Updated on January 31, 2022.
Most diagnoses of Parkinson’s disease come after age 60, but about 4 percent of diagnoses come before age 50. Regardless of the age of onset, the manifestations of the disease can be subtle. What changes might clue you in to possible Parkinson’s?
Diagnosing Parkinson’s
Some Parkinson’s disease signs are well-known, like the tremors that boxing great Muhammad Ali experienced. But Parkinson’s can start with very mild signs that appear years before a diagnosis. The disease is often difficult to diagnose in its early stages, and no blood or imaging test can confirm if someone has it.
So, how is Parkinson’s diagnosed?
For starters, a healthcare provider (HCP) will take a medical history and do a physical exam. In addition to slow body movement (also known as bradykinesia), stiffness or tremors must also be present for a diagnosis to be made. The HCP may also use a brain imaging test called SPECT that tracks the chemical dopamine in the brain.
But in order to check for Parkinson’s, your HCP needs to know to look for it. That’s where you come in. Tell your HCP if you’ve noticed any of these potential warning signs.
Possible warning signs of Parkinson’s disease:
Tremors: If one of your fingers, a hand, or your chin shakes while you’re at rest, that can signal early Parkinson’s. Tremors usually start on one side of the body. Other conditions, such as a nervous system disorder called essential tremor, can also cause shaking.
Changes in handwriting: How can your handwriting reveal if you have a disease or not? With Parkinson’s, a person's handwriting often changes, such as becoming smaller or more crowded. Just remember that stiff fingers or poor vision can also affect handwriting in people without Parkinson’s.
Rigid limbs: Stiffness in the body, arms, or legs that does not go away after you begin to move is another potential sign of Parkinson's. Take note if you’re starting to shuffle, or if you’re not swinging one of your arms as you walk. Stiffness could also occur if you have arthritis or another injury.
Loss of smell: Maybe you don’t notice the fragrance from a bouquet of flowers or you didn’t detect that you kept last week’s leftovers in the fridge a little too long. A weakened sense of smell may happen years before a Parkinson’s diagnosis. Your sense of smell can also go away for other reasons, including a cold or COVID-19, but in those cases it should return after you recover.
Changes in voice: This change often takes the form of a softer or hoarser voice. It could also be that you speak less clearly or that you need to strain to speak. Like the loss of smell, however, bear in mind that vocal changes can also happen if you’re having a respiratory infection. In that case the changes are temporary and should go back to normal once you get better.
Masking: A person with Parkinson's may sometimes appear to have their “game face” on. In other words, they may look serious or depressed or have a blank stare, sometimes hardly blinking. This occurs because the muscles of the face become stiff, making it harder to be expressive. Some medicines can also have this effect.
Disturbed sleep: People with Parkinson’s may talk or make jerky movements while sleeping, as if they are acting out their dreams. They may also have trouble turning over in bed, or have difficulty falling and staying asleep. These signs can develop before movement problems show up. Other factors besides Parkinson’s can cause sleep disturbances, too. These include certain medications, mental health problems, or poor sleep habits.
Constipation: Having fewer than three bowel movements a week is sometimes related to Parkinson’s disease, and as with some other signs, it can occur before movement problems develop. Remember that constipation can also arise from dietary problems, dehydration, and taking certain medications. If the issue doesn’t go away, it deserves medical attention.
Slouching over: A change in posture (where you are leaning over, stooping, or hunched) could be due to Parkinson’s. Injuries and bone diseases may also affect posture in the absence of Parkinson’s.
Dizziness: Do you ever feel dizzy, lightheaded, weak, or as if you are about to black out after standing up? This is typically due to a drop in blood pressure, and it may be a warning sign of Parkinson’s. Other conditions can also cause this issue, though, including heart disease, medications, or dehydration.
Don’t panic
If you’ve noticed any of these signs in yourself or a loved one, don't be alarmed. Having just one of them doesn't necessarily mean it’s Parkinson's. But if you have more than one—or if any of them is concerning you—talk with your HCP. Parkinson’s is treatable.
