Understanding Parkinson’s: symptoms, causes, and early signs

Parkinson’s is a progressive neurological condition that affects movement, as well as many other aspects of physical and mental health. According to Parkinson’s UK, Parkinson’s affects around 166,000 people in the UK, and while it is more common in older adults, it can also develop earlier in life.

Understanding the symptoms of Parkinson’s, its causes, and how it progresses can help families recognise early signs and plan the right care and support.

Insights in this guide are supported by Dr Arthur Roach, who has spent 25 years in research, discovery and development for drug companies and universities, working on projects developing new treatments for Alzheimer’s, Parkinson’s and MS.

What is Parkinson’s disease?

Parkinson’s disease is a condition that primarily affects the brain’s ability to control movement. It happens when there is a loss of dopamine-producing cells in a specific part of the brain.

Dopamine plays a key role in coordinating smooth and controlled movement. As levels decrease, symptoms gradually begin to appear and worsen over time.

What are the symptoms of Parkinson’s?

According to Stanford Medicine, the symptoms of Parkinson’s can vary widely from person to person, but they are typically grouped into motor and non-motor symptoms.

Common motor symptoms

• Tremor (often starting on one side)
• Slowness of movement (bradykinesia)
• Muscle stiffness (rigidity)
• Balance and coordination problems

Non-motor symptoms

• Sleep disturbances
• Constipation
• Loss of smell
• Anxiety and depression
• Cognitive changes.

As the condition progresses, non-motor symptoms can have a significant impact on quality of life.

Early signs of Parkinson’s

The early signs of Parkinson’s are often subtle and may be mistaken for normal ageing or other conditions.

These can include:

• A slight tremor in one hand
• Reduced facial expression
• Changes in handwriting
• Loss of smell
• Sleep problems
• Constipation

As explained by Dr Arthur Roach: “Often the first indicators of Parkinson’s might not actually be a tremor, but stiffness, a painful shoulder, sleep difficulties or constipation.”

How does Parkinson’s affect quality of life?

Parkinson’s is a complex condition that affects much more than movement.

Dr Roach explains:

“Parkinson’s is a very complex condition. The majority of Parkinson’s diagnoses are in later life, but people can develop it at a younger age. Also, some people develop symptoms rapidly, some less so – and not all people have the same symptoms.”

“In the early stages, many of the motor symptoms are reasonably well treated by the medications we have now, which work through the dopamine pathway.”

“As the condition progresses and involves more brain areas, virtually every aspect of someone’s life is affected – thinking, emotions, gastrointestinal function, constipation, urinary problems, salivation, swallowing, speech and pain.”

“These are the non-motor symptoms, and there is much less that is available to control them. By the time someone is ten years into the condition, there will be many aspects of their life that will be affected, both for them and for their family.”

“In later stages, there is often a major dementia component too, which makes care and treatment for Parkinson’s even more complex.”

Parkinson’s tremors and visible symptoms

Tremors are often the most recognisable symptom of Parkinson’s, but they are only one part of the condition.

Dr Roach explains:

“The thing that people see most easily from the outside are the motor functions – the tremor, stiffness, shuffling gait, difficulty in getting up and initiating moving – so this is what most people associate with Parkinson’s.”

“However, there are many ‘hidden’ non-motor symptoms, such as constipation, sleep difficulties, loss of smell, confusion, and later there are even more severe cognitive issues.”

What causes Parkinson’s disease?

Parkinson’s disease is caused by the gradual loss of nerve cells in a part of the brain called the substantia nigra. These cells are responsible for producing dopamine, a chemical that helps control movement and coordination.

As dopamine levels fall, the brain struggles to regulate movement properly, leading to symptoms such as tremor, stiffness, and slowness.

This process happens slowly over time, and symptoms usually begin to appear once a significant number of these cells have been lost.

Why do these nerve cells become damaged?

The exact cause of this cell loss is still unknown. However, research suggests that Parkinson’s is likely triggered by a combination of factors, including:

• Genetics: Certain genetic changes can increase the risk, although Parkinson’s is rarely directly inherited
• Environmental factors: Exposure to things like pollution or pesticides may play a role, but evidence is not yet conclusive.

In most cases, Parkinson’s develops due to a complex interaction between these factors rather than a single clear cause. For more information, read the NHS guide to the causes of Parkinson’s disease.

Parkinson’s stages and progression

Parkinson’s is a progressive condition, meaning symptoms worsen over time. While progression varies, it is often described in stages:

• Early stage: Mild symptoms, minimal impact on daily life
• Mid stage: Increased movement difficulties and non-motor symptoms
• Advanced stage: Significant physical and cognitive challenges

Not everyone will experience all stages in the same way or at the same speed.

What are the challenges for carers?

Caring for someone with Parkinson’s becomes more demanding as the condition progresses.

Dr Roach highlights:

“It’s incredibly important for the person with Parkinson’s to have the right support, and people who are understanding of the condition – and there’s a lot of education needed on everyone’s part.”

“When people are first diagnosed with Parkinson’s, their understanding is usually rudimentary, so they and their carers need to understand that many things which they might never have thought of as Parkinson’s are actually part of the condition.”

“I’ve had people tell me that for several years before they were diagnosed, their wife was scolding them, saying, ‘You walk like an old man, hurry up. You’re always the last one,’ – and they later realised this was actually the beginning of Parkinson’s.”

“It takes more and more time and effort to care for someone with Parkinson’s as the condition progresses, and they may need support as well as education.”

Parkinson’s research and future treatments

Research into Parkinson’s is advancing, with a growing focus on treatments that could slow or stop the condition.

Dr Roach explains:

“Parkinson’s is going to affect over a million people alive in the UK today, and everyone wants to see a cure – or at least a treatment that will stop or reverse it. However, those living with Parkinson’s for a number of years can see that it’s not going to come suddenly – it is something that will come in some years, and step by step.”

“In the meantime, there are symptoms of Parkinson’s – especially motor symptoms in the first five or ten years – which can be eased by certain treatments quite successfully in many cases, with existing medications.”

Lifestyle and Parkinson's

While lifestyle factors don’t directly cause Parkinson’s, they can influence how symptoms are managed.

Dr Roach notes:

“That’s an interesting area… one thing that certainly seems to be important is exercise.This could be because it’s reducing the damage or perhaps just because it is making people stronger, have better balance and be more resilient”.

“Exercise also improves people’s mood. We often hear that people with Parkinson’s who experience depression and anxiety symptoms are helped by keeping active.”

“So we know that for many reasons exercise can make a huge difference to people with Parkinson’s, but especially, it seems, exercise programmes that are vigorous – not riding a bicycle slowly for three hours, but riding it like crazy for 30 minutes, is more beneficial.

And one of the things Parkinson’s UK does is try to ensure that the right types of exercise classes are available to people with Parkinson’s everywhere in the UK”.

“Diet doesn’t seem to be a terribly strong lifestyle factor in developing Parkinson’s.”

How can Elder help?

As Parkinson’s progresses, many families start to consider how best to support their loved one, especially if they want to remain at home.

Live-in care can provide:

• One-to-one support tailored to Parkinson’s symptoms
• Help with mobility, medication, and daily routines
• Companionship and emotional support
• Continuity in a familiar environment.

At Elder, we help families find experienced carers who understand complex conditions like Parkinson’s, so your loved one can stay safe and comfortable at home.

If you would like more information about live-in care, don’t hesitate to contact one of our friendly care advisors today for an obligation-free consultation.

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