RELATED: If You Notice This When You Walk, It Could Be an Early Sign of Parkinson’s. Parkinson’s disease (PD) can affect your body in many ways, but usually, the first sign that leads to a diagnosis is a tremor in one hand, according to John Hopkins Medicine. This isn’t to say that there aren’t others, however, including a slight change in your voice that could easily go unnoticed. “Even at that early stage, many patients will, in fact, have mild speech impairment that could be identified on the neurological exam or detected by using instruments,” says Zoltan Mari, MD, Director of the Nevada Parkinson’s Disease & Movement Disorders Program at Cleveland Clinic. According to the Cleveland Clinic, up to 90 percent of Parkinson’s patients experience difficulties with their speech at some point, and changes in the quality of their voice could be one of the first signs of the disease. One frequent symptom is speaking softly, which is known as hypophonia. “The symptoms can actually vary tremendously from person to person, but one incredibly common symptom is a quiet/low speaking volume,” says Gianna Nebbia, a licensed speech-language pathologist. “In fact, when I first ask someone with PD why they’re seeking speech therapy, they often respond with, ‘Everyone keeps telling me to speak up.’” RELATED: This Was the First Sign of Parkinson’s That Michael J. Fox Noticed. Some Parkinson’s patients notice changes in the tone and pitch of their voices, too. For example, Celia Montes, MS, CCC-SLP, speech-language pathologist at Control Bionics, notes that one’s voice can sound nasal when they talk, making it sound like they have a stuffy nose. Montes says slow and labored speech is also common with the disease. “Patients with Parkinson’s typically have some type of respiratory component in which they are unable to take an adequate breath, therefore affecting the quality of their speech,” she explains. Slurred speech is another potential vocal symptom of Parkinson’s. In a 2009 study published in the journal Topics in Geriatric Rehabilitation, author Kris Tjaden, PhD, details how 15 to 45 percent of people with Parkinson’s have dysfluency, which is difficulty speaking clearly or fluently. Speech impairments due to Parkinson’s can also affect patients’ language skills. “Language problems may affect the ability to understand speech or form speech, including finding the right words and constructing grammatically appropriate sentences,” Mari adds. “To that extent, language issues correlate closely with cognitive impairment.” RELATED: For more health advice delivered straight to your inbox, sign up for our daily newsletter. Parkinson’s symptoms can also affect your mouth in other ways beyond how you speak. Many patients have problems swallowing, leading to coughing or choking when eating or drinking, also known as dysphagia. In her study, Tjaden notes that between 40 to 95 percent of people with Parkinson’s have dysphagia.ae0fcc31ae342fd3a1346ebb1f342fcb Nebbia says the symptom can even make eating painful for Parkinson’s patients. “Weakness due to PD or other neurological disorders can make it difficult to chew, move food around the mouth, and/or swallow with enough force to get the food down to the esophagus and stomach,” she says. Montes says that Parkinson’s patients can also experience changes in taste and smell, which “can impact a patient’s ability to consume adequate nutrition and hydration.” While there is no cure for Parkinson’s, there are different wants to manage it. Nebbia notes that working with a speech specialist and exercising the voice a lot can be extremely helpful. “A speech-language pathologist can evaluate the person’s voice and recommend/teach exercises that will help the person specifically,” she adds. “Remember, no two individuals with PD present the exact same way.” RELATED: This Sign of Parkinson’s Could Show Up 20 Years Before You’re Diagnosed.