The movement symptoms of Parkinson’s disease — shaking, slowed movement, poor balance and muscle stiffness — can improve with medication or surgery, but the disease worsens over time, and no cure is currently available. The non-movement symptoms, while to some extent treatable, can also significantly impact a person’s quality of life. Parkinson’s disease is not fatal, but it does carry an increased risk of death, and a variety of complications occur as the disease progresses.
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Years before the movement problems begin, a person with Parkinson’s disease may experience a variety of symptoms. Examples include constipation, decreased sense of smell, pain, fatigue and depression. Sleep problems are also common, such as excessive daytime sleepiness and REM sleep behavior disorder, in which a person acts out vivid or frightening dreams.
Early Movement Symptoms and Progression
The initial movement symptoms of Parkinson’s disease can differ from one person to another. People who have stiffness and slowed movement as their most prominent symptoms at the time of diagnosis can have a faster progression of disease than those whose first symptom is tremor. Older age when symptoms begin also predicts a faster progression of movement symptoms. In people for whom poor balance is a problem, falls can be a major risk and worsen disability at any point in the disease.
Late Movement Complications
As Parkinson’s disease progresses, medications gradually become less effective, leading to what is known as motor fluctuations. Movement symptoms gradually or suddenly return, known as “off-time,” as opposed to “on-time,” when symptoms are under better control. These “on-time” periods get shorter as the disease progresses. Another late movement complication is dyskinesia — abnormal involuntary movements — such as jerking, twisting or writhing movements, or dystonia, an abnormal tightening of muscles.
The non-movement symptoms of Parkinson’s disease can occur at any point in the disease. While some are treatable with medication or other interventions, they can have a significant impact on quality of life. Examples include problems with thinking, which, in its most severe form, is called dementia. Dementia affects 60 percent of people with Parkinson’s disease within 12 years of diagnosis, according to the February 2013 American Family Physician. Psychiatric problems are also common, ranging from depression and anxiety to hallucinations (seeing things that aren’t there). Parkinson’s disease affects sleep in many people as well. Sleep issues range from trouble falling or staying asleep to daytime “sleep attacks” and fatigue. Restless legs syndrome (an uncomfortable need to move one’s legs that is worse at night) and sleep apnea (periods in which one stops breathing at night) are also common. Pain from a variety of causes also affects people with Parkinson’s disease. Other problems include constipation, urinary and sexual problems, swallowing problems and drooling, and low blood pressure upon standing.