080 6801 6801
080 6801 6901
Cardiac Sciences
Bone and Joint
Gastrointestinal Sciences
Neurosciences
Renal Sciences
Maa Kauvery (Women and Child Health)
Robotic Surgery
Accident and Emergency Care
Anaesthesiology
Arthroplasty (Joint Replacement Surgeries)
Arthroscopy
Bariatric Surgery
Cardiology
Cardiothoracic and Vascular Surgery
Critical Care and ICU
Dermatology
Diabetes and Endocrinology
ENT
Medical Gastroenterology
General Surgery
Hand Surgery_698dd3b2b1a0c.jpg)
Tuesday, 10 February, 2026
Parkinson’s disease often begins quietly. A hand that trembles once in a while. Mornings that feel slower than they used to. Nothing alarming at first, yet something feels off. Many people brush these signs aside, assuming they are part of ageing or everyday stress. Over time, though, patterns start to form. Understanding what those early changes might mean can help you make clearer decisions, ask better questions, and reach the right specialist sooner.
This guide explains symptoms, causes, and risk factors in straightforward language that patients and families can actually relate to. Along the way, you’ll also see insights from neurologists. Clinical experience often fills the gaps that numbers alone cannot. As one consultant neurologist puts it, “Patients rarely arrive with textbook symptoms. The challenge is recognising patterns before disability sets in.”
What Is Parkinson’s Disease?
Parkinson’s is a progressive neurological condition that mainly affects movement and balance. It develops when brain cells responsible for producing dopamine begin to deteriorate. Dopamine plays a key role in coordinating smooth, controlled movement. As levels drop, communication between the brain and muscles becomes less efficient. This leads to slowness, stiffness, tremor, and changes in walking.
Movement symptoms are the most visible, but they are only part of the picture. Parkinson’s can also affect sleep, mood, digestion, memory, sense of smell, and overall energy levels. For many people, these non-motor changes appear early, sometimes long before a tremor is noticed.
A senior neurologist once shared, “Two people with Parkinson’s may look completely different in the clinic. That’s why listening carefully to the patient’s story matters just as much as the examination.”
Why Early Diagnosis Matters
Identifying Parkinson’s early can make a real difference. It allows a neurologist to confirm the condition, rule out other causes, discuss treatment options, and create a plan that supports both physical and emotional health. Physiotherapy, regular exercise, and medication, when needed, may help preserve independence and function for longer.
For families, a diagnosis often brings relief. Naming the problem turns months of uncertainty into something that can be addressed, planned for, and managed step by step.
Early Symptoms of Parkinson’s Disease
Early signs are often subtle and easy to dismiss. A faint tremor. Slight slowness. Handwriting that suddenly looks cramped. A softer voice or fewer facial expressions. These changes may point toward Parkinson's disease symptoms, particularly when they develop gradually and affect one side of the body more than the other.
Here are some of the early features neurologists watch for.
Tremors at rest
A resting tremor commonly starts in one hand. It may resemble the fingers gently rolling a pill. Stress, fatigue, or anxiety can make it more noticeable. Interestingly, the tremor often reduces during movement and returns when the hand is relaxed.
Muscle stiffness
Stiffness, also called rigidity, can make routine activities feel awkward. Turning over in bed, fastening buttons, or reaching overhead may require more effort. Loved ones may notice that one arm swings less while walking.
Slowness of movement (bradykinesia)
Movements may become slower and smaller over time. Simple tasks begin to take longer. Some people describe feeling “stuck” when standing up or taking the first step. This symptom often has the greatest impact on daily life as the condition progresses.
Changes in handwriting
Handwriting may shrink, become crowded, or harder to read. Many patients recall noticing this while signing a cheque or filling out a form, realising something had shifted.
Reduced facial expression
Friends or family may comment that the face looks less expressive or unusually serious. This masked appearance is not linked to emotion. It reflects reduced movement of facial muscles.
Advanced Symptoms of Parkinson’s Disease
As Parkinson’s advances, walking, speech, and thinking can be affected. With treatment and therapy, many people remain active for years. Still, recognising later-stage symptoms helps families plan with clarity and compassion.
Balance and walking problems
Walking may become slower with shorter steps and difficulty turning. Freezing of gait can occur, where the feet feel momentarily stuck to the floor. This raises the risk of falls, making safety planning important.
Speech and swallowing difficulties
Speech may become softer, monotone, or slightly slurred. Swallowing can also become challenging, increasing the risk of choking or chest infections if not addressed early.
Cognitive and mood changes
Memory issues, slower thinking, anxiety, depression, apathy, and hallucinations may appear later. One neurologist explained it well: “Treating Parkinson’s isn’t just about movement. Supporting mental health is equally important, and family awareness plays a huge role.”
Non-Motor Symptoms of Parkinson’s Disease
Non-motor symptoms can appear years before the first tremor. These include constipation, loss of smell, sleep problems such as acting out dreams, urinary urgency, pain, fatigue, dizziness on standing, and mood changes.
Many people describe feeling “not quite themselves” for a long time. When these symptoms begin to cluster alongside movement changes, clinical suspicion increases.
Causes of Parkinson’s Disease
Researchers continue to study why Parkinson’s develops in some people and not others. Current evidence suggests a combination of genetic vulnerability, ageing, and environmental exposure.
Dopamine deficiency
Damage to dopamine-producing cells in the substantia nigra leads to the classic movement symptoms. As dopamine levels fall, movement control becomes less precise.
Brain cell degeneration
Lewy bodies, which are abnormal protein deposits, form inside nerve cells. Over time, this process spreads across different regions of the brain.
Genetic causes
A small percentage of people inherit gene changes such as LRRK2, PINK1, or SNCA. These increase susceptibility but do not guarantee disease. Genetic counselling may help families with multiple affected members.
Environmental triggers
Long-term exposure to certain pesticides, solvents, or heavy metals has been linked to higher risk. Repeated head injury also appears to play a role. These associations vary by population and exposure patterns.
Risk Factors for Parkinson’s Disease
Several factors influence who develops Parkinson’s. Having one or more risk factors does not mean a person will develop the condition. Some individuals develop symptoms without any clear risk factors at all.
Age
Risk increases significantly after age 60. Younger-onset cases do occur but are less common.
Family history
Having a close relative with Parkinson’s slightly raises risk, particularly where genetic variants are present.
Gender
Men are affected more often than women, although the reasons remain under investigation.
Environmental exposure
Long-term agricultural or industrial exposure, especially without protective measures, may increase risk.
Head injury
Moderate to severe head trauma, particularly repeated injuries, has been associated with higher risk later in life.
How Parkinson’s Disease Is Diagnosed
Diagnosis is based on medical history, neurological examination, and excluding other conditions. There is no single test that confirms Parkinson’s. Neurologists look for patterns such as asymmetrical slowness, rigidity, and resting tremor, along with response to medication.
Imaging like MRI may be used to rule out other causes. In selected cases, dopamine transporter scans provide additional support. Early referral matters because conditions such as drug-induced parkinsonism or atypical syndromes require different management.
When to See a Neurologist
Consider specialist evaluation if you or a loved one experiences:
• A new resting tremor, especially on one side
• Noticeable slowness or stiffness
• Recurrent falls or freezing while walking
• Loss of smell combined with sleep disturbances
• Early mood or cognitive changes
• A strong family history of Parkinson’s-like illness
As one neurologist put it, “I would rather see someone early and reassure them than meet them later when symptoms have already limited daily life.”
Living With Parkinson’s: What to Expect
Parkinson’s is a long-term condition, but its course varies widely. Some people remain independent for many years with the right combination of medication, physiotherapy, speech therapy, occupational support, and lifestyle changes such as regular exercise. Mental health care and social connection are just as important.
Simple adjustments help. Clear routines, safer home layouts, medication reminders, and breaking tasks into smaller steps can make daily life feel more manageable.
I have spoken with families who felt overwhelmed at first. Over time, they found their rhythm, rebuilt confidence, and stayed engaged with work, hobbies, and relationships. That sense of agency matters.
Key Takeaway: Early Symptoms Should Not Be Ignored
Small changes today may signal something larger developing quietly. Paying attention, without alarm, is sensible. If you notice tremor, stiffness, slowness, walking changes, loss of smell, dream enactment, or persistent constipation, consult a neurologist. Early evaluation helps clarify what is happening and what steps to take next.
FAQs
1. What are the first signs of Parkinson’s disease?
Early signs of Parkinson’s Disease often include a resting tremor in one hand, slowness of movement, muscle stiffness, smaller handwriting, reduced facial expression, and changes in walking. Non-motor symptoms such as constipation, loss of smell, acting out dreams during sleep, anxiety, or fatigue may appear years earlier.
2. What causes Parkinson’s disease?
Parkinson’s develops when dopamine-producing brain cells gradually degenerate. The cause differs between individuals and may involve ageing, genetic susceptibility, and environmental exposure to toxins or head injury.
3. Is Parkinson’s disease genetic?
Most cases are not inherited. Certain gene changes can increase risk in some families. Genetic counselling may be advised when multiple relatives are affected or symptoms begin early.
4. At what age does Parkinson’s usually start?
Symptoms most often appear after age 60, though some people develop the condition in their 40s or 50s. Earlier onset is uncommon but possible.
5. When should I see a neurologist for tremors?
Seek evaluation if a tremor is new, persistent, occurs at rest, worsens over time, or is accompanied by slowness, stiffness, balance issues, speech changes, or falls.
