An evidence based review on the role of ayurved in geriatric care
Journal name: Ayushdhara
Original article title: An evidence based review on the role of ayurved in geriatric care
AYUSHDHARA is an international peer-reviewed journal. It focuses on research in Ayurveda, Yoga, Unani, Siddha, Homeopathy, Allopathy, and Pharmaceutical Sciences.
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Dhingra Harsh
Assistant Professor, Department of Swasthvritta, Sanskriti Ayurvedic Medical College & Hospital, Chhata, Mathura, Uttar Pradesh,
Ayushdhara:
(A peer-reviewed, bi-monthly open-access journal)
Full text available for: An evidence based review on the role of ayurved in geriatric care
Year: 2020
Copyright (license): CC BY-NC-SA 4.0
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Summary of article contents:
Introduction
Aging is an inevitable and irreversible process that comes with various physical, psychological, and social challenges. The elderly population globally is on the rise, leading to increased healthcare needs in geriatric care. As life expectancy increases, understanding and addressing the intricacies of aging becomes crucial. Ayurveda, an ancient Indian system of medicine, offers a holistic approach to health and has a dedicated branch called Jara or Rasayana to combat aging-related issues. This review highlights the significance of Ayurveda in geriatric care, emphasizing the need for comprehensive research in this important field.
The Role of Rasayana in Geriatric Care
Rasayana, a branch of Ayurveda, focuses specifically on promoting health, longevity, and vitality in aging individuals. It encompasses a variety of treatments and lifestyle modifications aimed at preventing and delaying the aging process. Ayurvedic texts classify aging as Jara, which involves inherent physical and mental decline over time. The use of rejuvenating herbs, dietary practices, and therapies such as Panchkarma, yoga, and specific Rasayana drugs, e.g., Amlaki and Giloy, plays a vital role in mitigating the adverse effects of aging. Evidence-based studies indicate that these Ayurvedic treatments can significantly improve the quality of life for elderly individuals by enhancing their physiological and psychological well-being.
Comprehensive Geriatric Assessment
A key strategy for addressing the complex needs of the elderly is Comprehensive Geriatric Assessment (CGA), which aims to provide a thorough evaluation across multiple domains, including medical, functional, and psychological aspects. This holistic approach facilitates individualized care planning to enhance the overall health outcomes of geriatric patients. The CGA process includes assessments of nutrition, cognitive function, medication compliance, and social circumstances, thereby addressing various potential health risks. Integrating Ayurvedic principles into CGA can further enrich the assessment, offering more tailored interventions that respect the traditions and wisdom of Ayurveda while ensuring modern healthcare standards.
Conclusion
The process of aging requires a multifaceted approach that combines traditional wisdom and contemporary medical practices. Ayurveda provides valuable insights and strategies for managing the challenges associated with aging through its emphasis on prevention and holistic health. The integration of Rasayana therapies, alongside comprehensive assessments, promotes better health outcomes and enhances the quality of life for older adults. Given the rising aging population, it is vital to advance research in Ayurvedic practices to develop evidence-based protocols aimed at geriatric care, thereby fostering awareness and acceptance of these methods in the broader healthcare community.
FAQ section (important questions/answers):
What is the significance of Ayurveda in geriatric care?
Ayurveda offers a holistic approach to enhance health and quality of life in the elderly. It includes preventive measures through Rasayan therapies, lifestyle modifications, dietetics, and yoga, addressing the challenges of aging.
What are the common physical problems associated with aging?
Aging can lead to numerous physical issues including cardiovascular problems, osteoporosis, reduced lung capacity, diabetes, and cognitive decline. These issues emphasize the need for special attention and comprehensive care for the elderly.
How does Ayurveda classify the aging process?
Ayurveda classifies aging as 'Jara', divided into phases based on body changes. Acharya Sushrut identifies two types: 'kalaj' (inevitable) and 'akalaj' (preventable), acknowledging that aging is a natural process inherent to living beings.
Glossary definitions and references:
Scientific and Ayurvedic Glossary list for “An evidence based review on the role of ayurved in geriatric care�. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.
1) Disease:
A disease is an abnormal condition affecting the body of an organism. The relevance of the term 'disease' in the text relates to the various ailments and health conditions that are prevalent in the geriatric population, highlighting the need for geriatrics as a major medical specialty globally.
2) Jara (Jara°, Jará):
Jara is the term for aging in Ayurveda, defined as 'jiryate iti jara,' which means 'that which wears to get old.' The text mentions Jara as a natural, unavoidable process that Ayurveda aims to manage with therapies and lifestyle modifications to prolong health and vitality in old age.
3) Cancer:
Cancer refers to diseases in which abnormal cells divide uncontrollably and destroy body tissue. In the context of the provided text, telomers act as a 'biological clock' to prevent uncontrolled cell division and cancer, highlighting the importance of maintaining cellular health.
4) Dhatu:
Dhatus are the seven fundamental tissues of the body in Ayurveda. They are essential for the body's physiology and function. The relevance in the text is in the human development stages, where Rasadi sapta dhatus develop during childhood.
5) Hair:
Hair issues in the elderly, such as hair loss and baldness, are common problems mentioned in the text. This is a part of the various physical changes experienced as part of the natural aging process.
6) Ashvagandha (Asvagandha, Ashwagandha, Ashvagamdha, Ashva-gandha):
Ashwagandha is an adaptogenic herb used in Ayurveda. The text highlights its efficacy in improving resistance towards stress and enhancing the quality of life in individuals, making it a valuable component in managing aging-related issues.
7) Depression:
Depression is a common psychological issue in the elderly, often accompanied by insomnia and cognitive decline. The text discusses the prevalence of depression among old age people and the need for comprehensive geriatric assessment to address such issues.
8) Triphala (Tri-phala):
Triphala is a well-known Ayurvedic formulation with potential antioxidant properties. The text mentions its protective effects on human skin cells and its role in stimulating selective youth genes, thus supporting its use in geriatric care.
9) India:
India has a significant elderly population. The text states that although the percentage of aged persons is lower compared to developed countries, the absolute size of the aged population is considerable and is expected to rise substantially by 2050.
10) Death:
Death is the cessation of all biological functions that sustain a living organism. In the text, it is discussed as the final stage of the human life cycle, following old age, which Ayurveda aims to prolong through various therapies and lifestyle interventions.
11) Drug:
A drug is any substance that causes a change in an organism's physiology or psychology when consumed. The text refers to review of medicines and drug therapies as part of comprehensive geriatric assessments to manage health conditions in elderly patients.
12) Shilajit (Silajit, Shila-jit):
Shilajit is an Ayurvedic substance known for its potential to enhance cognition and potentially prevent Alzheimer's disease. The text underscores its utility as a dietary supplement and a powerful rejuvenator for the elderly.
13) Rasayana (Rasa-ayana):
Rasayana is a branch of Ayurveda focused on rejuvenation and anti-aging treatments. The text discusses various Rasayana therapies, highlighting their role in enhancing health, longevity, and the quality of life in the elderly.
14) Indriya (Imdriya):
Indriyas are the senses in Ayurveda. The text notes that during the developmental stage of life, different indriyas or sensory organs develop, and their functioning might decline with age, necessitating a holistic approach to geriatric care.
15) Mathura (Mathur):
Mathura is a city in Uttar Pradesh, India. The relevance in the text is that Dr. Dhingra Harsh, the author, is an Assistant Professor in the Department of Swasthvritta at Sanskriti Ayurvedic Medical College & Hospital located in Mathura.
16) Shakti (Sakti):
Shakti means power or energy. In the text, terms like 'ahara shakti' (appetite) and 'vyayama shakti' (exercise) demonstrate its application in assessing the physical capabilities of elderly individuals, aiming to enhance their overall vitality.
17) Brahmi:
Brahmi is an Ayurvedic herb known for its cognitive-enhancing properties. The text highlights research indicating its potential as a promising agent for treating Alzheimer's disease and cognitive impairments, reinforcing its value in geriatric care.
18) Kapha:
Kapha is one of the three doshas in Ayurveda, associated with structure and lubrication in the body. The text outlines the dominance of Kapha during the 'balyavastha' or childhood phase, affecting the overall development in early life.
19) Vayas:
Vayas refers to age or life stages in Ayurveda. The text explains the classification of life into various phases like 'bala,' 'madhya,' and 'vriddha,' each dominated by different doshas, with Vayas playing a critical role in understanding aging.
20) Birth:
Birth marks the beginning of life. The text describes the journey of life starting from birth, emphasizing the progression through different life stages, ultimately leading to old age, which is managed through Ayurveda.
21) Vaya:
[see source text or glossary: Vaya]
22) Yoga:
Yoga is a holistic practice in Ayurveda that includes physical, mental, and spiritual disciplines. The text mentions Yoga in conjunction with Rasayana and Panchakarma therapies as essential for delaying aging and improving the quality of life in the elderly.
23) Leptadenia reticulata:
Leptadenia reticulata, also known as Jeevanti, is an Ayurvedic herb. The text lists it among the age-stabilizing dravyas or rejuvenators that have beneficial effects on the aging process and the overall health of elderly individuals.
24) Tinospora cordifolia:
Tinospora cordifolia, known as Giloy, is an Ayurvedic herb mentioned in the text. Research has shown it significantly increases lifespan, making it a valuable ingredient in anti-aging and geriatric care therapies.
25) Phyllanthus emblica:
Phyllanthus emblica, commonly known as Amla or Amlaki, is highlighted for its effectiveness in treating aging symptoms like insomnia and digestive weakness. It is a key Rasayana in Ayurveda for promoting longevity and vitality.
26) Terminalia chebula:
Terminalia chebula, or Haritaki, is an herb listed in the text as Amrita, mentioned among the age-stabilizing dravyas. It is known for its rejuvenating properties, contributing to better health and prolonged life.
27) Human body:
The human body undergoes various physiological changes over a lifetime. The text describes how the strength of the human body ascends in childhood, remains stable in middle age, and then declines in old age, requiring holistic health management.
28) Asparagus racemosus:
Asparagus racemosus, known as Shatavari, is an Ayurvedic herb. The text mentions it as one of the rejuvenators that can delay the aging process, hence playing a crucial role in the holistic geriatric care outlined by Ayurveda.
29) Tribulus terrestris:
Tribulus terrestris, referred to as Gokshura, is noted in the text for its significant antihypertensive effects. It is safe for long-term use, particularly for managing fluid retention-related conditions in the elderly.
30) Rasayanatantra (Rasayana-tantra):
Rasayana-tantra is a branch of Ayurveda dedicated to rejuvenation practices. The text emphasizes its role in promoting health and longevity, offering various methods and measures for enhancing the quality of life in geriatric populations.
31) Pharmacological:
Pharmacological interventions refer to the use of drugs to treat diseases. The text uses this term in discussing treatments like turmeric for Alzheimer's disease, which significantly improve behavioral and psychological symptoms in dementia patients.
32) Vyayamashakti (Vyayamasakti, Vyayama-shakti):
Vyayama-shakti refers to the energy or capacity for exercise. The text mentions improvements in this capacity through the use of Chyawanprash, highlighting its importance in maintaining physical fitness in the elderly.
33) Vayasthapana (Vaya-sthapana):
Vayasthapana is a term referring to age-stabilizing properties. The text mentions Chyawanprash as having Vayasthapana quality, which is beneficial in improving the quality of life and physiological health of elderly individuals.
34) Aharashakti (Aharasakti, Ahara-shakti):
Ahara-shakti refers to the power or capacity for digestion and appetite. The text discusses how Chyawanprash improves Ahara-shakti, thus enhancing the overall nutritional status and health of elderly participants.
35) Tuberculosis:
Tuberculosis is a bacterial infection that primarily affects the lungs. The text includes TB among the conditions for which elderly individuals should be screened, underscoring the importance of preventive healthcare in geriatric populations.
36) Saptadhatu (Sapta-dhatu, Saptan-dhatu):
Sapta-dhatu refers to the seven fundamental tissues of the body in Ayurveda. The text mentions their development during childhood, emphasizing their importance in growth and the body's physiological processes.
37) Shatavari (Satavari):
Shatavari, or Asparagus racemosus, is highlighted in the text as one of the age-stabilizing dravyas. It is known for its rejuvenating properties and is a valuable herb in managing the aging process and geriatric care.
38) Punarnava (Punar-nava):
Punarnava, known as Boerhavia diffusa, is an Ayurvedic herb mentioned in the text. It is one of the rejuvenators that help delay aging and maintain health, making it significant in the holistic approach to geriatric care.
39) Aparajita:
Aparajita, or Clitoria ternatea, is listed among the age-stabilizing dravyas in the text. It is valued in Ayurveda for its rejuvenating properties, contributing to the management of aging-related health issues.
40) Evolution:
Evolution in the context of aging involves the gradual progression of physiological changes in the human body. The text describes aging as a process with both growth (evolution) and atrophy (involution), highlighting its complex nature.
41) Ayurveda (Ayus-veda):
Ayurveda is a holistic system of medicine originating in India. The text emphasizes the relevance of Ayurveda in geriatric care, discussing its various therapies and lifestyle measures aimed at delaying aging and improving quality of life.
42) Gokshura (Goksura, Go-kshura):
Gokshura, or Tribulus terrestris, is noted for its antihypertensive effects in the text. This Ayurvedic herb is effective in managing blood pressure without side effects, making it suitable for long-term use in elderly patients.
43) Sadvritta (Sadvrtta, Sat-vritta):
Sadvrtta refers to ethical conduct in Ayurveda. The text suggests incorporating Sadvrtta, along with Rasayana, Panchkarma, dietetics, Yoga, and spirituality, as part of a holistic package for geriatric care, promoting overall well-being.
44) Medicine:
Medicine encompasses substances or preparations used in treating diseases. The text discusses various Ayurvedic herbs and formulations as medicinal interventions to manage and improve health conditions in the elderly population.
45) Mutation:
Mutation refers to changes in the DNA sequence. The text mentions mutations in the context of aging, where oxidative damage to nuclear chromosomal DNA can cause mutations and deletions, ultimately reducing gene function.
46) Turmeric:
Turmeric, known as Haridra in Ayurveda, is noted in the text for its beneficial effects on Alzheimer's disease symptoms. It significantly improves behavioral and psychological symptoms, showcasing its therapeutic potential in geriatric care.
47) Swelling:
Swelling is a common symptom of various health conditions. The text lists swelling as a physical issue in old age, emphasizing the need for comprehensive medical assessments to manage such health concerns in the elderly.
48) Vyayama:
Vyayama means exercise in Ayurveda. The text underscores the importance of Vyayama in maintaining physical health and vitality, mentioning improvements in exercise capacity in elderly participants through the use of Chyawanprash.
49) Avastha:
Avastha refers to the different stages of life. The text details various phases like 'balavastha' (childhood), 'madhyamavastha' (middle age), and 'vriddhavastha' (old age), each characterized by different dosha dominances and health challenges.
50) Haridra:
Haridra, or turmeric, is highlighted in the text for its positive effects on Alzheimer's disease. It significantly improves neuropsychiatric symptoms and is included in the list of herbs beneficial for the geriatric population.
51) Tantra (Tamtra, Tantrism):
Tantra in Ayurveda refers to a systematic framework. The text mentions Rasayana Tantra, a branch focused on rejuvenation and anti-aging practices, emphasizing its comprehensive methods to improve health and longevity in elderly individuals.
52) Dravya:
Dravya refers to substances or ingredients in Ayurveda. The text lists several age-stabilizing dravyas like Giloy, Amlaki, and Shatavari, which are instrumental in managing the aging process and enhancing the health of geriatric populations.
53) Sthira:
Sthira is identified as Desmodium gangeticum, listed among the age-stabilizing dravyas in the text. It is valued in Ayurveda for its rejuvenating properties, contributing to the overall health and longevity of elderly individuals.
54) Madhya:
Madhya refers to middle age in Ayurveda. The text discusses the characteristics of 'madhyamavastha,' where dhatus and indriyas fully develop and eventually stop growing, marking a phase between childhood and old age.
55) Kshaya (Ksaya):
Kshaya refers to the decline phase in the life cycle. The text describes it as a period after 70 years where all body organs start decaying, underscoring the need for effective geriatric care to manage this inevitable process.
56) Amrita (Amrta):
Amrita, identified as Terminalia chebula, is included among the age-stabilizing dravyas in the text. It is known for its rejuvenating properties, making it a valuable component in promoting health and longevity in the elderly.
57) Vyadhin (Vyadhi):
Vyadhi means disease or ailment in Ayurveda. The text mentions that aging comes under 'Swabhavaj vyadhi,' inherent conditions that naturally occur with aging, necessitating appropriate therapeutic interventions to manage them.
58) Family:
Family is mentioned in the context of social issues affecting the elderly. The text highlights the lack of family support as a major concern, which can impact the psychological and physical well-being of geriatric individuals.
59) Repair:
The text mentions repair mechanisms in the context of aging, where multiple repair and maintenance systems attempt to counteract the accumulation of molecular defects over time. Despite these mechanisms, aging results in functional impairments.
60) Edema (Oedema):
Oedema refers to swelling caused by excess fluid trapped in the body's tissues. The text includes oedema as part of the physical assessment parameters for elderly individuals, highlighting its significance in comprehensive geriatric care.
61) Nature:
Nature in the text refers to the inherent biological processes. Aging is described as a 'swabhavaj vyadhi,' meaning it is the natural course of life for all living beings to experience aging, making it a universal and unavoidable phenomenon.
62) Animal:
The text briefly mentions experimental studies on animals to value certain Ayurvedic herbs like Brahmi for cognitive enhancement and Alzheimer's disease treatment, suggesting the role of preclinical trials in validating Ayurvedic therapies.
63) Manas (Mano, Manash):
Manas refers to the mind in Ayurveda. The text mentions 'Manas' as unstable during the developmental phase of 16-30 years, highlighting the importance of mental health in conjunction with physical development throughout different life stages.
64) Dosha (Dosa):
Doshas are the three fundamental bodily bio-elements in Ayurveda: Vata, Pitta, and Kapha. The text discusses the relation of doshas to different stages of life, emphasizing their influence on health and aging.
65) Pitta:
Pitta is one of the three doshas in Ayurveda, associated with metabolism and energy. The text mentions Pitta as dominant in 'madhyamavastha' or middle age, affecting overall physiological functions during this phase of life.
66) Rasna (Rashna, Rasona, Rasa-una):
[see source text or glossary: Rasna]
67) Ahara:
Ahara means food or diet. The text emphasizes the importance of dietary habits and nutrition in maintaining health and delaying the aging process, particularly highlighting the role of Ahara Shakti (digestive capacity) in geriatric care.
68) Ayus (Ayush):
[see source text or glossary: Ayush]
69) Sugar:
[see source text or glossary: Sugar]
70) Ulcer:
An ulcer is a break in the skin or mucous membrane that fails to heal. The text mentions skin ulcers as part of the physical assessment parameters for the elderly, underscoring the need for comprehensive health evaluations in geriatric care.
71) Pulse:
Pulse refers to the rhythmic throbbing of arteries as blood is propelled through them. The text mentions widened pulse pressure as a common cardiovascular issue in the elderly, highlighting its significance in assessing aging-related health conditions.
72) Blood:
Blood plays a crucial role in transporting nutrients and oxygen to cells. The text discusses various blood-related health issues like increased risk of glucose intolerance and reduced arterial oxygen saturation in the elderly, emphasizing the need for thorough medical assessments.
73) Panca (Pancan, Pamca):
[see source text or glossary: Panch]
74) Bala:
Bala refers to the childhood phase in Ayurveda. The text discusses the dominance of Kapha during Balavastha, where various dhatus and indriyas develop, highlighting the importance of this phase for growth and development.
75) Vata:
Vata is one of the three doshas in Ayurveda, associated with movement and communication within the body. The text mentions Vata as being dominant in 'Antim avastha' or old age, affecting various physiological functions and health conditions during this phase.
[Note: The above list is limited to 75. Total glossary definitions available: 79]
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