What is the Hoehn and Yahr Scale in Parkinson’s?

What is the Hoehn and Yahr Scale in Parkinson’s?

Parkinson’s is a degenerative condition that affects the central nervous system and the motor system. The symptoms experienced by any individual occur at a slow pace and turn to worse over a period of time. It is difficult to find the presence of the illness in the early stages, as the symptoms could be due to other health conditions. Hence, it is unpredictable and often makes it difficult for any physician to offer appropriate treatment at the right time.

The signs that an individual displays in the early stages of Parkinson’s disease are stiffness of the muscles, difficulty in movement, shaking, and the beginning of the loss of memory. The slow progression of the Parkinson’s disease further leads to the development of depression, changes in the behavior pattern, and occurrence of dementia. Other problems include emotional and sleep disturbances. Parkinsonism or Parkinsonian Syndrome is the term that addresses the collective symptoms that change the motor system of the individual.


There is no treatment or permanent cure for Parkinson’s disease. However, with appropriate care and diet, it is possible to bring down the progression and prolong the lifespan. A healthy diet further helps in prevention of weight loss, which is one of the critical factors in a patient who has Parkinson’s disease because it consumes excessive calories than the body requires. A dietician will come to the aid in such instances and prepares the menu. The menu additionally consists of the timing of the meals along with the inclusion of liquids to maintain the required levels of water content in the body at all times.

What is the Hoehn and Yahr Scale in Parkinson’s?

As it is difficult to address the situation of the condition or the suffering that the individual undergoes, Dr. Hoehn and Dr. Yahr prepared a scale that will help in finding out the stage of the disease. The scale or the rating system consists of the symptoms experienced by the patient and the progression. A consistent monitoring by the healthcare provider ensures in understanding the condition of the patient. Both the physicians divided the scale into five stages, which begins from mild and ends at worst.
As Parkinson’s disease is unpredictable and does not have a particular time, it is common for a patient to jump from stage 1 to stage 3. The reason is the change in the variation of the disease, which alters according to the individual, gender, and age. The following are the details of the five stages as represented by the Hoehn and Yahr scale:

Hoehn and Yahr Scale, Stage 1: Stage 1 is the mild or the beginning stage, where the patient shows symptoms such as a decline in the movement, muscle stiffness, tremors and problems related to the posture. A few people may also see changes in the body balance.

Hoehn and Yahr Scale, Stage 2: In the second stage, the patient begins to experience the signs of the Parkinson’s disease on both sides of the body. Furthermore, they tend to show additional symptoms apart from stage one, which includes difficulty in swallowing food, talking, and loss of facial expression called as facial masking.

Hoehn and Yahr Scale, Stage 3: When a patient reaches the third stage, it becomes difficult for the individual, as the symptoms present in the stage two now turn to the worse condition. It is also at this stage that a person notices a loss in the balance of the body. Even at this stage, the patient is still independent of the Parkinson’s disease.

Hoehn and Yahr Scale, Stage 4: The fourth stage is critical, and the patient will display severe conditions of the symptoms of all the stages above. Disability creeps in, and the patient requires assistance from a healthcare provider to look after the daily activities.

Hoehn and Yahr Scale, Stage 5: It is the worst stage of the Parkinson’s disease, and the patient confines to a bed or wheelchair and requires all-time monitoring from a healthcare provider.

Pramod Kerkar, M.D., FFARCSI, DA
Pramod Kerkar, M.D., FFARCSI, DA
Written, Edited or Reviewed By: Pramod Kerkar, M.D., FFARCSI, DA Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:January 4, 2018

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