Parkinson’s is a progressive neurodegenerative condition most commonly seen among the ageing population. After Alzheimer’s disease, it is the second most common age-related neurodegenerative disorder. An estimated seven to 10 million people worldwide are victims of Parkinson’s. Globally, neurological disorders are now the leading source of disability and ageing is increasing the burden of neurodegenerative disorders. Parkinson’s disease is one such example. In the year 2016, 6·1 million people had Parkinson’s disease globally, compared with 2·5 million in 1990. Total number of deaths caused by this disease in the year 2016 is 211,296.The prevalence of the disease varies according to age. It ranges from 41 people per 1 lakh among people in their forties to more than 1,900 people per 1 lakh among those who are eighth decade of life and older. According to several surveys conducted on this disease, men are 1.5 times more prone to have Parkinson’s than women.

Although Parkinson’s disease (PD) is progressive in nature and worsens over time, it is highly individual and affects people differently. Not everyone who has Parkinson’s disease will experience all the symptoms, and symptoms between patientsmay vary in their severity. The speed of the progression differs from people to people as well. However, physicians have distinguished definite stages that describe how the disease progresses. There are five distinctive stages that are usually seen in a person with Parkinson’s disease. These five stages are known as the Hoehn and Yahr Scale used by physicians throughout the world to classify patients in research studies.

• Stage 1: The first stage usually has mild symptoms such as tremors along one side of the body. Slight changes in walking, posture, or facial expressions may be noticed by those around them otherwise often the symptoms are mild enough not to interfere with daily life.
• Stage 2: In this stage, both sides of the body may be affected by slightly worsened tremors or rigidity. Everyday activities may get harder to achieve and issues with posture and walking may become quite noticeable but the patients are still more or less independent in this stage to do things for themselves.
• Stage 3: In the third stage of PD, with the motor symptoms becoming worse, patients may begin to experience loss of balance leading to falls and movement can become very slow. However, for many patients living independently it is still possible, but they may have difficulty in everyday activities such as eating or dressing.
• Stage 4: In this later stage, patients experience extremely limiting. With greatly impaired movement, most will need help with everyday activities and will not be able to look after themselves. There are exceptions who can still stand without assistance.
• Stage 5: At this advanced stage of the disease, most people will require a wheelchair as they experience difficulty in walking and standing. With seriously impaired motor skills, assistance will be needed in all areas of daily life. Hallucination is an additional nightmare at this stage of the disease.

Parkinson’s disease is like a doom to the ones affected and their dear ones as well. It affects patients’ quality of life in a horrible way, making social interaction more difficult and worsening their financial condition, due to the medical expenses associated with the disease.

The Writer is Dr atul Prasad Director & HOD, Neurology BLK Super Speciality Hospital, New Delhi