It could be an early warning sign if you find yourself leaning, slouching, or hunching forward when you stand up. Likewise, if your voice becomes softer and fades when you start talking, or it takes longer than usual to regain your balance, see your doctor.
Other prodromal symptoms include sleep problems, constipation and loss of smell. But some signs may go unnoticed or be confused with normal aging.
Slowness of movement
A new study found that a laboratory test can identify Parkinson’s disease early in people by looking for clumps of alpha-synuclein protein. This clumping is a hallmark of the disease and reflects the loss of cells that make dopamine, a chemical that helps control movement.
The test identifies the presence of this protein in cerebrospinal fluid and can detect it much earlier than a DaTscan, an imaging test for the disease. The researchers hope to develop a tool to help doctors discover PD in its premotor stage, when patients have no symptoms but still have the potential to create them.
Are you noticing that your handwriting has changed? For example, the letters seem smaller and are crowded together. This is a sign of a change in your motor skills, and talking to your doctor is important. You might also notice a difference in your sense of smell. It may be harder to smell certain foods, such as bananas, dill pickles or licorice. Often, this is the first sign of the disease. Having the right knowledge and understanding Parkinson disease will give you the upper hand in dealing with it.
Loss of balance
Difficulty staying upright or balanced can be an early sign of Parkinson’s disease. A person may find stepping from one foot to another harder or experience a sensation like falling backward. In the later stages of PD, people also tend to develop swallowing problems, which can lead to drooling.
People with PD often have a “staring” or serious look on their faces, called facial masking. A protein in Lewy bodies causes this called alpha-synuclein. Over time, the clumped proteins damage nerve cells and can cause changes in movement, thinking, behavior and mood.
Other early symptoms include changes in handwriting, where letters appear smaller, and words crowd together. Bladder problems, such as frequent urination or a feeling of incomplete emptying of the bladder, are common in PD. In many cases, PD can affect a person’s sense of smell, causing a loss of ability to taste foods such as bananas, dill pickles or licorice.
Difficulty walking
People with Parkinson’s begin to experience problems walking. Typical movements, such as swinging arms and landing the heel of the foot on the ground first, are lost, turning becomes challenging and can be triggered by freezing episodes that may lead to falls. A short shuffle-like walk is also common, causing balance problems and increasing the risk of falling.
In addition to the change in gait, the body may develop stiff muscles, resulting in reduced mobility and flexibility. This is called bradykinesia and can shorten the steps taken when walking, affecting the ability to move forward and turn.
A recent study looked at perceived walking difficulties over three years and found that concerns about falling were the strongest independent predictor of future problems. Researchers are exploring other non-motor factors that can predict future perceived difficulty in PD, such as sensory and cognitive symptoms, such as depression or REM sleep behavior disorder (RBD). Exercise is important and can help improve gait, balance and mobility. Moderate walking, for example, has been shown to improve movement and quality of life in people with PD.
Involuntary movements
Uncontrollable shaking, tremors and other movement disorders are common early symptoms of Parkinson’s disease. These may affect any body part but are often felt in the hands or face. Jerking movements can be small or large, quick, repetitive or rhythmic. The shaking usually stops when you relax or stop taking the medication causing it.
You also might have a serious stare or “mad” look on your face (facial masking), or your voice may sound different when you speak, even if it is only a little bit. This may be a sign of PD, but it can also be caused by other conditions, like a chest cold or flu.
You should tell your doctor if you have these uncontrollable movements, as they could indicate a serious problem, such as Parkinson’s. Your healthcare provider will want to know when the activities started, if they come and go, which parts of your body are affected, and what makes them worse or better. They may also order a spinal tap to check for misfolded proteins in your cerebrospinal fluid or do a skin biopsy of surface nerve cells from a spot on your back and two spots on your legs.
Slowness of speech
Have you noticed that your speech is slower than it used to be? A change in voice volume is a common early sign of Parkinson’s. You may find that you have to shout or whisper to be heard. The softer voice may also lack inflections, making you sound flat or robotic. Swallowing problems, a dry mouth and drooling are also related to the disease.
Your face may seem to have a serious or angry look on it, even when you’re not in a bad mood. This is called facial masking and can be a sign of the condition. You may also notice a decrease in your sense of smell, which is usually temporary.
As technology improves, we can expect to see more ways of detecting symptoms of Parkinson’s disease earlier. Researchers use machine-learning techniques to uncover PD before symptoms emerge to slow the disease’s progression and give people access to better therapies. This is especially important as no currently available treatment slows the disease’s progression or stops it entirely.
