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Physical/Psychological/Metabolic Aspects of Jara and Care Through Rasayana

  1. Physical/Psychological/Metabolic Aspects of Jara and Care Through Rasayana Prof. Y. K. Sharma Professor Kayachikitsa , Former Principal Cum Dean Rajiv Gandhi Govt Post Graduate Ayurvedic College Paprola- Himachal Pradesh
  2. Definition: Jara is state of becoming “ksheen” (debilitated), physically and psychologically weak as a result of old age usually after 60 years of life. The word geriatrics too is derived from latin word “geras” meaning “to grow old” Aging is described as a progressive loss of adaptability with passage of time so that individual is less and less able to react abruptly to challenges from the external or internal environment. With time the individual becomes progressively more frail and in need of increasing support to maintain his or her autonomy.
  3. Difference Between ? AYU and VAYA  Biological age and chronological age ?  What is line of demarcation between middle and old age?  What is individual aging and population aging?  Mlsp : maximum life span span period
  4. Aging a Continuous Process – Sharangdhar DACADE WISE AGING 1. Balyam – childhoot 2. Vriddhi – growth 3. Chhavi – lusture 4. Medha – sharpness in perception 5. Twak – skin and appendages 6. Drishti – visual acuity 7. Shukra – fertility 8. Vikram – valour and courage 9. Buddhi – commulative intellect 10. Karamindri – physical capacities Finally there is loss of ultimate that is functions of mind life substance.
  5. Phenomenon of Life Birth Maturity scenence decay/death Procreation Continuity of life and species Evolution New species
  6. Jara Hetu Kalasya parinam – swabhawaja or essential by Charak other ayurvedic literature mentions few specific factors for jara esp Aakaljara 1. Pantha : excessive travelling or physical activities 2. Sheetam : taking unwholesome or chilled food 3. Having sexual desires for olderwomen or to remain sexually active even after onset of oldage. 4. Kaddana : taking tubers in excess in food. 5. Manaspratikoolta : to remain under continuous mental stress.
  7. Charak In Description of Rasayana Describes that indulgence in “gramya ahara” leads to agnimandya, vataprakopa and dhatukshaya thus it is important factor for premature aging Two major factors responsible for aging are: 1.Srotorodha 2.Agnimandata.
  8. What The Modern Science Concludes Regarding Factors Of Aging: 1. DNA Cross Linking Theory : failure to manufacture essential enzymes/proteins 2. Random Damage Theory- free radical damage 3. Somatic Mutation Theory- death in groups 4. Pacemaker Theory or Organ system : decay of endocrinal and immunological potentials 5. Death hormone Aging is gene/environmental controlled phenomenon.
  9. Dosha kshaya Dhatu kshaya Mala kshaya Ooja kshaya Mano karya kshaya That is deterioration of Shareerika, Vachika and Manasika functions. All these are reflected in features of aging. Onset Of Jara Is Accompanied By
  10. Presence of inclusion bodies in cells like metabolic debris, lipids, calcium, cholesterol Intracellular sodium increases and potassium falls.  Ph and intracellular water contents decreases. Total body water decreases Fat accumulates in body leading to fall in specific gravity of body from 1060 to even 1036 Cellular metabolism suffers due to altered DNA, RNA and enzyme systems Oxygen uptake and utilization decreases Body temperature falls Etc. Major Metabolic Changes in Geriatric Patients:
  11.  Sharirshaktiheena – regression of physical capacities  Smiritinasha – diminishing memory  Manasik glani – loss of cheerfulness and alertness  Balinam – appearance of wrinkles  Palitya – greying of hair  Dantashaithilya – loosening of denture  Swabhava vaipparya – change in personality components.  Kasa swasa pravritti – proneness to repeated coughs and dyspnoea on effort  Sarvakriya asamarthata ; loss of physical, perceptual and mental faculties Sushrut Sutra Sathana Features of jara
  12.  Vakayaparushta  Karshya  Gatrasfurana  Nidranasho  Alapbalatvam  Ghadvirchissaya Features of Vatavriddhi are Found as Permanent Features In old E.G.
  13.  Mandachesta – slowness of physical and mental activities  Aapraharsh – unsatisfying nature  Mudhasangyata – slowness of perception and resolution  Nishprabhava – loss of luster  Rookshta – dryness and wasting  Sandhisathalya – instability of joints  Manoshunyta – lack of ideation  Shramm – easy fatigability  Shirashaithilya – prominent and tortuous blood vessels  Sfeeg, greeva, udar shuskata : wasting of muscles  Asthi shool – degenerative bone disease  Klaivya – erectile dysfunctions and sterility Old People Show Features of Dosha and Dhatu as Well as Mala Kshaya. The Important Among Them are:
  14.  Durbalata – general debility  Aabeekashanam – intaking of small quantity of food.  Yyathitendriya – ailments and diminished capacities of indriyas.  Duschaya – lack of lusture  Durmana – decreased mental capacities  Rookshta – dryness of skin Features of Jara Attributable To oja Kshaya:
  15.  It is at physical metabolic and psychological level on once onset uccers it is progressive.  Every system contributes to these features.  Only when it hampers the quality of life , threatens life it is usually appreciated.  Physical incapacities are more complained and attended than mental . Features of Aging are Due To Anatomical and Physiological Regressions in Body Over The Years.
  16. General – increased body fat and decreased body water leads to obesity, anorexia Eyes – presbiopia and lens opacity – blindness. Decreased testosterone, estrogen – decreased libido, impotence, sterility Respiratory – decreased lung elasticity and increased lung stiffness – dyspnoea and hypoxia Cardiovascular- increased arteriosclerosis, decreased autonomic responsiveness – heart failure, lowered tissue profusion, heart block Git- decreased liver function – lowered appetite, portal hypertension. Decreased gastric secretions – poor digestion, anemia Decreased colonic motility – constipation and impaction of stools. Selected age Related Changes and Their Consequences:
  17. Haematological and immune system – anaemia, lowered immunity, autoimmune damage Genito urinary – increased frequency, retention, incontinency, bph Muskuloskeletal – power, tone , fracture, in-cordination Nervous system – dementia, delirium and depression. Termers, ataxia.
  18. Major change is loss of neurons leading to dementia resulting Loss of memory Deterioration of intellect Change in behavior Change in personality Apathy Mood instability Alzheimer's disease leads to early onset of the features with fast progression mind functioning deterioration is accompanied by proportionate bodily functioning deterioration Aging and Mind Functioning:
  19. Why Sudden Interest in Geriatrics? Economic development of world Better food, better living conditions, better health care Demographic transition Low birth and death rate Lowered younger and increased older population Average life expectency over 60 years High geriatric load High geriatric care need both domiciliary and hospital
  20. Cataract – IOL Denture loss – artificial denture Hearing loss – hearing aid Osteoarthritis – joint replacement Ataxia – prosthetic support Bph – tur But, what for brain, mind, autonomic and voluntary control over activities ? Extended physical life may be vegetative in nature with low quality of life without Emotional component Memory, insight Gross ataxia Incontinence Unproductively Common Geriatric Ailments and Remedies:
  21.  Physical wellbeing  Mental wellbeing  Spiritual wellbeing  Social wellbeing For biological wellbeing : preventive, curative, palliative as well supportive care is needed Need Is To Extend Life of Mental or Neurological Components Along With Physical and Other Biological Components of Geriatric Life For Quality of Life Which Gives
  22. Physical care: Through proper swasthvritta, dincharya, ritucharya, yoga, Biological care : Through required balanced diet, vitamins, essential minerals, specific drugs and rasayanas like ashwagandha, chyavanprash, amritprash, shilajeet, medhya rasayana, pranakameeya and other ayushyakameeya rasayana. Mental and spiritual care: Mangal, pranipatgamanam, sadvritta, aachar rasayana, aparigrha, family support Social care : Government through economic support, old age care home, free travelling and health insurance, legal support, terminal care. Care trough ngo’s Geriatric Care Through Ayurveda:
  23.  Screen for hypertension, DM, CAD.  Prostate and colorectal cancers  Breast and cervical cancer  Dental ailments  Stress  Depression  Stroke factors Secondary Prevention of Old age Related Disorders:
  24.  Staying in family  Open life in villages  Less stress  Regular physical activity  Definite purpose of life  Medical care at hand Ideal Atmosphere for Aging:
  25. Aahar – milk, snehapana, madhur rasa, low salt, laghu aahara Rasayana Avoiding alcohol and smoking Avoiding fasting Avoiding sexual activity Regular exercise Avoiding hard exercising Regular cold water bath Day time sleep Regular avyanga Social care Spiritual care Factors That Sustains Life and Delay Jara: