These 5 Changes to Your Walk Can Show Up 7 Years Before a Parkinson’s Diagnosis, Study Finds

• New research suggests that changes to your walk can surface years before a Parkinson’s diagnosis.
• Changes in gait, speed, and how arms move while walking were all detected.
• There are a few benefits of catching the disease early, per doctors.

Parkinson’s disease is a central nervous system disease often diagnosed in older adults that worsens over time, causing tremors, stiffness, and trouble with balance. But new research suggests that symptoms of Parkinson’s disease may start subtly before many of those hallmark signs appear—and they can even show up in the way you walk up to seven years before you’re diagnosed.

The study, which was published in the Journal of Neural Transmission, drew on data from more than 100,000 people who wore monitors that detected how they moved. By analyzing the data, the researchers were able to detect five key changes to the way people walked that raised the odds they would eventually be diagnosed with Parkinson’s disease.

“This is a really important paper, and an interesting finding,” says David Charles, M.D., professor and vice-chair of neurology at Vanderbilt University Medical Center. There is value in detecting Parkinson’s disease earlier, according to doctors who treat people with the disorder—though not necessarily in the same way as with many other diseases. Here’s what the study found, plus what doctors recommend if you notice any of these changes yourself.

Meet the experts: Jian Feng, Ph.D., professor of physiology and biophysics at the State University of New York at Buffalo Jacobs School of Medicine & Biomedical Sciences; David Charles, M.D., professor and vice-chair of neurology at Vanderbilt University Medical Center; Clifford Segil, D.O., neurologist at Providence Saint John’s Health Center; Hassaan Bashir, M.D., neurologist at Tufts Medicine New England Neurological Associates—Lawrence.

What did the study find?

For the paper, researchers analyzed info from a long-running health study called the UK Biobank. They specifically looked at data from 73,413 people who wore wrist sensors for a week to track their movements, and followed their medical records for up to 10 years. During the study period, 314 participants were diagnosed with Parkinson’s disease.

The researchers used software that estimated how many steps people took, their walking speed, and how regularly their steps fell. After crunching the data, they found that people who were later diagnosed with Parkinson’s were more likely to have these five changes to their walks compared with those who didn’t develop the neurological disorder:

• They took fewer steps each day (about 4,000 vs. 6,400 within 40 months of their diagnosis)
• They walked at a slower pace
• They walked in shorter stretches or bouts
• They had an “altered step regularity,” or less of a rhythm to their steps
• They spent less time swinging their arms naturally as they walked

“These findings suggest that digital gait biomarkers may help characterize early motor changes detectable up to 6.8 years before a clinical diagnosis of Parkinson’s disease,” the researchers wrote in the study.

Why can Parkinson’s disease affect your walk?

There are likely a few things happening here, according to doctors. “Our movement, including walking, is very complex and regulated by the brain,” says Jian Feng, Ph.D., professor of physiology and biophysics at the State University of New York at Buffalo Jacobs School of Medicine & Biomedical Sciences. “The brain sends instructions to the muscles to contract or relax—that’s how we move.” But this complex system gets disrupted in people who have Parkinson’s disease, he says.

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“I can pick out a Parkinson’s patient in a crowd,” says Clifford Segil, D.O., neurologist at Providence Saint John’s Health Center, noting that these patients do tend to walk differently from others. “I use gait analysis in my diagnosis and treatment of Parkinson’s disease.” After all, he says, Parkinson’s is a movement disorder.

In fact, there are four key features of Parkinson’s, and all of them can affect the way someone walks, according to Dr. Charles:

• Tremor, which is more common at rest
• Bradykinesia, or slowed movement
• Rigidity, or stiffness in the muscles
• Postural instability, which is trouble with coordination that makes it difficult to balance and walk

“It’s been known for some time that people with Parkinson’s disease can have symptoms for a number of years before it’s diagnosed,” Dr. Charles says. “Some people believe it may be up to 20 years before the diagnosis is made.”

More findings like this keep surfacing, according to Hassaan Bashir, M.D., neurologist at Tufts Medicine New England Neurological Associates—Lawrence. “Many subtle changes can go unnoticed by both patients and doctors,” he says. “With the advent of wearable technology, subtle changes in movement can be picked up much sooner.” He points to a body of research showing slower or more variable, asymmetric walking, and reduced arm swing many years before diagnosis.

What’s the benefit of an early diagnosis?

The progression of some diseases can be slowed by medical means if they’re detected early enough. Unfortunately, that’s not the case for Parkinson’s disease. “There’s no [medication] that slows or stops the progression of Parkinson’s,” Dr. Charles says. “It progresses in everyone and taking medications early doesn’t change that.”

Still, doctors say there is value in getting a Parkinson’s diagnosis earlier. That’s because it gives you more opportunity to try to incorporate certain lifestyle measures—namely, exercise—that can be helpful. “It’s valuable to catch it early. There is good evidence that exercise may slow progression of Parkinson’s,” Dr. Charles says. “A person can choose to involve themselves in a structured exercise program.”

It’s also possible to develop Parkinson’s-like symptoms but not actually have the disease, Dr. Feng points out. “Parkinson’s is really rare,” he says. It’s possible that some people who develop symptoms are being exposed to neurotoxins that are affecting their movement. So early awareness could reduce or eliminate that exposure, he says.

What to do if you notice these changes

If you notice these changes to your walk, along with tremors or other signature symptoms of Parkinson’s disease, doctors recommend flagging them to your healthcare provider. They should be able to refer you to a specialist, who can do a full evaluation to try to figure out what’s going on, Dr. Feng says.

Just don’t freak out and assume what you’re experiencing is necessarily pointing to Parkinson’s disease. “Many different neurological conditions can cause walking problems,” Dr. Segil says. “Movement disorders like Parkinson’s are just one group.”

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