Modified Hoehn and Yahr Scale for Parkinson's Disease
Stages severity of Parkinson's disease from Stage 0 (no signs) to Stage 5 (wheelchair-bound). Modified version adds 1.5 and 2.5 intermediate stages.
Score interpretation
Hoehn & Yahr Stage 0–1.5 — early Parkinson's disease
→ Initiate dopaminergic therapy when symptoms impact quality of life; exercise programme; physiotherapy; monitor annually
Hoehn & Yahr Stage 2–2.5 — bilateral involvement without balance impairment
→ Optimise dopaminergic therapy (levodopa ± DA agonist ± MAO-B inhibitor); falls prevention; occupational therapy; DBS consideration in refractory cases
Hoehn & Yahr Stage 3 — balance impaired but still independent
→ Gait and balance rehabilitation; occupational therapy assessment; medication review; fall risk mitigation; home modifications
Hoehn & Yahr Stage 4–5 — severe disability; requires assistance or fully dependent
→ Multidisciplinary care; palliative approach; subcutaneous apomorphine or intestinal levodopa pump; swallowing assessment; carer support; advance care planning
Interpretation bands for the Hoehn & Yahr. Apply clinical judgement and local guidance.
References
- Hoehn MM, Yahr MD. Parkinsonism: onset, progression, and mortality. Neurology. 1967;17(5):427–442.
Related
Curated clinical cross-links plus same-class fallbacks.
- Entacapone · COMT Inhibitor — Parkinson's Disease
- Ropinirole · Dopamine Agonist — Parkinson's Disease
- Rasagiline · MAO-B Inhibitor — Parkinson's Disease
- Tetrabenazine · VMAT2 Inhibitor — Hyperkinetic Movement Disorders
- Trihexyphenidyl · Anticholinergic — Parkinson's Disease / Dystonia
- Apomorphine · Dopamine Agonist — Parkinson's Disease Rescue / Continuous Infusion
- Acute Stroke / TIA Assessment · NICE NG128; RCP Stroke Guidelines 2023
- Status Epilepticus (Adults) · NICE CG137; ESEM guidelines; RCP Neurology Guidelines
- Suspected Subarachnoid Haemorrhage · NICE NG228; RCEM 2023; AHA/ASA 2023
- Adult Head Injury · NICE NG232 (2023)
- Bell's Palsy / Facial Nerve Palsy · ENT UK 2017; AAN
- Vertigo Workup · ENT UK; NICE CKS
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.