The 5-2-1 Parkinson's Self-Check: Is Your Parkinson's Advancing?
A one-minute self-check based on the published 5-2-1 criteria for advancing Parkinson's: 5+ levodopa doses a day, 2+ hours off time, 1+ hour of dyskinesia. Includes a printable conversation guide for your care team.
This self-check is an educational tool, not medical advice, a diagnosis, or a treatment recommendation. The 5-2-1 criteria are a screening signal used in published research, not a rule. Only your own care team, who knows your full history, can say what these answers mean for you. Never change any medication based on this page.
The Three Questions
5 or more levodopa doses a day
How many times a day is levodopa taken?
Count every scheduled dose of any levodopa medicine (Sinemet, Rytary, generic carbidopa-levodopa, and similar). Rescue doses count too.
- 4 times a day or fewer
- 5 or more times a day
- Not taking levodopa, or not sure
2 or more hours of off time a day
On a typical day, how much time is spent in an off state?
"Off" time is when the medication is not working well: movement gets slower, stiffer, or shakier until the next dose kicks in. Add up all the off periods across a normal day.
- Less than 2 hours
- 2 hours or more
- Not sure
1 or more hours of dyskinesia a day
On a typical day, how much time is spent with dyskinesia?
Dyskinesia is extra, involuntary movement (writhing, fidgeting, or swaying) that is different from tremor. It often appears when medication is at its peak.
- Less than 1 hour, or none
- 1 hour or more
- Not sure what dyskinesia looks like
What the Results Mean
This pattern is worth a conversation with your care team
The answers you gave match at least one of the published 5-2-1 criteria. Doctors use these criteria as a simple signal that someone's Parkinson's may be advancing beyond what their current medication routine controls well.
This is not a diagnosis, and it does not mean the current treatment is wrong. It means the pattern is worth describing to your neurologist or care team, in these specific terms, at your next appointment. Many people live with this pattern for a long time without anyone naming it out loud.
The conversation guide below gives you the exact questions to ask. Print it or save it to your phone and bring it along.
Some answers were unsure. That is worth pinning down
None of your definite answers met the 5-2-1 criteria, but at least one answer was a not-sure. Off time and dyskinesia are easy to miss or mislabel, even for people who have lived with Parkinson's for years.
A simple way to find out: keep a small diary for three ordinary days. Note when each dose is taken, when movement feels slow or stiff (off time), and any extra involuntary movement (dyskinesia). Then take this check again, or bring the diary straight to your care team.
Your answers do not match the 5-2-1 pattern right now
Based on what you entered, none of the three 5-2-1 criteria are met today. That is a reasonable signal that the current routine is holding.
Parkinson's changes over time, so it is worth repeating this check every few months, or whenever doses get more frequent or off periods start creeping in. Mention any new pattern to your care team early; small adjustments are easier than big ones.
Questions for Your Care Team
Doctors know the 5-2-1 criteria. Naming them turns a vague worry into a specific, answerable question. You are not asking for a particular treatment; you are asking for an assessment.
A way to open the conversation: "I did a 5-2-1 self-check and I want to make sure we are tracking my medication timing, off time, and any extra movements. Can we go through them together?"
- Do my symptoms suggest my Parkinson's is advancing beyond what my current medicines control?
- Is my off time or dyskinesia something we can reduce by adjusting the current routine?
- At what point would you refer me for an advanced-therapy evaluation, and what would that involve?
- Are there device-assisted or other advanced options that people like me are typically evaluated for?
- Should I see a movement disorder specialist, if I am not already seeing one?
- Is there a clinical trial that might fit my situation?
What to Bring
- A list of every Parkinson's medicine, with dose times, for a typical day.
- A rough diary of off periods and dyskinesia over two or three ordinary days.
- A note of anything that has changed in the last six months: falls, swallowing, sleep, mood, or thinking.
- This sheet, with your self-check answers.
If the visit feels rushed, ask for a follow-up appointment dedicated to this conversation. Advancing symptoms are exactly what your care team wants to hear about early.
Frequently Asked Questions
What are the 5-2-1 criteria?
A screening signal from published Parkinson's research: taking levodopa 5 or more times a day, having 2 or more hours of off time a day, or having 1 or more hours of dyskinesia a day. Meeting any one of the three suggests the disease may be advancing beyond what oral medication alone controls well, and that an assessment conversation with a care team is worthwhile.
Does meeting the 5-2-1 criteria mean I need surgery or a device?
No. It means an assessment is worth asking for. Some people's routines can be adjusted; others may be evaluated for device-assisted therapies. Only a clinician who knows your history can say which applies to you.
Is this self-check a diagnosis?
No. It is an educational tool that helps you recognize a pattern and describe it precisely to your own care team. It stores nothing unless you are signed in and explicitly choose to save your result.
What is off time?
Periods when levodopa is not working well and symptoms like slowness, stiffness, or tremor return before the next dose takes effect. Many people underestimate their daily off time until they track it for a few days.