A Geriatrics Review through Ayurveda

Abstract

In Ayurveda Human life is classified into three states: Balyavastha, Tarunyavastha, and Vardhakyavastha. Old age is thought to be the most vulnerable stage of life, requiring the greatest comfort and care. Ayurveda is one of the oldest systems for health management, with different branches for various health goals, one of which is Kayachikitsa. Geriatric medicine is the discipline of medicine that deals with the issue of aging and disease in the elderly. Aims and Objectives: To study the conception of Jara and to explore the provocative and feasible treatment through Ayurveda. Materials and Methods: Classical Ayurvedic texts on Jara on aging were investigated, gathered, analyzed, and presented in a systematic manner. Conclusion: Ayurveda is the science of life and longevity, and it has the ability to prevent and treat geriatric ailments.

Introduction

I. INTRODUCTION

Kayachikitsa is an Ayurvedic branch that considers many components such as Nidana, Shamana, Shodhana, and Satwawajaya for disease management and total health restoration. The Kayachikitsa not only aids in the maintenance of physical health but also in the restoration of mental wellness. Kayachikitsa's tactics, such as pharmaceuticals, counseling, and the employment of detoxification measures, among others, aid in maintaining excellent health1. The term GERIATRICS is derived from the Latin word 'Gera,' which means "to grow old." Geriatric medicine is the discipline of medicine that deals with aging issues and diseases that affect the elderly. Aging is the multifaceted and irreversible process of physical, psychological, and social changes that begins at birth and continues throughout life. Aging is a biological process that is mostly related with the decline of Dhatu, Balya, and Tridosa. It is believed that Vata Dosa initiates degenerative activity in old age, causing Agni to weaken, Srotamsi and Ojabala to lessen, and Doshic degeneration to occur. A lot of ideas have been advanced to explain the aging process, but simply put, aging is a regular occurrence among most living things and is a permanent slow physiological cellular breakdown2. The prevalence of diseases associated with old age is increasing as the geriatric population grows. There is now a need to develop fresh ways for geriatric health care through Ayurveda that slow or postpone the aging process in humans throughout the later phases of life when deterioration of body tissues and senses happens at an increased rate. Ayurveda encourages healthy aging through daily and seasonal routines, as well as codes of conduct such as Sadvritta, Rasayana Chikitsha, and Panchakarma. Ayurvedic medications such as Arjuna, Guggulu, Puskarmula, Brahmi, Triphala, and Amrita, among others have various beneficial health effects that help to delay the onset of aging.

II. AIM AND OBJECTIVES

To study and discuss various notions related to aging, as well as to understand geriatric specific disease and its treatment using Ayurveda.

III. MATERIALS AND METHODS

This review article on aging (Jara), A variety of single and compound Rasayana,  and other important issues was compiled from Ayurvedic sources such as Charak Samhita, Ashtanga Samgraha, Ashtanga Hridaya, Bhavaprakash, and Sharangdhar Samhita, as well as published commentary on these.

A. Concept of Ageing (Jara)

According to Charaka, the desire of every individual is for longevity of life; hence they developed Dirghamjeevitiyamadhyay (chapter on longevity of life) in the beginning of their text Charaka samhita.

Stages of life as described in Ayurveda are as follows3.

1. Balayavastha (Childhood), which extends up to age 16years.
2. Tarunayastha (Adult age), which extend after 16 to 60years.
3. Vriddhavastha (old age), where in after wherein after 60 to 100 years, the body elements, sensory organs, strength, vitality, manhood, velour, memory, understanding, speech, and discrimination begin to deteriorate.

B. Types of Jara

Ayurveda classifies Kalaj and Akalajjara as forms of Jara. KalajaJara is considered Swabhavikavyadhi, which cannot be prevented by medicines; however Akalajajara, or premature aging, can be prevented by practicing regular Panchakarma (body purifying procedures) and taking Rasayana drugs.

Decade wise stages of ageing and its impacts as per Ayurveda4.

C. Health Issues in Old Age

The number of health-related diseases rises with age. These health issues can be divided into several categories, including physiological, pathological, psychological, socioeconomic, morphological, cellular, and molecular and so on.

Physiological issue: These are common occurrences caused by the aging process, which leads in disability. For example, senile cataract, glaucoma, nerve deafness, skin wrinkles, age spots on the skin, hair turns grey and changes in mental attitude.

Pathological Issues: Many chronic inflammatory and degenerative disorders arise in the human body as people age. Common old-age conditions include respiratory issues, heart disease, stroke, and cancer, among others.

Socioeconomic Issues: In India, the elderly face a burden of communicable and non-communicable diseases, as well as impairment of special sensory capabilities such as eyesight and hearing, as well as other degenerative diseases. Low retirement income, loneliness due to the death of family members, misalignment with the younger generation, poor geographical access, and pricey treatment all contribute to low usage of health care, particularly among the elderly.

A research in Chennai of 400 community-dwelling old people aged 65 and up discovered a 14% prevalence of abuse. The most common type of abuse was chronic verbal abuse, followed by financial abuse, physical abuse, and neglect5.

D. Methods of Prevention and cure in Old Age

According to Ayurvedic principles, Swasthasyaswasthyarakshanam can only be attained by keeping Dhatus in an equilibrium state. Rasayanchikitsa (rejuvenating therapy) and Ahar (diet) must be taken properly for this, especially in old age. In old age, it is critical to pay special attention to Jatharagni (digestive fire). Doshanulomana (laxation) is also essential for good health.

E. Rasayan Chikitsa's role in the Elderly

Rasayana is an Ayurvedic branch that contains a variety of specific treatments for extending life, preventing aging and diseases, removing degenerative processes, and boosting health. Rasayana, according to Acharya Charak Longevity, memory, intelligence, independence from disorders, youthful age, excellence of luster, skin, and voice, optimum strength of physique and sense organs, successful words, respectability, and brilliance are all benefits of promotional treatment6. Rasayana (promotive treatment) refers to the path to achieving outstanding Rasa (Dhatus). Rasayana according to Acharya Sushruta, is one that prevents aging, enhances life time, improves intellect and memory and boosts resistance to diseases7.

Some Rasayankalpas and otherproven single herbs have been scientifically proven:

1. Guggulu (Commiphora wightii) - Guggulu suppresses joint discomfort, works as an anti-oxidant, and improves circulation. A clinical trial using Guggulu at a dose of 8 gm/day was attempted. A significant decrease in lipid fractions such as cholesterol (27%), triglycerides (36%), phospholipids (20%), and free fatty acids (37%), indicated the likelihood of atherosclerosis regression. The reversal of ECG abnormalities supported the drug's anti-ischemic action in the treatment of ischemic heart disease8.
2. Guduchi (Tinospora cordifolia) - Guduchi can revitalize skin tissues and boost immunity in geriatric patients, reducing the occurrence of frequent illnesses to which the old are predisposed. Guduchi has anti-aging, antioxidative, and anticancer effects in geriatric patients.
3. Amalaki(Emblica officinalis) - Amalaki is high in Vitamin C, Vitamin A and Vitamin E, as well as iron, calcium, and dietary fiber. Amalaki ability to promote a healthy digestive tract, vascular activity and the bodies natural cleansing process. Amalaki has antioxidant and protects against age-related degeneration and cataracts.
4. Ashwagandha (Withania somnifera)-Ashwagandha promotes cell regeneration, Heart health, increase muscle strength, and the delay of aging symptoms, and the preservation of skin texture. Ashwagandha has been shown lower stress and anxiety and reduced blood glucose levels.

• Withania somnifera (Ashwagandha) - As an immunomodulator, Ashwagandha can help cancer patient’s live longer lives when their immune systems are compromised. The findings point to its potential application as an anti-tumor and immunological modulator agent9.
• Withania somnifera (Ashwagandha) and aging - Using Ashwagandha powder in old age results in a statistically significant rise in hemoglobin, RBC count, hair melanin, and seated stature, as well as a drop in serum cholesterol and ESR10.

5. Brahmi(Bacopa monneria) - Brahmi has a variety of pharmacological effects, including memory enhancement in the treatment of Alzheimer's disease and schizophrenia, as well as antiparkinsonian, antistroke, and anticonvulsant properties. Brahmi acts as a memory enhancer, particularly in cases of age-related memory decline; it improves overall mental activity and refreshes the brain.

6. Turmeric(Curcumalonga) -Turmeric has anti-aging qualities, anti-inflammatory capabilities that reduce pain, antioxidant properties that aid in oxidative damage, and immunological capacity.

7. Shilajit(AsphaltumPunjabianum) - The medication aids in the treatment of Alzheimer's disease, weariness, and sleeplessness, as well as other age-related health issues. Fulvic acid, a Shilajit component, acts as an antioxidant, preventing oxidative tissue damage. It improves physical strength, sexual stamina, and digestive power. Asphaltum punjabianum

8. Moring(Moringaoleifera) - It is regarded as an important source of vitamins and nutrients that improve skin texture and color, assist to seem younger, promote cognitive activity, and improve cardiovascular efficiency.

The following drugs are used for specific purposes in geriatric care.

• Drugs for respiratory system :Vardhaman Pippli
• Drugs for Digestion system : Long pepper,Haritaki
• Drugs for Cardiovascular system: Arjuna,Puskarmula
• Drugs for Nervous system : Vacha, Shankhapushpi,Tagar
• Drugs enhance the shine and complexion of the skin: Somaraji,Bhringaraja
• Drugs improve Drugs enhance the Vision(Drishti): Saptamrta lauha,Kataka
• Drugs used for hearing improvement :Dashamula Taila and Apamarga Taila
• Drugs increase Shukra (sexual power):Ashwagandha, Kapikacchubija and Musal
• Drugs boost excretory system in elderly: Vidanga and Punarnava

F. Nutrition and Diet in Geriatric Care

According to Ayurvedic principles, the Vaatdosha increases with age. Vishamagni (irregular digestive fire) is similar to vaat, therefore to sustain Agni in old age; one should eat according to the status or strength of Agni. Diet in old age should be well balanced, low in saturated fats, calcium rich, and include fruits and green leafy vegetables. Diet is a major factor in the process of premature aging.

Faulty eating habits such as Vishamashana, Adhyashana, Ajeernashana, Amla-Lavana Rasa Atisevana can hasten the aging process at the micro and macro cellular levels, resulting in premature aging. As a result, it is critical to adhere to the good food pattern described in Ayurvedic classics in order to live a long and healthy life11.

Alcohol and elderly it has been related to liver disease, hypertension, ulcers in the stomach, heart disease, gout, depression, and osteoporosis. Alcohol sensitivity is proportional to age.

IV. DISCUSSION

A variety of single and compound Rasayana medicines with diverse actions such as immuno-enhancement, free-radical scavenging, anti-depressant, and nutritive effects are described in Ayurvedic literature for use in health promotion and disease curing with improved quality of life. Rasayanchikitsa for the elderly is cost effective, inexpensive, and has no side effects. Lifestyle modification is still an important part of preventing geriatric diseases. Diet is a major factor in the process of premature aging.  Kaya Chikitsa is the use of various internal medications for the management of aging or geriatric care. Some medications that help in age-related health concerns include Ashwagandha, Musali, Arjuna, Haritaki, Giloy, Shilajit, and Turmeric, among others

Conclusion

Although the likelihood of getting diseases grows with age, it is not a necessary consequence of aging. Prevention and treatment of health problems may assist the elderly enhance their quality of life and remain independent in their everyday activities to some extent. Kaya Chikitsa methods include the total management of health/body, which primarily involves the diagnosis and treatment of health disorders utilizing medicine and other modalities. These therapies serve to maintain Vata, Pitta, and Kapha balance, potentiate Dhatu, improve nutrition, regularize the circulatory process, and detoxify the body, thereby preventing disease and combating the negative effects of aging. Ayurveda promotes longevity and so has a high response in geriatric care. Kaya Chikitsa is the use of various internal medications for the management of aging or geriatric care. Some medications that help in age-related health concerns include Ashwagandha, Musali, Arjuna, Haritaki, Giloy, Shilajit, and Turmeric, among others. Kaya Chikitsa medicines and other ways promote skin luster, Drisht, Shukra, cardiac functioning, metabolic activities, nervous system functioning, and excretory system regularization in the aged. Finally, it can be concluded that ayurvedic medicine can be employed as an alternate technique for geriatric care with no negative consequences.

References

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Copyright

Copyright © 2024 Dr Divya Singh Charan, Dr Hemant Kumar. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.