When you think of Parkinson’s disease symptoms, tremors probably come to your mind. Tremors are indeed a classic symptom of the condition, but other worrisome signs could point to Parkinson’s. And some of them are noticeable a long time before any tremors start.
It’s important to know what signs to watch for and to talk to a health care provider if you notice them. That way, if it turns out to be Parkinson’s, you can start managing the condition as early as possible.
David Shprecher, DO, a neurologist specializing in movement disorders at Banner Sun Health Research Institute, said, “Though there is no cure, there are many treatments available that can alleviate the burden of symptoms from Parkinson’s disease. A delay in diagnosis can lead people to struggle unnecessarily with symptoms that have treatments.”
Here are eight signs of Parkinson’s disease you might notice:
1. Acting out dreams
“Acting out your dreams when you’re asleep, which may be a sign of REM sleep behavior disorder, can be the very first symptom of Parkinson’s disease,” said Dr. Shprecher. “The reason for this link isn’t clear. It doesn’t always appear before the movement problems, but when it does, it does so by an average of seven to eight years.”
REM sleep behavior disorder is a condition where you’re able to move your muscles during REM sleep. People with this disorder often have vivid, scary and action-packed dreams. When they dream, they might talk, yell, punch, kick or jump out of bed.
If you often remember having intense dreams, or your bed partner notices that you act strangely during your dreaming, talk to your health care provider. Not everyone with REM sleep behavior disorder has Parkinson’s, but it could be a sign of the condition.
2. Handwriting changes
A shift to smaller handwriting, called micrographia, could be a sign of Parkinson’s disease. You may notice:
- You make your letters smaller.
- You leave a smaller space between lines.
- Your handwriting is less detailed—your signature is less distinct and the loops and curves in your letters are less noticeable.
- Your handwriting isn’t consistent.
3. Trouble using your hands
Parkinson’s disease can affect the small muscles in your hands, making it hard to do things like:
- Button clothes
- Tie shoelaces
- Use forks, spoons and knives
- Turn keys
- Use electronics
- Play a musical instrument
4. Reduced sense of smell
People with Parkinson’s disease may not be able to identify scents as well as they used to. A reduced sense of smell is called hyposmia. It affects almost everyone who has Parkinson’s.
You might not notice that your sense of smell is getting worse. You can test it by seeing if you notice the odor of strongly scented things like:
- Coffee
- Freshly cut grass
- Flowers
- Citrus fruit
- Spices or herbs like cinnamon, cloves or basil
5. Changes in walking
People with Parkinson’s disease often take small, shuffling steps. Many people move more slowly or have some issues with balance when they get older. But if you’re noticing changes, you should talk to your doctor about them.
To check your walking pattern or gait, you can watch yourself walk in front of a full-length mirror, ask others if they’ve noticed anything different about the way you walk or record a video of yourself walking.
“Reduced arm swing and stride length is very common in people with Parkinson’s disease and is usually much worse on one side than the other. Often, one arm doesn’t swing anymore,” said Dr. Shprecher.
6. Voice changes
Speaking softly or in a monotone (called hypophonia) can be an early sign of Parkinson’s disease. That’s because Parkinson’s can affect the muscles you use for speech. This change can happen a long time before you notice any tremors.
You can pay attention to how your voice sounds, listen for changes and ask people close to you if they’ve noticed anything. You can also listen to recordings of your voice from the past and see if your voice sounds the same now.
7. Constipation
Parkinson’s disease changes your autonomic nervous system, which regulates digestion. Constipation is something that affects about half of the people who have Parkinson’s disease.
With constipation, you may notice:
- You have bowel movements less frequently.
- You strain during bowel movements.
- You don’t feel like you’ve fully emptied your bowels.
- Your stool is dry and hard, or you’re bloated.
Lots of different health conditions can cause constipation. It’s important to see a health care provider if you frequently have constipation or if you have constipation that lasts for a long time.
8. Mood changes
People with Parkinson’s disease may have mood swings, anxiety or depression before they notice tremors. That’s because Parkinson’s can affect the brain’s chemistry and the way the brain functions.
If you’re experiencing emotional changes, talk to a health care provider. These changes could be a sign of an underlying health condition. Whether you have Parkinson’s disease or not, treating mental health conditions can improve your overall well-being.
What to do
If you notice any of these symptoms, or someone points them out to you, connect with your health care provider. You may also want to see a neurologist.
“There is no definitive test for Parkinson’s disease. The diagnosis depends on a careful medical history, a neurological exam and long-term follow-up with an experienced neurologist,” said Dr. Shprecher.
The bottom line
Many people recognize that tremors are a sign of Parkinson’s disease. However, the condition has several other symptoms that can start well before tremors begin.
If you notice any of these changes in yourself or a loved one, reach out to your health care provider to evaluate your symptoms. It’s important to get an early diagnosis of Parkinson’s disease so you can most effectively treat its symptoms.
