Aging is a very vital issue and a challenging problem of 21^st century. India is the second largest country dealing with the population above the age of 60 years (8.3%) after China in the world. Old age is a chronic progressive impairment of functions of organ systems, loss of adaptability to stress, susceptibility to age related disease and disability, and increasing living cost. On an average, elderly people consume about 30% of drugs of the world. Ayurveda, the most ancient sea of medical knowledge of the world deals with graceful aging under a specialized branch known as Jara chikitsa or Rasayana Tentra. Ayurvedic approach to graceful/successful aging consists of Prana – Bala – Marma paripalan, Stri – Garbhini - paricharya, Swasthavritta and sadavritta, Sattvika diet, Vyama, Pranayama, Meditation, Selective Panchakarma and Rasayana therapy.

DEPRESSION AND INFLAMMATION

It is the universal law of life cycle that anything which takes birth (utpatti) gets developed (vikas) and at the end ceases (laya). Human being not an exception to this law. Ayurveda, basically a health manual of the mankind which exclusively deals with protection of life, health, and its maintenance, disease and cure through natural ways. The concepts of long life, quality of life, mental health and graceful aging is well documented in all the major Ayurvedic texts under the name of Jara Chikitsa or Rasayana Tantra [1]. Not only in Ayurveda, but also in Yayurveda – 36/24, a prayer is uttered to win over the Jara or Vardhya or senility and to remain healthy for long hundred years. A long life does not necessarily mean a healthy life. Graceful aging is a multidimensional phenomenon involving physical, psychological, social, economical and spiritual dimensions [2]. Normal aging is marked by high risk of illness on the other hand graceful aging is marked by low risk of disability and high cognitive and physical functioning. For deeper understanding and insights of the subject Wh- question words, i.e., who, why, where, when, how are needed.

AIMS AND OBJECTIVE OF GRACEFUL AGEING WITH AYURVEDA

·         Low probability of disease or disability

·         High cognitive and physical function capacity

·         Active engagement of life

WHO IS AGED?

Chronological/functional age 60+, 65+ processes which converts healthy adults into frail one with diminished physiological reserve and susceptible to develop diseases. Older people play an important role in transferring experiences and knowledge to the young generation [3]. They can contribute in a more meaningful way if they are given appropriate opportunities. Chronological age is divided into young old (60-74 years), the old (75-84 years) and very old (85 years+). Biological aging closely associated with interaction of genetic, environmental, restricted calories and lifestyle. Charak Samhita vimana sthana 8^th chapter nicely has explained the characteristic features of changes after the age of sixty, i.e., dhatus, indryas, Bala, veerya, paurusha, parakrama, Grahana, Dharana Smarana, Vachana, Vignana began to decay and aggravation of vata dosha [4].

WHY AGING?

The people between 65-85 years are rising throughout the globe due to decrease in mortality and fertility rate, improvement of environmental condition such as clean water supply, improvement of sanitation, potential drug therapy, healthier lifestyle and prevention and treatment of infectious diseases. The elderly population in India has risen from 12 million in 1901 to 70 million in 1995, i.e., 7% of the total population. Gerontology is the study of biological, psychological and social aspects of ageing (from Greek word geron, “old man” and logy, “study of”) and Geriatric medicine is a subspecialty of medicine devoted to medical and social care of the elderly. Ayurveda has a full classical clinical branch to enhance health span or delay ageing known as Jara chikitsa or Rasayana chikitsa, i.e., correction and establishment of pathway of nutrition (RASA=first tissue of the body and essence of food, AYANA means pathway). Jara is two types, i.e., Akala jara or premature ageing and Kala jara or timely ageing. It offers different principles for a long active and healthy living [5].

HOW ELDERLY DIFFERS FROM YOUNG?

There is anatomical change, physiological change and change in Pharmacology in the elderly, decrease physiological reserve and store house of many diseases such as arthritis, high blood pressure, diabetes, heart disease, urinary disorder, cancer, dementia, depression, delirium. They also presented with multiple problems (social, financial, familial and abuse) and side effects of drugs (patient related, prescriber related and drug related). Common hidden illnesses are also common like incontinence, poor nutrition, sexual dysfunction, constipation [3]. In Vrddhavastha there is predominant of Vata dosha and all the properties, i.e., ruksha, laghu, shita, kshara, shuksha, chala guna become increased giving rise to various clinical symptoms and signs [6].

WHAT IS THE IDENTIFIABLE ABNORMALITY IN MAJOR SYSTEMS BY AGING?

In old age there is deterioration of functional capacity all organ systems of the body but six major systems namely: Cardiovascular health, brain and mental functions, musculoskeletal health, endocrine functions, immune function and homeostasis particularly glucose homeostasis is affected by aging as per medical science.

How?

How refers to Ayurvedic strategies to get aging gracefully. Where there is life there is Ayurveda. Ways and means should be adopted in every phase of life from beginning to end of life in the following ways –

Physical care: a) Stri, Grabhadhana samskara, Grabhini paricharya, Prasuti paricharya, sutikaparicharya, sishu palaniya bidhi (Pre-reproductive, reproductive care, antenatal, natal and postnatal care and care of infant and children) to obtain a good progeny.

b) Svasthavritta (lifestyle) – It mainly comprises of Dinacharya (total conduct right from get up early in the morning to night sleep), Ritucharya (specific diet and regimen in different seasons), Adharaniya vega (timely attending to nature’s call – hunger, thirst, defecation, urination, sleep, etc.). The purse of swasthavritta palan not to accumulate ama in the system (Niramayata). A ama free body is just like nectar and body with ama like poison [7].

c) Hita, mita and kala Bhojan (qualitative, quantitative and timely balanced diet) – Nutrition and dietetics plays a vital role for maintaining health and prevention of disease. Diet concepts in Ayurveda are very vast and scientific. Red variety of rice, wheat, green gram, rock salts, fruit of Amalaki, milk, ghee honey, potable water is considered as balanced diet. Use of incompatible diet (Viruddha ahara) should be avoided.

d) Timely Dosha shodhana: To avoid seasonal diseases, long active healthy productive life and get optimum result in Rasayana and Vajikarana drugs our acharyas’ advice evacuation of vitiated doshas (malas) timely, i.e., Vata in Varsha by Vasti, pitta in Sharada by virechana and Kapha in Vasanta by Vamana karma for our internal balance.

e) Use of Rasayana (Rejuvenation): Rasayana is the therapy containing drug, non-drug or diet that supports rasa and stimulates the production of Ojas. Rejuvenation therapy not only delays ageing but also quality of life, it gives health span, good memory, high intelligence, youthfulness, good complexion, increase immunity. There are single or compound formulations such as Haritaki (tonic action on GI tract), Pippali (on lungs), Bakuchi (on skin), Brahmi (acts on brain and improve intellectual faculty), Guduchi (on the liver), Amalaki (best general tonic), Shatavari (female reproductive organs), Ashvagandha (on male reproductive organs), Chyvanprash (anti-ageing medicine and lung tonic). Apart from medicine some activities like chanting of mantra, good conducts, regular study and discussion, good company also rejuvenates the body and mind.

Mental care: a) Dharniya Vega – Not to release mental emotions like Kama, Krodha, Lobha, mada, Moha, Matsaryas because these are the root cause of psychosomatic diseases.

b) Achara Rasayana – Good conduct, respectful attitude, avoidance of alcohol, prayer and avoidance of violence, etc.

c) Spirituality – It gives us a way to discover the answers to fundamental life questions it includes auspicious reading, pilgrimage, worship, Pranayama and meditation.

d) Medhya rasayana – Rejuvenation of brain by drugs and conduct delay aging because mental tension augments ageing. For sound mental health 4D’S must be practiced regularly, i.e., discrimination, detachment, devotion and discipline.

Sexual health care and healthy progeny: After food and drink sex is the second biological instinct of animal. In Ayurveda, there is a special branch which exclusively deals with promotion of sexual health, healthy offspring and treatment of male sexual dysfunction, nourishment of reproductive organs known as vajikarana. There are two faces of Vajikarana, i.e., procreation and recreation. The woman who is young attractive, educated and dedicated is supreme vajikara. Touch stimuli, music, perfumes, etc., come under vajikaran adjuvant.

Social health: Special behavior or code of conducts related to body, mind and speech to improve individual health and social life known as sadavritta. These moral ethics elaborately mentioned in charaka samhita.

Four keys for graceful ageing as per western thought

i) Appropriate nutrition and balance diet; ii) Appropriate physical activities; iii) Avoidance of bad habit such as smoking, alcohol and drugs; and vi) Tension free life such as mental relaxation, social involvement, socialization, yoga, pranayama and dhyan, along with involvement with the family are the keys for graceful ageing.

CONCLUSION

There are four particular problems with which all of us familiar, i.e., Janma, Mrityu, Jara and Vyadhi (birth, death, old age and disease). Geriatric is emerging as a challenging problem of 21^st century not only in India but also all over the globe. Aging is a natural process characterized by a progressive deterioration of our biological features. Jaraa means old age, a swabhabik vyadhi. This phase of life exerts its influence on body, mind, family, society, economy. There is enough scope in Ayurveda such as swasthavritta, sadavritta, geriatric panchakarma, Rasayana, Pranayama, Meditation, diet, etc., by which health span of the individual can be increased and graceful aging can be obtained. There is a common saying if any one spent his childhood in Russia, middle age in UK or USA and old age in India then his life will complete because Indian soil is religious soil with spiritual superpower.

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