Bulber Parkinson's disease manifests with speech and balance issues. My concern is to rule out Basal ganglionic pathology to demonstrate that it's just neurology degenerative disease we are dealing with here. If it is neurodegenerative type Parkinson's disease, then normal progression will be 2 to 5 year when you will find early complication of Parkinson's disease like falls and aspiration pneumonia. Until then, maintain your quality of life with medication and supportive care.
With best regards,
Dr. Vasoya Pravinkumar