Parkinson’s: an individual experience
When you have Parkinson’s, particularly in its advanced stages, you can experience a wide range of symptoms. No two people will have the same pattern of symptoms over the same time frame.
Understanding your Parkinson’s symptoms and communicating these with your doctor and other healthcare professionals — including any new or worsening symptoms — can help you and your healthcare team make informed decisions about managing your condition.
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Tremor: Involuntary shaking, often in the hands, at rest.
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Rigid muscles: Muscle stiffness and reduced flexibility
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Loss of automatic movement: Diminished natural, automatic motions.
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Writing changes: Smaller, cramped handwriting.
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Slowed movement: Significant slowing of voluntary actions.
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Impaired posture and balance: Difficulty maintaining an upright position or increased fall risk.
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Speech changes: Altered speech patterns, softness, or slurring.
Identifying the early signs of Parkinson’s
Small changes to your movement and behaviour may indicate the onset of Parkinson’s. These include tremor, small handwriting, loss of smell, trouble sleeping, constipation, loss of facial expression (masked face), dizziness and other symptoms.
While having one or two symptoms of Parkinson’s doesn’t guarantee a diagnosis, early identification is key. If you are experiencing any of these symptoms it is important to book in a visit with your GP and discuss this with them. To confirm a diagnosis of Parkinson’s your GP will likely refer you to a neurologist. A specialist neurologist who has specific expertise in Parkinson’s is called a movement disorder specialist.
Motor signs of progressing Parkinson’s
As your Parkinson’s progresses, you may notice movement issues (motor symptoms) and other health concerns (non-motor symptoms) affecting your quality of life.
Dyskinesia
These involuntary movements of the limbs and/or head are related to disease progression but may also be a side effect of some Parkinson’s medications. Dyskinesia is more common in people who were young when symptoms started and occurs in more than half of people with Parkinson’s who have been taking medication for between five and 10 years.1
‘On/off’ mobility
Some people who have had Parkinson’s for a long-time experience unpredictable periods of fluctuating mobility, which can last up to several hours. Fluctuations are times when your Parkinson’s symptoms seem to be controlled and times when your Parkinson’s symptoms feel less controlled – with people describing them as feeling like a light switch being turned on and off.
An ‘off’ period may be time when you experience slowness, stiffness, muscle tightness, difficulty walking, increased tremor or shakiness.
An 'on' period refers to times when medication is effectively managing symptoms, allowing smoother movement and better control, with less slowness, stiffness, tremors, and improved mobility.
Wearing off
‘Off’ periods can occur before the next dose of medication is due – known as ‘early wearing off’. However, as Parkinson’s progresses, ‘on/off’ fluctuations become less closely related to the timing of the medication dose and more unpredictable.
Non-motor signs of progressing Parkinson’s
There are a range of non-motor symptoms that, like the motor symptoms, worsen as the loss of dopamine increases. Not everyone will go on to develop all of these non-motor symptoms.
Almost 90% of people with the condition have at least one non-motor symptom.2 While non-motor symptoms are often present from diagnosis of Parkinson’s, they may get worse or more unpredictable as your Parkinson’s progresses. It’s important to communicate any symptoms to your doctor as many can be managed.
Anxiety
Anxiety affects up to 40 per cent of individuals with Parkinson’s to varying degrees.3 It can range from general worry and stress to physical symptoms associated with fear and panic, sweating, rapid heart rate, shortness of breath and chest tightness.
Apathy
Apathy is a lack of motivation or interest, often accompanied by a neutral mood and a sense of indifference. Apathy affects more than 10 per cent of people with Parkinson’s.4
Constipation
Constipation is common, potentially affecting up to two out of three people with Parkinson's.5 Constipation and other bowel problems can be attributed to various factors, including mobility symptoms, low-fibre diet, reduced activity, fluid intake, anxiety about bowel movements, ‘off’ periods, and medications.
Dementia and cognitive impairment
Dementia is a general term describing a group of symptoms like loss of memory, language, thinking and problem solving — caused by the impact of disease on the brain — that interfere with an individual's daily life. Research indicates that more than three-quarters of people with Parkinson’s develop dementia after eight years with the condition.6
Depression
Between 40-50 per cent of people with Parkinson’s experience significant feelings of depression at some stage.4 Depression is often underdiagnosed and undertreated in people with Parkinson’s because many of its symptoms, like fatigue, are present in both conditions.
Fatigue
Around half of people with Parkinson’s experience fatigue, with around one-third considering it their most severe disease-related problem; worse than motor symptoms.4 Fatigue is characterised by lack of energy and motivation.
Sleep problems
Sleep problems are thought to affect 60–98 per cent of people with Parkinson’s.4 These symptoms include sleep disruption, painful early morning cramps in the hands and feet, urge to urinate, wakefulness, violent dreams and sleep and behaviour disorders.
Daytime sleepiness
Excessive daytime sleepiness causes people with Parkinson’s to fall asleep or doze frequently during normal waking hours. It can be caused by poor sleep, sleep disorders and certain medications.
This is not a comprehensive list of motor and non-motor symptoms. Always refer to your healthcare professional for further questions.
Monitoring changes in symptoms
If you feel like your Parkinson’s is progressing, it’s important to speak to your healthcare team. This may be a movement disorder specialist, neurologist, geriatrician, general practitioner or Parkinson’s nurse specialist. By planning for the future, you can work with your healthcare team to ensure your care continues to meet your individual needs.
To help with monitoring and identifying changes in your symptoms download the symptoms checklist
Download the guide to Advanced Parkinson’s
With information and support to help you and those around you, this guide is for anyone with progressing Parkinson’s. Learn more about your symptoms, care and management approaches so that you can access the right support.
- Schrag A, Quinn N. Dyskinesias and motor fluctuations in Parkinson's disease. A community-based study. Brain. 2000;123 ( Pt 11):2297-2305.
- Durcan R, Wiblin L, Lawson RA, et al. Prevalence and duration of non-motor symptoms in prodromal Parkinson's disease. Eur J Neurol. 2019;26(7):979-985
- Richard IH, Schiffer RB, Kurlan R. Anxiety and Parkinson's disease. J Neuropsychiatry Clin Neurosci. 1996;8(4):383-392.
- Borek LL, Amick MM, Friedman JH. Non-motor aspects of Parkinson's disease. CNS Spectr. 2006;11(7):541-554
- Sakakibara R, Kishi M, Ogawa E, et al. Bladder, bowel, and sexual dysfunction in Parkinson's disease. Parkinsons Dis. 2011;2011:924605
- Aarsland D, Andersen K, Larsen JP, Lolk A, Kragh-Sørensen P. Prevalence and characteristics of dementia in Parkinson disease: an 8-year prospective study. Arch Neurol. 2003;60(3):387-392
AU-NEUP-250005. August 2025
