Adding life to years with Ayurveda.

“Healthy Aging” was the theme of World Health Day this year. This should be a decadal research mission for Ayurveda. Advancements in agriculture, science, technology, and biomedicine have increased human life expectancy, while the same have also contributed to the fall in the birth rates. As a result, for the first time in human history we will soon have more geriatric population as compared to the young. Elderly population of India is expected to share about 12.4% of the total population by 2026. India needs to be prepared to handle this demographic shift, especially the healthcare issues of the elderly, otherwise long life without health will certainly be a agony for them. Against this background, the World Health Day aphorism for this year – “Good health adds life to years” was pretty consequential and evocative. It is especially challenging for the Ayurveda community because geriatrics is one of its core strengths.

The Indian population is growing fast; it has grown from about 450 million in 1961 to 1200 million in 2011. In the last 50 years, the global life expectancy has gone up from 52.65 to 69.41, an astounding 16.76 years.[1] In all history, such a remarkable change in both life expectancy and falling birth rates was never seen. In India, the life expectancy has gone up by 25 years in the same period! The quantitative and qualitative change in the population makes demands on policy makers, governments, and administrators to change their outlook toward people at large and older people in particular.

It is well understood that the needs of the older people are different than those of youngsters, especially in respect of their healthcare needs. There is also a subtle shift in size and composition of the family leading to a large number of older people living all alone without support. Delivery of healthcare to the population takes a place of importance in a civilized society. The way the weakest members of the society are treated, speaks volumes about human development in the society. The policy on older people recognizes that “old persons have to cope with health and associated problems, some of which may be chronic, of a multiple nature, requiring constant attention and carrying the risk of disability and consequent loss of autonomy.” The national policy details a number of changes needed in the healthcare delivery mode, but it is not clear when these will actually be implemented. The policy speaks of healthy aging, but does not state precisely how this is to be achieved.[2] Why is the Ayurveda knowledge system not being harnessed by policy makers to develop a uniquely Indian “integrative research program” for healthy ageing?

The concept of Vayasthapana in Ayurveda deals with preserving the youthfulness of a body irrespective of its age and restricting progression towards senescence, along with enhancement of longevity, intellect, physical and mental strengths, and prevention from diseases. Rasayana Tantra, one of the eight branches of Ayurveda is dedicated to rejuvenation, regeneration, immunomodulation, and healthy aging. The process of degeneration and wear out increases with age and maintenance of normal function obviously requires special efforts. The scope of Rasayana therapy is not necessarily restricted to herb or formulation, but includes a combination of meditation, yoga, daily and seasonal diet, lifestyle interventions, and personal and social behavioral conduct too. All these measures that assist in the maintenance of healthy body tissues consisting of Saptadhatus are grouped together as Rasayana.[3] If one invests adequately in the creative design and implementation of a long-term Indian research program for the elderly based on Ayurveda principles, a definite output will be that elderly population not only in our society but also globally can remain healthier and require lesser need of curative interventions.

“Achar Rasayana”[4] is another Ayurvedic strategy for regulating the behavioral social conduct, which ensures a healthy life in a healthy society. In modern times when individuals are exposed to different types of societies in their life time, the ability to adapt to the behavioral modes of that society alone can ensure social health of the individual. In fact “Achar Rasayana” is of greater relevance in today's highly mobile society than it was when first proposed. Life should be like a Banyan tree giving shade and shelter to others, and send out its aerial roots earthwards to propagate the philosophy of providing shade and shelter. We cannot do away with ageing, but we can make it healthy and comfortable.

Ayurveda classic Sharngadhara Samhita quotes that we naturally deplete with each decade of life. Ayurveda observes natural dominance of vata dosha in old individuals and vata dominant diseases are expected more in this age group. Thus degenerative and debilitating diseases like osteoarthritis, Alzheimer's disease, dementia, stroke are commonly seen in older populations. Contemporary medicine has not yet been able to either prevent or retard the progress of these age-related disorders, and that is the reason why elderly people look toward Ayurveda with hope. Ayurvedic interventions are being tried for various health areas like skin,[5] and brain aging,[6] etc. however, more wholesome and systematic scientific programs to establish the safety and efficacy of Ayurvedic therapies are required.[7] Unfortunately, most of the studies pertaining to Rasayana till date have truncated the concept and therefore are mainly restricted to selecting formulations. The non-pharmacological interventions related to lifestyle, diet, and panchakarma therapies that Ayurveda advocates have been overlooked. Whole system management will be the appropriate study design to demonstrate the benefits of Ayurveda's understanding of geriatric interventions including bold therapies like Kutipraveshik Rasayanas. Biological effects of Ayurvedic interventions monitored during such studies may give new insights for modern biology and medicie. As WHO advocates, it is not important to add just years to your life but add life to your years. With help of wisdom of Ayurveda Shastra and advancements in Science, we can make life livable and more pleasant while it exists.