Recognizing the early signs of Parkinson’s disease (PD) can be difficult. Some changes develop gradually and may initially seem like normal signs of aging.

Below are 10 signs that may be associated with Parkinson’s disease. Having one or more of these symptoms does not necessarily mean someone has Parkinson’s. However, if you notice persistent or unexplained changes, talk with your doctor about an evaluation.

#1 Tremor

A tremor is an involuntary shaking movement that may affect a finger, hand, thumb or chin. In Parkinson’s disease, a tremor often begins on one side of the body and may be more noticeable when the affected limb is resting.

What else can cause shaking?

Stress, fatigue, certain medications and other medical conditions can also cause tremors. A new or persistent tremor should be discussed with a healthcare professional. A tremor alone does not establish a diagnosis of Parkinson’s disease.

#2 Small Handwriting

Have you noticed that your handwriting has become smaller over time? Your letters may appear crowded together, or your writing may become harder to read as you continue across the page.

This change is called micrographia. It can occur in people with Parkinson’s disease and may be related to changes in movement control.

What else can cause handwriting changes?

Stiffness, arthritis, hand weakness, fatigue and changes in vision can also affect handwriting. If you notice a persistent change, discuss it with your healthcare provider.tremor

#3 Loss of Smell

Have you noticed that foods, flowers or familiar scents do not smell as strong as they once did? A reduced sense of smell, called hyposmia, can sometimes occur years before other symptoms of Parkinson’s disease appear.

Some people notice difficulty recognizing familiar smells, even when their nose is not congested.

What else can affect your sense of smell?

Colds, respiratory infections, allergies, sinus problems and certain medications can affect your ability to smell. A persistent change in your sense of smell should be discussed with your healthcare provider.

#4 Trouble Sleeping

Have you or your bed partner noticed that you move suddenly, kick, punch or appear to act out your dreams while sleeping?

Some people with Parkinson’s disease experience a sleep condition called REM sleep behavior disorder. During normal REM sleep, the body temporarily limits most muscle movement. In people with this condition, that muscle relaxation may be incomplete, allowing them to physically act out their dreams.

What else can affect sleep?

Restless sleep, sleep apnea, medications, stress and other sleep disorders can cause nighttime movements or disrupted sleep. Repeated dream enactment, particularly if it involves sudden or forceful movements, should be discussed with a healthcare provider.

#5 Trouble Moving or Walking

Have you noticed stiffness in your arms, legs or body? Does one arm swing less when you walk? Are your steps becoming shorter or slower?

Parkinson’s disease can affect movement and coordination. Some people experience muscle stiffness, slower movements or difficulty starting to walk. Others may notice their feet briefly feel stuck to the floor, a symptom known as freezing of gait.

What else can affect walking?

Arthritis, previous injuries, muscle weakness, joint problems and other neurological conditions can also affect walking.

A physical therapy evaluation can help identify changes in walking, strength, flexibility and balance. Early attention to these changes can help people work toward safer mobility and greater independence.

#6 Constipation

Have you noticed changes in your bowel habits, such as less frequent bowel movements or difficulty passing stool?

Constipation can occur years before other symptoms of Parkinson’s disease. Changes in the nervous system can affect how the digestive tract moves food and waste through the body.

What else can cause constipation?

Not drinking enough water, eating too little fiber, reduced physical activity and certain medications can contribute to constipation.

Persistent constipation should be discussed with your healthcare provider, especially if it is a new or unexplained change.

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What Does Recent Research Tell Us About Constipation and Parkinson’s Disease?

Research continues to explore the relationship between the digestive system and Parkinson’s disease, sometimes called the gut-brain connection.

Recent studies have found:

• Constipation may be an early warning sign. A 2025 study involving more than 20,000 people with Parkinson’s found that constipation was associated with other non-motor symptoms and an increased likelihood of developing additional symptoms over time.

• Possible links to inflammation. A 2026 study published in Movement Disorders found an association between constipation severity and markers of neuroinflammation in people with early Parkinson’s disease. Researchers are continuing to investigate this relationship.

• The gut microbiome may play a role. A 2026 clinical trial investigated prebiotics and short-chain fatty acids as possible ways to improve constipation in people with Parkinson’s. The findings were encouraging, but more research is needed.

These findings highlight the importance of recognizing and addressing digestive changes in people with Parkinson’s disease. Constipation is common and has many possible causes. It does not mean that someone has, or will develop, Parkinson’s disease.

#7 A Soft or Low Voice

Have family members or friends mentioned that they have difficulty hearing you, even when you are speaking directly to them?

Parkinson’s disease can affect the muscles involved in speaking. Your voice may become softer, quieter or more monotone. Some people also experience changes in speech clarity, speed or expression.

What else can affect your voice?

Respiratory infections, vocal cord problems, acid reflux and other medical conditions can cause changes in your voice. Persistent changes should be discussed with your healthcare provider.

Speech-language therapy can help address voice volume, speech clarity and communication. A physical therapist can also work on posture, breathing mechanics and mobility as part of an individualized treatment plan.

#8 Masked Face

Have others told you that your face looks serious, sad or less expressive, even when you are feeling perfectly fine?

Parkinson’s disease can affect the muscles responsible for facial movement. This reduced facial expression is sometimes called facial masking or hypomimia. You may blink less often or notice that your face does not show emotions as easily as it once did.

What else can affect facial expression?

Certain medications, neurological conditions and other health issues can affect facial movement. A noticeable or persistent change should be discussed with your healthcare provider.

Reduced facial expression does not necessarily reflect how a person feels emotionally. Family members should remember that someone with Parkinson’s may still experience the same emotions, even when their facial expressions change.

#9 Dizziness or Fainting

Have others told you that your face looks serious, sad or less expressive, even when you are feeling perfectly fine?

Parkinson’s disease can affect the muscles responsible for facial movement. This reduced facial expression is sometimes called facial masking or hypomimia. You may blink less often or notice that your face does not show emotions as easily as it once did.

What else can affect facial expression?

Certain medications, neurological conditions and other health issues can affect facial movement. A noticeable or persistent change should be discussed with your healthcare provider.

Reduced facial expression does not necessarily reflect how a person feels emotionally. Family members should remember that someone with Parkinson’s may still experience the same emotions, even when their facial expressions change.

#10 Stooping or Hunching Over

Have you or your family noticed that you are not standing as straight as you once did? Do you find yourself leaning forward, rounding your shoulders or bending your upper body when standing or walking?

Parkinson’s disease can affect posture and the ability to maintain an upright position. This change, sometimes called stooped posture, may develop gradually and can affect balance, walking and everyday activities.

What else can affect posture?

Osteoporosis, arthritis, spinal conditions, muscle weakness and previous injuries can also contribute to changes in posture.

A physical therapy evaluation can help assess posture, flexibility, strength, balance and walking. Individualized exercises and movement strategies may help improve functional mobility and reduce fall risk.

What Can You Do If You Have Parkinson’s Disease?

A diagnosis of Parkinson’s disease does not mean giving up the activities you enjoy. With the right support, exercise and treatment plan, many people can maintain mobility, participate in daily activities and remain as independent as possible.

Work with your healthcare team.

Your care team may include a neurologist, primary care provider, physical therapist, occupational therapist and speech-language pathologist. Each professional addresses different needs and helps manage different symptoms.

Stay physically active.

Regular exercise is an important part of managing Parkinson’s disease. Walking, strengthening, stretching, balance exercises and activities that encourage larger movements can help maintain strength, flexibility and mobility. Exercise should be appropriate for each person’s abilities and safety needs.

Address walking and balance changes early.

Short steps, shuffling, freezing, difficulty turning and trouble getting up from a chair can increase fall risk. A physical therapy evaluation can identify these challenges and help develop strategies for safer movement.

Make your home safer.

Good lighting, clear walking paths, appropriate bathroom equipment, secure handrails and attention to transfer safety can help reduce fall hazards. A home safety assessment can identify areas that may need attention.

Maintain good posture and flexibility.

Stiffness and changes in posture can make everyday activities more difficult. Individualized exercises and movement strategies can help address these challenges.

Stay connected.

Keep family and friends involved. Ask for support when daily activities become more difficult. Staying socially active and participating in meaningful activities can support overall well-being.

How Can Physical Therapy Help?

Physical therapy plays an important role in helping people with Parkinson’s disease maintain mobility and independence.

A physical therapist can evaluate:

• Walking patterns, stride length and walking speed.

• Balance and fall risk.

• Strength, flexibility and posture.

• Getting in and out of bed and chairs.

• Difficulty turning or freezing during walking.

• Safety when moving around the home.

Treatment may include individualized strengthening, balance training, walking practice, posture exercises and strategies for safer transfers.

At EDEN Home Health Care, we provide in-home physical therapy for older adults. Seeing someone in their own home allows the therapist to evaluate the challenges they face during everyday activities and recommend practical strategies to improve safety and mobility.

Our goal is to help older adults stay strong, safe and independent at home.

To learn more about in-home physical therapy, contact EDEN Home Health Care.

EDEN Home Health Care LLC

In-home physical therapy and skilled nursing for older adults in Massachusetts.

Phone: 781-202-5401

Website: https://edenhomehc.com/

For more information about Parkinson’s disease, symptoms and treatment, visit the Parkinson’s Foundation.

Educational note: This article is for informational purposes only. It is not intended to diagnose or treat Parkinson’s disease. Symptoms should be evaluated by an appropriate healthcare professional.