Parkinson’s Disease: 9 Very Early Warning Signs to Be Aware Of

Early treatment can slow the progression of symptoms and preserve quality of life for many, say experts

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Parkinson’s disease is a progressive neurological disorder that affects movement by causing the damage or death of neurons in the brain region that’s responsible for muscle control.

When assessing Parkinson’s disease, doctors distinguish between two phases: the prodromal and clinical phases. The prodromal phase is characterized by patients noticing symptoms that aren’t yet serious enough to warrant a diagnosis, while the clinical phase comes once symptoms are significant enough to justify testing to diagnose the disease.

Understanding this progressive neurological disorder is crucial because of its life-changing impact. Recognizing the different phases helps patients to identify concerning symptoms and enables doctors to diagnose the disease accurately.

Key Early Signs to Watch Out For

Tremors

Among the most common early signs of Parkinson’s disease are tremors or shaking, primarily in the hands, arms, legs, jaw, or face, Dr. Guy Schwartz, co-director of the Stony Brook Parkinson’s and Movement Disorders Center at Stony Brook Medicine, told The Epoch Times. The tremors may occur at rest or during tasks and can initially be mild, but tend to worsen over time.

Changes in Movement

Parkinson’s disease can lead to changes in movement, including limb stiffness or rigidity, which can impede daily activities such as dressing and turning in bed, Dr. Schwartz said. Additionally, individuals may experience bradykinesia, a slowing of movement, which makes simple tasks more time-consuming.

Impaired Balance and Coordination

Parkinson’s disease can disrupt one’s balance and coordination, thus increasing the likelihood of falls and related injuries. Common manifestations include a stooped posture, shuffling gait, and challenges in turning or changing direction during walking.

Loss of Smell

Anosmia, a loss of the sense of smell, is a notable early symptom of Parkinson’s disease. Individuals may struggle to detect specific odors such as those from food or flowers and may face difficulties in identifying familiar smells.

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Dr. Schwartz stressed that a clinician must identify these four cardinal signs, particularly bradykinesia, to diagnose Parkinson’s disease or a Parkinsonian symptom accurately. “The slowness is an obligatory sign; there has to be bradykinesia. Without it, one can’t be certain about the diagnosis,” he said.

However, early nonmotor symptoms can suggest the onset of Parkinson’s disease, preceding noticeable motor symptoms by several years or even decades. While there’s currently no cure for Parkinson’s, initiating treatment early can significantly enhance a patient’s function and quality of life.

Behavioral Changes

Acting Out Vivid Dreams

Some of the earliest signs of Parkinson’s disease may not be noticed by the person experiencing them but rather by friends or family members.

Dr. Schwartz explained that one of the most established early symptoms is rapid eye movement (REM) sleep behavior disorder, a sleep disorder characterized by physically acting out vivid dreams and sudden, sometimes violent, arm and leg movements during REM sleep.

However, in some cases, Dr. Schwartz added, the full account of symptoms may not be obtained due to incomplete patient history, such as when a bedmate sleeps in a separate room or is a deep sleeper.

Basic Abilities, Such as Breathing, Disrupted

Another particular symptom of Parkinson’s disease is multiple-symptom atrophy. This rare degenerative neurological disorder affects the body’s autonomic functions, such as blood pressure, breathing, digestion, and motor control.

Multiple symptom atrophy and REM sleep behavior disorder typically appear about 10 years before the onset of Parkinson’s disease, Dr. Schwartz said.

Changes in Handwriting

Handwriting changes, such as progressively smaller and cramped writing, may be an early indicator of Parkinson’s disease.

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Characterized by the gradual reduction in the size and legibility of handwriting, the condition—called micrographia—occurs because of the disease’s impact on motor control and coordination, particularly the fine motor skills required for writing.

Constipation

Constipation is another early sign to watch for. It arises as the disease interferes with the autonomic nervous system, which controls various involuntary bodily functions, including digestion.

Parkinson’s disease can affect the digestive system’s muscles, leading to a slowing of bowel movements and a decrease in the muscle contractions needed for proper digestion and elimination.

Sweating

One symptom that may not be commonly associated with a neurodegenerative condition is sweating.

“There could be some problems with sweat, regulating sweat, and a rash. These are what we call nonmotor precursors of Parkinson’s disease,” Dr. Schwartz said.

Changes in sweat regulation are caused by the autonomic dysfunction associated with the disease.

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It’s important to note that experiencing one or more of these symptoms doesn’t necessarily indicate Parkinson’s disease. Still, the symptoms could serve as early indicators, prompting the decision to consult a doctor.

Depression and Anxiety Can Occur Before Diagnosis

A 2013 study of more than 23,000 people found that those diagnosed with depression had more than three times the risk of developing Parkinson’s disease than those without it.

Another study published in 2015 observed more than 140,000 people diagnosed with depression. The condition was found to potentially serve as a prodromal symptom, a very early sign, or a contributing factor to the risk of developing Parkinson’s disease.

Anxiety disorders are also known to co-occur with Parkinson’s, with an estimated 40 percent of patients experiencing “substantial anxiety.”

Researchers also found that anxiety often emerges before the typical movement disorders associated with Parkinson’s, indicating a link to disease-related brain changes rather than psychological or social factors.

Consequences of Delaying Treatment

Delayed treatment may cause people to miss the opportunity to start medication when it’s most effective. Untreated Parkinson’s can lead to decreased mobility and difficulties in daily activities, significantly affecting one’s quality of life.

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Research published in the American Journal of Managed Care highlights the importance of early intervention for optimal outcomes in Parkinson’s disease. Clinical trials suggest that early treatment may slow disease progression and alleviate symptoms, greatly improving the patient’s quality of life.

Dr. Schwartz also emphasized the significance of early diagnosis, although it marks the beginning of a challenging neurodegenerative journey. “On the downside, [some] early-onset people would rather not know,” he said.

A Parkinson’s diagnosis can have a significant psychological impact on a person and on their social circle.

“Some patients are in denial, and that’s OK,“ Dr. Schwartz said. ”I’ve often got a kind of respect for that. Sometimes, ignorance is bliss. Some people have a burning desire to know, and it’s only fair. Some of them, you can sense that they can wait. They’ll come back in a year and revisit the diagnosis if something changes.”