It can be challenging to tell when a loved one is developing Parkinson’s disease (PD). In this article, Ability Central addresses the early symptoms of the disease and answers common questions, including:

• What are the early warning signs of Parkinson’s disease?
• What are the early motor symptoms of Parkinson’s?
• How does Parkinson’s affect speech patterns?
• What non-motor and mental changes often accompany Parkinson’s disease?
• What other physical changes accompany Parkinson’s?
• What is young-onset Parkinson’s disease?
• How is Parkinson’s diagnosed?
• Where can I get more information about Parkinson’s disease?

What are the early warning signs of Parkinson’s disease?

The ten early signs of Parkinson’s are:

• Tremors
• Small handwriting
• Loss of smell (which may also affect the sense of taste)
• Trouble sleeping
• Trouble moving or walking
• Constipation
• A low or soft voice
• Masked face
• Dizziness or fainting
• Stooping or hunching over

The individual symptoms are not a cause for concern, but when several co-exist, it may warrant a doctor’s visit.

Let’s break down these early symptoms to better understand what Parkinson’s looks like in a person.

What are the early motor symptoms of Parkinson’s?

Motor symptoms involve movement. They are often the first sign that other people notice. The three "cardinal" motor symptoms of PD are:

• Muscle stiffness. 
• Dystonias, involuntary muscle twisting and spasms that cause cramping, abnormal posture, and stiffness.
• Decrease in voluntary movement like slower walking, less arm swinging while walking, or decreased blinking.
• A rhythmic, involuntary shaking in a finger, hand, or limb referred to as resting tremor.

The slowed movements and stiffness of Parkinson’s disease may cause a hunched-over or stooped stance as the disease progresses. 

According to the Michael J Fox Foundation for Parkinson’s Research, “not everyone with Parkinson's experiences all three motor symptoms, but slowness always is present. And although tremor is the most common symptom at diagnosis, not everyone with Parkinson's has tremor.”

How does Parkinson’s affect speech patterns?

People with Parkinson’s may speak softly or quickly, slur their speech, or hesitate before talking. In addition, there may be a loss of the normal variation in volume and emotion in the voice. 

In more advanced Parkinson’s:

• Speech may become rapid.
• Words may crowd together.
• Stuttering may occur.

What non-motor and mental changes often accompany Parkinson’s disease?

Beyond speech changes and motor changes, people with Parkinson’s disease may experience mental and non-motor changes, including:

• Cognitive changes like problems with thinking or lack of sound judgment.
• Mood changes, including apathy, depression, or psychosis.
• Autonomic dysfunction, also called dysautonomia or AD. In AD, the autonomic nervous system, which controls “automatic” things like breathing, blood circulation, and digestion, stops working the way it should. People can develop dysautonomia due to nerve damage from diseases like Parkinson’s and some forms of epilepsy. AD symptoms include constipation, low blood pressure, sexual problems, sweating problems, and urination issues.

What other physical changes accompany Parkinson’s?

In addition to speech, motor, and mental changes, people with Parkinson’s may experience physical changes like:

• Drooling
• Eye and vision issues
• Excessive daytime sleepiness or fatigue
• Pain or discomfort in one body part or the entire body
• A consistent serious, depressed, or mad look on the face (referred to as facial masking) 
• Skin changes such as oily skin, dry skin, and an increased risk of melanoma (skin cancer)
• Sleep problems including difficulty falling or staying asleep, restless leg syndrome, or REM sleep behavior disorder

What is young-onset Parkinson’s disease?

Early-onset Parkinson’s, also known as young-onset Parkinson’s disease (YOPD), is when Parkinson’s is diagnosed in someone who is 21-50 years old. 

People with YOPD generally experience the same symptoms as people diagnosed with PD later in life, although progression of symptoms is usually slower in younger people. This is because young people’s bodies tend to have less general health problems and more success in physical therapy. 

Depending on a person’s age and symptom progression, they may experience differences between Parkinson’s disease and young-onset Parkinson’s disease. Compared to people with idiopathic (typical) PD, people with YOPD typically experience:

• More issues with involuntary movements as a side effect of commonly prescribed Parkinson’s medications. 
• Less issues with balance, memory loss, dementia, and confusion.
• Earlier appearance of dystonias like arching feet, “clawed” hands, or strained vocal cords. 

How is Parkinson’s diagnosed?

Many medical conditions mimic or can be misdiagnosed as Parkinson’s, including dyskinesia, dystonia, Lewy body dementia, and multiple system atrophy. If you have several symptoms associated with Parkinson's disease, contact a medical professional to rule out other muscular and neurological conditions. 

There are currently no blood or laboratory tests to diagnose non-genetic cases of Parkinson’s. Doctors rely on medical history and both physical and neurological exams to diagnose PD. 

Because Parkinson’s has no concrete cause, doctors often use their best judgment based on the symptoms they observe to make recommendations for care, like starting or stopping a medication. If someone’s symptoms improve after starting PD medications, that can be another indicator that they have Parkinson’s.

Use the Ability Central Service Locator tool to find a nonprofit near you offering assistance with movement disorders like Parkinson’s. These organizations can connect you with doctors, specialists, funding, research, clinical trials, and more. 

Where can I get more information about Parkinson’s disease?

To learn more about Parkinson’s, see:

• What You Need to Know About Your Parkinson's Disease Diagnosis
• Long-term Care for Parkinson’s Disease (PD): Finances, Treatment, and Your Options 
• Parkinson’s Disease Fact Sheet: Symptoms, Stages, and Statistics