Parkinson's disease is widely associated with visible symptoms such as tremors and stiffness, but experts say the condition often begins much earlier with subtle, easily overlooked signs. These early indicators, largely non-motor in nature, can emerge years before diagnosis, frequently mistaken for stress, ageing or lifestyle changes.
Medical professionals warn that recognising these quiet warning signals would significantly improve outcomes. Early intervention, while not curative, allows for better symptom management and improved quality of life.
One of the earliest changes reported is a diminished sense of smell. Everyday scents, tea, perfumes or spices, may gradually fade, a symptom often dismissed as a minor or temporary issue.
Handwriting changes may also surface early. Once-fluid strokes can become smaller and cramped, reflecting declining fine motor control, though many attribute this to fatigue or age.
Sleep disturbances are another red flag. Patients may experience restless nights, act out dreams or struggle with fragmented sleep patterns, symptoms rarely linked to neurological conditions at first.
"Parkinson's disease is often misunderstood as a condition defined primarily by tremors, but in reality, some of its earliest signs are far more subtle and frequently overlooked," said Dr Kunal Bahrani, noting that symptoms like reduced smell, sleep issues, depression and fatigue can appear years earlier.
He stressed the need for broader awareness beyond tremors, urging people to pay attention to persistent, subtle changes that may signal deeper neurological issues.
Speech changes can also emerge gradually. A person's voice may become softer or less expressive, a condition known as hypophonia, often unoticed until communication becomes difficult.
Beyond movement, Parkinson’s affects internal systems. Persistent constipation, for example, may appear years before diagnosis, signalling disruptions in the nervous system controlling digestion.
Physical movement can also subtly shift, with reduced arm swing, stiffness or slower actions creeping in. These signs are often mistaken for natural ageing or inactivity.
Mental health changes, including anxiety, depression or low motivation, may also occur early, driven by neurological changes rather than external triggers.
“The early phase of Parkinson’s disease is often marked by non-motor symptoms that quietly progress before any visible tremors or stiffness appear,” said Dr Neha Pandita, who added that these signs are frequently dismissed as unrelated health concerns.
Experts note that Parkinson’s presents differently in individuals, making vigilance critical among both patients and healthcare providers.
Dr Vinit Suri explained that early symptoms are often mild and misattributed. “Parkinson's disease starts with relatively minor symptoms that are likely to be missed or associated with normal aging and stress,” he said, adding that tremors may not appear in all cases.
He highlighted other overlooked indicators such as slowed movement and changes in handwriting, which can delay diagnosis until more obvious symptoms emerge.
Health advocates say this delay comes at a cost. By the time hallmark signs appear, the disease has often progressed significantly, limiting the effectiveness of interventions.
On World Parkinson’s Day, Parkinson’s Africa called for urgent action to improve awareness, early diagnosis and inclusive care across the continent. The organisation raised concerns over stigma, misconceptions and gaps in healthcare systems.
“Today is World Parkinson’s Day and we are standing in solidarity with thousands of families and individuals affected across Africa and the world. It is more than a health condition; it affects movement, independence and everyday living,” said Communications Officer Success Nwanedo.
She warned that poor awareness often leads to misdiagnosis and stigma, urging Nigerians to seek professional medical evaluation. “It is important to consult qualified healthcare professionals for proper diagnosis. Early detection can make a significant difference in managing the disease,” she said.
Charity Manager Ruth Ebe emphasised that Parkinson’s is not limited by age or geography. “It is not an ‘old white man’s disease’. Africans are also affected, including younger people. We have recorded cases among teenagers and young adults,” she said.
She also dismissed cultural misconceptions. “It is not a curse, it is not witchcraft and it is not contagious. It is a medical condition that requires proper understanding and care,” she stressed.
Ebe identified late diagnosis, limited access to specialists and high treatment costs as major barriers, adding that many cases remain undiagnosed until the disease has advanced.
Caregiver Obinna Chima shared the challenges of delayed diagnosis, recounting how his wife’s condition went unrecognised for years. “For years, the symptoms were not correctly identified. When we finally got the diagnosis, we were able to begin proper treatment,” he said.
He described caregiving as demanding and called for stronger government support. “You have to plan your life around the patient. It requires full commitment,” he added.
Stakeholders concluded with a call for stronger collaboration among governments, healthcare providers and civil society to improve early detection, expand access to care and reduce the burden of Parkinson’s disease across Nigeria and Africa.
