10 Early Signs of Parkinson’s in Older Adults

Motor Symptoms of Parkinson’s Disease:

These symptoms are related to the body’s ability to control motion and coordination. Some are easy to notice, while others are subtle and can be mistaken for normal aging.

1. Tremors:

This is one of the most visible early signs. It usually starts in the hands or fingers and occurs when the body is at rest. This is different from shaking due to nervousness or physical effort. In Parkinson’s, the tremor is rhythmic and doesn’t go away with rest.

2. Slowness of Movement (Bradykinesia)

Every day actions like dressing, writing, or even walking become slower over time. It may feel like the body is not responding quickly to the brain’s commands. This isn’t the usual slowing that comes with age—it’s more noticeable and affects daily functioning.

3. Stiffness:

Muscles feel tight even when you’re not moving. This stiffness can make it hard to turn your body, walk normally, or move your arms while walking. Unlike the temporary aches we all get, this stiffness doesn’t go away easily and can affect posture and comfort.

4. Changes in Facial Expression:

This is sometimes called a “masked face.” The person may look serious or show less emotion, even when they are happy or interested. This change happens because the small muscles in the face lose movement over time.

5. Balance Problems:

People with Parkinson’s often feel unsteady or off-balance. Their steps may be short and shuffling, and they may lean forward while walking. This is not the same as general weakness in old age—it’s related to how the brain controls posture and balance.

6. Changes in Gait:

The way a person walks begins to change. They may take very small steps, walk faster without intending to (called festination), and stop swinging their arms. This is often noticed by others before the person realizes it themselves.

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7. Dystonia and Muscle Cramps:

Some people feel sudden, painful muscle tightening, often in the feet or toes. These cramps, called dystonia, can make walking or standing uncomfortable, especially early in the morning. They are different from the occasional leg cramps many people experience.

8. Loss of Automatic Movements:

Movements we usually don’t think about—like blinking, swallowing, or swinging arms while walking—start to slow down or disappear. This makes the person’s movements look stiff or robotic. It’s a key sign that the brain’s movement control is changing.

9. Micrographia:

A person’s handwriting becomes very small and crowded. This change usually happens slowly and can be one of the earliest clues to Parkinson’s. It stands out because it’s different from the normal, gradual changes in handwriting due to aging.

10. Soft Speaking Voice (Hypophonia)

The voice may become very soft or flat in tone. Family and friends often notice this first. It’s not due to shyness or tiredness—it happens because Parkinson’s affects the muscles used for speaking.

11. Drooling:

Due to reduced control of facial and throat muscles, people may not swallow as often. This leads to a build-up of saliva and can cause drooling, especially in the early morning or while sitting still. This is more than just a dry mouth issue and can impact self-esteem.

Non-Motor Symptoms of Parkinson’s Disease:

These are symptoms that don’t directly affect movement, but they have a big impact on a person’s comfort, mood, and daily life.

1. Sleep Issues:

Many people with Parkinson’s have trouble falling or staying asleep. Some may talk, shout, or move their arms and legs during dreams — a condition known as REM sleep behavior disorder. This can disturb both the patient and their spouse or caregiver.

Unlike common sleeplessness due to stress, these sleep problems are directly linked to changes in the brain caused by Parkinson’s.

2. Depression and Anxiety:

It’s common for patients to feel sad, hopeless, or restless—sometimes even before they notice any movement problems. Families in Pakistan often assume this is just “boredom” or weakness in old age, but these feelings can be early signs of Parkinson’s affecting brain chemistry.

3. Constipation:

A slow digestive system is one of the earliest and most ignored signs of Parkinson’s. If a person is having fewer bowel movements than normal, especially without dietary changes, it could be due to how the disease affects the nerves in the gut.

This is different from temporary constipation caused by food or dehydration.

4. Loss of Smell:

A reduced sense of smell—called anosmia—can appear years before any motor symptoms. People may stop noticing the smell of food, perfume, or even smoke. In many Pakistani families, this is not seen as serious, but it’s an important early warning sign.

5. Urinary Problems:

Patients may need to go to the bathroom more often, feel urgency, or have trouble fully emptying the bladder. These changes are due to Parkinson’s affecting the body’s automatic (autonomic) systems, not just “old age” or weak muscles.

6. Fatigue:

Even after a full night’s sleep, people with Parkinson’s may feel tired, slow, or mentally drained. This fatigue is not the same as being tired after a busy day—it’s a deep sense of low energy caused by the condition.

7. Pain and Sensory Changes:

Some patients feel unexplained pain, tingling, or burning sensations in their limbs. These may come and go and are often overlooked or treated as unrelated joint issues. But they can be part of the early non-motor symptoms of Parkinson’s.