What Is Advanced Parkinson’s Disease?

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Advanced Parkinson’s disease (APD) is a late stage of Parkinson’s disease that is marked by limited mobility. Medications are used to control Parkinson’s in early stages. When these medications lose their ability to work effectively and symptoms progress, physicians classify it as advanced Parkinson’s disease.

APD usually occurs after 10 years of living with Parkinson’s, but can occur much later. Patients in this stage may require a wheelchair or other assistive devices, and they have a higher risk of falling, dementia, and other cognitive problems.

This article will discuss the symptoms, treatment, and prognosis for advanced Parkinson’s disease.

Home caregiver helping senior woman to walk

FG Trade / Getty Images

Advanced Parkinson’s Disease Symptoms

Parkinson’s disease typically occurs in adults as they age and is characterized by tremors in the hands, arms, legs, and face, as well as slow movement, poor balance, and lack of coordination.

Parkinson’s disease typically progresses in five stages. In the first three stages, symptoms are mild to moderate and less limiting to daily life. These include:

  • Tremors or shaking
  • Changes in posture, walking, and facial expression
  • Difficulty walking, talking, eating, or dressing
  • Falling

In the final two stages, when the disease has progressed to advanced Parkinson’s, the symptoms become more severe and limiting. These include:

  • Needing a walker or wheelchair to move
  • Needing help with daily activities
  • Having stiffness in the legs that makes it difficult to stand or walk
  • Becoming bedridden
  • Requiring regular nursing care
  • Experiencing hallucinations and delusions

Causes

Parkinson’s disease occurs when cells that produce dopamine (a neurotransmitter—or chemical messenger—in the brain) die and create a deficiency. Because dopamine helps communicate body movement, a deficiency can cause the movement issues that are associated with Parkinson’s.

While research into what causes Parkinson’s is ongoing, most researchers agree that Parkinson’s is caused by a combination of genetic and environmental factors. Environmental factors may include head injury, geographical location, and exposure to certain metals, pesticides, and herbicides.

Advanced Parkinson’s develops when treatments stop working or are no longer effective.

Risk Factors

The largest risk factor for developing Parkinson’s is age. People over the age of 60 are more likely to develop Parkinson’s. Men are more likely to develop the disease than women.

Diagnosis

There is no one specific test to diagnose Parkinson’s, but physicians will begin the diagnostic process by taking a thorough medical history.

Then they will perform a series of neurological exams to test reflexes, coordination, and movement. They may also order blood tests to test for toxins.

Medical imaging tests, such as an MRI, may be used to look at the brain and rule out other conditions.

Once diagnosed with Parkinson’s, your physician will follow the course of your disease. As symptoms progress and you reach the late stages of the disease, you may be diagnosed with advanced Parkinson’s and your treatment plan will change.

Treatment

Treating advanced Parkinson’s disease is tailored to the individual, because symptoms become more severe and quite complex.

Medications that are used to treat Parkinson’s focus on the dopamine chemicals in the brain. These have been shown to help with tremors and other symptoms that affect movement. While these dopamine therapies are used for as long as possible, they start to lose their effectiveness over time and may need to be adjusted for patients with APD.

More invasive treatments that can be used to treat symptoms of APD include:

Physical, occupational, and exercise therapy may all be used to help patients stand, move, and reduce the risk of falling.

Medications may be prescribed to treat dementia, hallucinations, or psychosis that can occur in APD.

Depression and Parkinson’s Disease

Depression is common in people with Parkinson’s disease, occurring in about 40% to 50% of patients. Depression can worsen when the disease becomes more advanced and treatment becomes less effective. Mental health counseling and treatment options are available to help people living with APD. Seek help if you or a loved one is experiencing depression with their Parkinson’s.

Prognosis

Though Parkinson’s is a slowly progressive disease, there are many treatment options to help maintain a good quality of life for as long as possible. The average life expectancy for someone with Parkinson’s is about the same as for someone who does not have the disease.

Having advanced Parkinson’s disease, however, does mean that the disorder has progressed. Symptoms in APD will make it difficult to live a fully independent life, and the prognosis becomes less positive once it has advanced.

Coping

While you may have adjusted to life with Parkinson’s, this later stage may present its own set of challenges. Learning to cope with the emotional and physical changes that come with APD may take some time and require outside help.

If you or a loved one is living with advanced Parkinson’s disease, you may need the support of professionals such as home nurses or a nursing care facility. Surrounding yourself with a team of healthcare professionals and counselors can help you cope with the disease and improve your quality of life.

A Word From Verywell

Living with a chronic illness that has progressed to an advanced stage can be overwhelming for you and your loved ones. Seeking guidance from trusted healthcare professionals can help you cope with the changes to your health and independence.

You may also find that support groups can help you feel less alone. The Parkinson’s Foundation offers resources and support for those living with Parkinson’s.

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8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Luquin MR, Kulisevsky J, Martinez-Martin P, Mir P, Tolosa ES. Consensus on the definition of advanced Parkinson’s disease: a neurologists-based Delphi study (CEPA study)Parkinsons Dis. 2017;2017:4047392. doi:10.1155/2017/4047392

  2. Varanese S, Birnbaum Z, Rossi R, Di Rocco A. Treatment of advanced Parkinson’s diseaseParkinsons Dis. 2011;2010:480260. doi:10.4061/2010/480260

  3. Parkinson’s Foundation. Stages of Parkinson’s.

  4. Cleveland Clinic. Parkinson’s disease. Updated May 1, 2020.

  5. Parkinson’s Foundation. Environmental factors.

  6. Johns Hopkins Medicine. Parkinson’s disease risk factors and causes.

  7. National Institute of Neurological Disorders and Stroke. Parkinson’s disease: hope through research. Updated August 4, 2021.

  8. Marsh L. Depression and Parkinson’s disease: current knowledgeCurr Neurol Neurosci Rep. 2013;13(12):409. doi:10.1007/s11910-013-0409-5