action tremors, in which the tremors occur not just during rest but also during the performance of daily tasks.
Movement, Balance and Coordination Difficulties
Johns Hopkins Medicine reports that one of the major symptoms of Parkinson's disease is bradykinesia, or slowed movements. This can be very disabling as the disease progresses, until the person is no longer able to initiate voluntary movements. Even tasks of daily living can become impaired because of this. Balance and posture is also affected during the end stages of Parkinson's disease, resulting to unsteadiness in walking and a risk for falls. The patient's walking can be characterized as "shuffling," since the patient can only walk using small back and forth steps.
Speech Changes
Problems with speech are common among Parkinson's disease patients, according to MayoClinic.com. People afflicted with Parkinson's disease often speak in a very soft, monotonous tone. They also have slurred speech, which makes it difficult for them to be understood. The patient may also find it difficult to find the right words.
Dementia, Confusion and Hallucination
Towards the end stages of the disease, dementia and depression may occur, as reported by Parkinson's Disease Guide. Symptoms associated with these include insomnia, mood swings and anxiety. Patients may experience both short- and long-term memory loss. Elderly patients may have confusion and hallucinations, since these are common side effects of anticholinergic drugs used to treat Parkinson's disease.
