Ageing in Ayurveda

Ageing in Ayurveda

Concept of Aging in Ayurveda

Types of Aging

Kalaja Jara: natural, inevitable decline due to time.

Akalaja Jara: premature aging caused by improper diet, unhealthy lifestyle, excessive stress, or indulgence.

Dosha–Dhatu–Mala Imbalance

Vata aggravation in old age leads to weakness of nerves, muscles, and bones.

Pitta decline affects vision and intellect.

Kapha depletion reduces nourishment and stability.

Ojas Decline

Ojas (essence of immunity and vitality) decreases, lowering resistance, memory, and mental clarity.

Rasayana (Rejuvenation)

Special Ayurveda interventions — herbal, dietary, lifestyle, and spiritual — aimed at delaying aging, restoring vitality, and improving quality of life.

Description of Ageing Process in Ayurveda Medical Sciences

This shloka from Sharangadhara Samhita describes the ten aspects of life that gradually decline with aging:

“बाल्य वृद्धि छवि मेधा त्वक दृष्टि शुक्र विक्रमौ । बुद्धि कर्मेन्द्रिया चेति जीवितो दशमो ह्रसेत ।”

Childhood vitality (Balya / Balapana)
Growth (Vriddhi)
Complexion (Chhavi)
Intellect / retention (Medha)
Skin (Tvaka)
Vision (Drishti)
Reproductive tissue (Shukra)
Strength / vigor (Vikrama)
Intelligence (Buddhi)
Organs of action (Karmendriya)

The shloka concludes that in old age (jīvitaḥ daśamo hraset), all these decline. Ayurveda calls this Jara (aging), a natural but modifiable process.

Below is a detailed comparative essay on Aging in Ayurveda and Modern Medical Science.

Modern Medical Science — Mechanisms of Aging

Cellular Changes

Telomere shortening: limits cell replication.
Mitochondrial dysfunction: reduced energy, increased ROS (oxidative stress).
Loss of proteostasis: misfolded proteins, impaired autophagy.
DNA damage and repair decline: mutations, apoptosis, cancer risk.

Inflammation

Low-grade chronic inflammation (↑ IL-6, TNF-α) linked to diabetes, CVD, Alzheimer’s.

Hormonal Decline

Decrease in estrogen, testosterone, growth hormone, IGF-1, DHEA → osteoporosis, sarcopenia, cognitive changes.

Immunosenescence

Weak adaptive immunity, susceptibility to infections and malignancies.

Physical and Sensory Decline

Sarcopenia, osteoporosis, thin skin, presbyopia, cataract, hearing loss, mild cognitive impairment → dementia.

Mapping Shloka to Modern Findings

Balya / Vriddhi (Growth, strength) → Sarcopenia, GH/IGF-1 decline.
Chhavi / Tvaka (Complexion, skin) → Collagen loss, photo aging, glycation.
Medha / Buddhi (Intellect, cognition) → Synaptic decline, neurodegeneration.
Drishti (Vision) → Presbyopia, macular degeneration, cataract.
Shukra (Reproductive tissue) → Menopause, decreased sperm count and motility.
Vikrama (Vigor) → Reduced stamina, cardiovascular decline.
Karmendriya (Motor organs) → Weak coordination, neuropathy, decreased reflexes.

Prevention and Lifestyle – Ayurveda vs. Modern

Ayurveda

Dinacharya: daily regimen — waking up early, oil massage, meditation, balanced diet.
Ritucharya: seasonal lifestyle adaptation.
Rasayana herbs: Aamalaki, Guduchi, Ashwagandha, Triphala — proven antioxidant, immune-boosting, neuroprotective effects.
Panchakarma: detoxification and rejuvenation.
Sadvritta (ethical lifestyle) and meditation for mental stability.

Modern Medicine

Exercise: strength and endurance training to prevent sarcopenia.
Diet: Mediterranean-style diet, antioxidants, sufficient protein, intermittent fasting.
Sleep hygiene: restorative sleep for memory and metabolism.
Screening: bone density, blood pressure, glucose, lipid, cognitive tests.
Medication when needed: vitamin D, calcium, vaccines, selective hormone therapy.

Integrated Therapeutics

Early stage: lifestyle + Rasayana + yoga/pranayama.
Middle stage: Rasayana with medical treatment for comorbidities (diabetes, CVD).
Late stage: geriatric care, fall prevention, polypharmacy review, functional support.

Research and Biomarkers

Ayurveda research needs: Telomere length, DNA methylation (epigenetic clock), cytokine levels, microbiome diversity as biomarkers for Rasayana impact.
Clinical trials required to validate anti-aging benefits of Rasayana herbs and Panchakarma.

Public Health Perspective

Aging population requires preventive health programs focused on lifestyle, diet, exercise, social support, and mental wellness.
Ayurveda principles can be integrated into geriatric care policies with scientific validation.

Epidemiology of Ageing

Definition

Epidemiology of ageing is the study of the distribution, determinants, and consequences of ageing populations, including patterns of morbidity, mortality, disability, and health service use among older adults.

Global Demographics of Ageing

Population shift:

In 2020, people aged 60 years and older = ~1 billion.
By 2030 → 1.4 billion.
By 2050 → 2.1 billion (≈ 22% of global population) (WHO).

Life expectancy:

Increased globally from 46 years in 1950 to over 73 years in 2019.
Projected to rise further, though with disparities between high- and low-income countries.
Oldest-old (80+ years):
Currently ~146 million globally (2020).
Expected to triple by 2050.

Epidemiology in South Asia and Nepal

Nepal census (2021):
9.2% of total population = 60+ years (~3 million people).
Expected to double by 2050.
Nepal has a faster ageing rate than many developed countries due to declining fertility and improved life expectancy.
Elderly women outnumber elderly men (because of longer female life expectancy).

Challenges: limited geriatric healthcare, poor social security, high dependency ratio.

Health Burden in Ageing Populations

Non-communicable diseases (NCDs) dominate:
Cardiovascular disease, hypertension
Diabetes mellitus (Type II)
Chronic obstructive pulmonary disease (COPD)
Cancers
Dementia and Alzheimer’s disease
Osteoporosis and arthritis
Functional decline:
Sarcopenia, frailty, falls, sensory loss (vision/hearing).
Mental health issues: depression, social isolation.
Disability-adjusted life years (DALYs):
Ageing contributes disproportionately to global DALYs through chronic diseases.

Risk Factors for Ageing-related Illness

Biological: genetic predisposition, telomere shortening, oxidative stress.
Lifestyle: poor diet, physical inactivity, smoking, alcohol use.
Environmental: pollution, occupational exposures.
Social determinants: poverty, lack of healthcare access, weak family support.

Epidemiological Models of Ageing

Compression of Morbidity Hypothesis: With better healthcare and lifestyle, morbidity is compressed into a shorter period before death.
Expansion of Morbidity Hypothesis: Increased life expectancy prolongs chronic disease duration.
Dynamic Equilibrium Hypothesis: A balance between survival and disease burden.

Ayurveda Perspective on Ageing Epidemiology

Ayurveda classifies ageing as a natural (kalaja jara) process, universal and inevitable.
But, premature ageing (akālaja jara) is influenced by poor diet, unhealthy lifestyle, and stress — similar to modern risk factors.
Preventive focus: Dinacharya, Ritucharya, Rasayana, Sadvritta, Panchakarma.
If adopted at a population level, Ayurveda offers a public health model to reduce ageing-related NCDs.

Public Health and Policy Implications

Need for geriatric healthcare infrastructure in developing countries.
Promotion of healthy ageing strategies: physical activity, balanced diet, stress management, social engagement.
Integration of Ayurveda & modern geriatric medicine in prevention and community health.
WHO’s “Decade of Healthy Ageing (2021–2030)” aligns with Ayurveda’s holistic model

Geriatric Care

Definition

Geriatric care (also called elderly care or senior care) is the branch of medicine and public health that focuses on healthcare, functional ability, quality of life, and wellbeing of older adults (60+ years). It is interdisciplinary, involving medical, social, psychological, and rehabilitative support.

Goals of Geriatric Care

Promote healthy ageing (maintaining physical, mental, and social well-being).
Prevent and manage age-related diseases.
Enhance independence and dignity.
Provide palliative and end-of-life care when necessary.
Support family caregivers.

Key Components of Geriatric Care

Medical Care

Management of chronic diseases (HTN, diabetes, COPD, heart disease, arthritis).
Polypharmacy review (avoiding unnecessary or interacting drugs).
Regular screening: cancer, osteoporosis, vision, hearing.
Vaccinations: influenza, pneumococcal, shingles, tetanus.

Functional Care

Assessment of ADLs (Activities of Daily Living) and IADLs (Instrumental Activities of Daily Living).
Prevention of falls and fractures.
Mobility support (physiotherapy, assistive devices).

Mental Health Care

Screening for depression, anxiety, dementia.
Cognitive therapy, memory training, social activities.
Counseling and caregiver support.

Nutritional Care

Adequate protein, calcium, vitamin D, and antioxidants.
Individualized diet plans (Mediterranean diet, balanced Ayurveda diet).
Hydration and digestive care.

Social and Emotional Care

Reducing loneliness and social isolation.
Community centers, group activities, intergenerational programs.
Respecting dignity and autonomy.
Palliative and End-of-Life Care
Pain management.
Psychological and spiritual support.
Advanced care planning.

Ayurveda and Geriatric Care (Jara Chikitsa / Rasayana Tantra)

Concept of Jara (Aging):

Kalaja Jara: natural, time-bound decline.
Akalaja Jara: premature aging due to unhealthy lifestyle.

Rasayana Therapy (Rejuvenation)

Herbal Rasayana: Aamalaki, Guduchi, Ashwagandha, Triphala, Shilajeet, Brahmi.
Achara Rasayana: good conduct, truthfulness, compassion, positive thinking.
Vajikarana: strengthening reproductive and sexual health.
Panchakarma: detoxification and rejuvenation procedures.

Lifestyle (Ayurveda guidelines for elderly)

Dinacharya: gentle yoga, meditation, oil massage, adequate sleep.
Ritucharya: adapting diet and habits to seasonal changes.
Aahara: light, easily digestible, nourishing food; avoidance of excessive heavy/oily/spicy foods.
Sadvritta: mental discipline, social ethics, spiritual practices for peace of mind.

Models of Geriatric Care

Home-based care: family-centered support, home visits.
Community-based care: day-care centers, senior clubs.
Hospital-based care: geriatric wards, specialized outpatient clinics.
Long-term care facilities: nursing homes, assisted living.
Integrative care model: combining Ayurveda and modern geriatrics (e.g., yoga with physiotherapy, Rasayana with nutrition).

Challenges in Geriatric Care

Rapidly growing elderly population worldwide (esp. in Nepal, India).
Shortage of trained geriatricians and geriatric nurses.
High cost of long-term care.
Social neglect, loneliness, and elder abuse.
Polypharmacy and drug interactions.

Public Health Perspective

WHO’s Decade of Healthy Ageing (2021–2030): emphasizes integrated care, supportive communities, and combating ageism.
Nepal: elderly population growing, but geriatric services are limited. Need for Ayurveda–modern integrative models at community level.

Healthy Ageing

Definition

WHO: “Healthy Ageing is the process of developing and maintaining the functional ability that enables wellbeing in older age.”
Ayurveda: Healthy ageing (Svasthya Jara) is maintaining balance of Dosha, Dhatu, Agni, Ojas, and following Dinacharya, Ritucharya, Rasayana, and Sadvritta to ensure longevity (Deerghayu) with quality of life.

Determinants of Healthy Ageing

Biological Factors

Genetic makeup, telomere length, cellular repair capacity.
Ayurveda: Prakriti (individual constitution) influences ageing rate.

Behavioral Factors

Nutrition, exercise, smoking, alcohol use.
Ayurveda: Aahara (diet), Vihara (activities), Brahmacharya (sexual discipline).

Social & Environmental Factors

Supportive family, social networks, safe environment.
Ayurveda: Sadvritta (ethical conduct, social harmony).

Healthcare Access

Preventive care, regular screening, geriatric services.
Ayurveda: Rasayana Chikitsa (rejuvenation), Panchakarma (detoxification).

Modern Science Perspective on Healthy Ageing

Lifestyle interventions:

Regular physical activity (aerobic + resistance training).
Balanced diet (Mediterranean, DASH, plant-based).
Adequate sleep and stress management.

Disease prevention:

Vaccination, regular screening (BP, glucose, lipid profile, cancer screening).
Early detection and management of NCDs (CVD, diabetes, osteoporosis, dementia).

Cognitive & Mental health:

Brain-stimulating activities, meditation, lifelong learning.

Social engagement:

Volunteering, community participation, avoiding isolation.

Ayurveda Perspective on Healthy Ageing

Rasayana Therapy (Rejuvenation)

Aaushadhi Rasayana: Aamalaki, Guduchi, Ashwagandha, Brahmi, Triphala.
Aahara Rasayana: wholesome, Sattvik, fresh, seasonal food.
Achara Rasayana: truth, compassion, mindfulness, moral conduct.

Dinacharya (Daily Regimen)

Wake up at Brahmamuhurta, gentle exercise, yoga, meditation, oil massage, balanced meals and adequate sleep.

Ritucharya (Seasonal Regimen)

Adjusting food and lifestyle according to seasonal variations.

Vajikarana
Promotes vitality, sexual and reproductive health.

Sadvritta & Spiritual Care

Maintaining ethical life, positive thinking, devotion, and meditation for mental stability.

Healthy Ageing Indicators

Physical: mobility, strength, absence of severe disability.
Mental: intact cognition, emotional resilience.
Social: independence, active social participation.
Spiritual: inner peace, contentment, purpose.

Public Health & Healthy Ageing

WHO Decade of Healthy Ageing (2021–2030):

Combat ageism.
Develop integrated, person-centered care.
Provide age-friendly environments.
Strengthen long-term care systems.

Nepal Context:

Elderly population (~9.2%) growing rapidly.
Need for community-level geriatric programs, integration of Ayurveda lifestyle promotion, and social support networks.

Integrated Approach (Ayurveda + Modern Medicine)

Preventive screenings + Rasayana herbs.
Physiotherapy + Yoga/Pranayama.
Nutritional science + Ayurveda Nutrition principles.
Counseling + Sadvritta and meditation.

Conclusion

Sharangadhara Samhita’s description – decline in ten domains of life – beautifully parallels modern biological science of aging. Ayurveda emphasizes lifestyle, Rasayana, and spiritual practices to delay premature aging, while modern science explains cellular and molecular mechanisms.
An integrative approach – individualized Rasayana, Panchakarma where needed, exercise, nutrition, mindfulness, and evidence-based modern screening – provides the best way to extend health span (quality of life) alongside lifespan.

Epidemiology shows that ageing is a rapidly growing public health issue worldwide, including in Nepal. The burden is shifting from infectious diseases to chronic, degenerative, and lifestyle-related disorders. Ayurveda and modern medicine both highlight the importance of prevention, lifestyle, and long-term care. An integrative, evidence-based approach can help achieve healthy ageing and compressed morbidity.

Geriatric care is not only about treating diseases but ensuring dignity, independence, and holistic wellbeing in old age.
Modern medicine provides advanced diagnostics, chronic disease management, and palliative care.
Ayurveda emphasizes prevention, rejuvenation, lifestyle, and spiritual balance.
The most effective model for the future is integrated geriatric care, blending Ayurveda’s Rasayana, lifestyle measures, and ethics with modern geriatrics’ evidence-based interventions.

Healthy Ageing is not just about living longer, but about living better with preserved physical, mental, social, and spiritual wellbeing.
Modern medicine emphasizes disease prevention, early detection, and lifestyle modification.
Ayurveda emphasizes balance, rejuvenation, and ethical living.
Together, they offer a holistic model for achieving longevity with dignity, independence, and fulfillment.

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