Pranam AGEING GRACEFULLY
1 Known as “compression of morbidity,” Fries’ hypothesis holds that if the age at the onset of the first chronic infirmity can be postponed more rapidly than the age of death, then the lifetime illness burden may be compressed into a shorter period of time nearer to the age of death. Evidence supporting this hypothesis thus must take two forms: first, that it is possible to substantially delay the onset of infirmity; second, that the accompanying increases in longevity will be comparatively modest. 2 Life expectancy from birth in this century in the United States has increased from 47 to 73 years (Fries 1980 <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2690269/#b16>)—an increase of 26 years (Figure 3 <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2690269/figure/fig03/>). The rise has been reasonably constant throughout the century, with some periods of plateau and some periods of acceleration. This striking advance is not as apparent when one considers life expectancy from age 20, which has increased only some 13 years; life expectancy from age 40, which has increased eight years; life expectancy from age 60, which has increased 5 years; from age 80, 2.5 years; or from age 100, 0.7 years (Faber 1982 <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2690269/#b13>). The greater slope of the curve representing life expectancy from birth reflects the great improvement in infant mortality over this period. In contrast, improvement in chronic disease control will result in a more nearly parallel slope to all lines, since these benefits accrue to individuals later in life. We are beginning to see, in terms of rate of change, some of these effects. To avoid misinterpretation of these “rate of change” data as indicative of galloping longevity, it is essential to look at absolute changes in life expectancy at the same time. Absolute changes in life expectancy, as above, show a progressive decline at higher ages. 3 Nine general lines of evidence confirm the existence of a finite human life span: 1. There are no exceptions to the declining numbers of individuals present at successive ages. 2. Gompertz's law appears to hold in all populations and assures an exponentially increasing mortality rate and, therefore, death for the entire population within a decade or two past the age of 100. 3. There has been no historical change over several centuries of observation with regard to maximum life potential, as underscored by studies of centenarians; this observation has been repeatedly made in the United States with good data since 1939 or earlier (Bowerman 1939 <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2690269/#b6>; Faber 1982 <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2690269/#b13>). Life expectancy at age 100 has changed at most 0.7 years over 80 years (Faber 1982 <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2690269/#b13>), and much of this improvement must have been due to reduction of premature death, not change in life span. 4. There is no biological reason to assume that any change in genetic longevity characteristics should have occurred merely because we have improved infant mortality, cleaned up water supplies, or invented penicillin. 5. The difference in species life span among animals is a commonplace daily observation. 6. Anthropological analyses (Cutler 1979 <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2690269/#b9>) suggest a formula by which mammalian life spans may be predicted by the brain size/body weight ratio; such models suggest an approximately constant life span for the human species for the past 100,000 years. 7. The linear decline in organ reserve, repeatedly the subject of physiologic observation, mandates a point at which function must be inadequate to support life, that point apparently being when organ reserve is reduced to approximately 20 percent over that function required for the maintenance of basic life processes; reserve of this magnitude is required for daily functions outside of bed. 8. The increasingly rectangular curve demonstrates the barrier to immortality. 9. We have the important phenomenon of a priori aging, the daily evidence of our senses. People do grow older, with changes which are apparent to all of us, as we age. And these changes—from hair color to hearing—are not the result of disease as we usually define it. A new group of Americans has become a subject of increasing concern, the “frail elderly.” This term is a new one; it refers to individuals, often without demonstrable disease, who have manifestly limited organ reserve and increased frailty to external perturbation. 4 There are several methods of estimating the human life span. One may use the anthropological formulas, reconstruct an ideal survival curve from the tail of the present curve using the assumption that these individuals have been essentially free of disease, make extrapolations from the rectangularizing survival curve, or use estimates based on observed decline in organ reserve. All suggest an average life span of approximately 85 years, with a distribution which includes 99 percent of individuals between the ages of 70 and 100 (Figure 5 <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2690269/figure/fig05/>). It is not clear whether this distribution is “normal,” based on the Gompertz function (which gives a slightly sharper drop-off) or some other distribution. For policy purposes, these distinctions are minor. 5 There is some controversy about whether the life span is totally fixed and about the precise projection of life span, but these disagreements fall within a narrow range. Advocates of a slowly increasing life span tend to cite continued gains by white females (Manton 1982 <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2690269/#b26>), and note increased percentage gains past age 50 in recent years; these observations are fully consistent with those discussed here. Present gains, accruing by postponement of chronic disease, are reflected in life expectancy increases at all ages; hence, the historically more slowly rising life expectancy from advanced ages will show a larger percentage, although smaller absolute, gain. The model presented here predicts that the male-female gap eventually may decrease, but does not anticipate dramatic change to occur in the next few years; such change requires that premature death in males decreases more rapidly than in females, and may occur if the present cardiovascular disease decline broadens, lung cancer rates follow anticipated trends, and traumatic deaths of males in early life decrease. The Hayflick (1980) <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2690269/#b20> phenomenon of cellular senescence is sometimes argued to be allegorical or even to represent a laboratory artefact (Manton 1982 <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2690269/#b26>). This may well be true, and the discussions presented here are not based on the Hayflick phenomenon. 6 When we ask medical students to draw a set of curves which represent changes in life expectancy in this century, they usually draw curves closely similar to a set of advancing sigmoid curves, equidistant along their entire length. Such are the curves that would be represented if the life span, as well as the life expectancy, were increasing (Figure 6 <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2690269/figure/fig06/>). As noted (Figure 4 <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2690269/figure/fig04/>), the actual curves show an increasingly rectangular character (Fries and Crapo 1981 <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2690269/#b17>). One does not have to be sophisticated in interpretation of mortality curves to have a reasonable feeling for where future progress may be made, and it is curious when demographic projections (Faber 1982 <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2690269/#b13>; Manton 1982 <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2690269/#b26>) show characteristics not present in the historical record. A problem with elaborate demographic projections may arise if a faulty model is used, a model which has built into it the shape of the equidistant curves of Figure 6 <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2690269/figure/fig06/>. The competing risk model, used without a hazard function representing natural death, leads to such a result. This model assumes that if there were no disease then there would be no death, and, thus, underestimates future mortality at the higher ages by not accounting for the mortal effects of physiologic frailty. A similar error can arise if recent “rates of change,” rather than absolute change, are used in projections. Since we have moved from an acute disease era to a chronic disease one, premature death now occurs at higher ages, and percentage gains with further improvement will be accordingly greater at higher ages. 7 Para 1 to 6 is the recent knowledge of the west under the science for the increase in mortality on account of not the prevention of the entry of any diseases, but by treatment by spending a lot of money (which shall be earned under the rat race which might send one to hospital). Compression of the morbidity if made possible hospitals should have become bankrupt. Or the pharma Industry should have been closed. Exercise increases the lifespan but not the over exercise through the Gyms spread all over the earth. Preventive medicines made of chemicals, can also cause adverse effects. Then the concept of the “compression of the morbidity”, floated is compatible? In this respect somewhere else I have written the long life out of the ayurvedam written by a British, how syphilis was introduced? So pioneer Ayurvedam, an upavedam of India through yoga, said people lived for 400 years once and got reduced as yugas advanced. So living a long life was thought of more by so many processes of living through food and local plant medicines and exercise of yoga than the modern concept. 8 Lifestyle is the perception of a particular society towards life and the way its people live, think and behave. It includes dietary practises, physical-mental activities, cognitive exposure as well as cultural and environmental revelation. The “Vedantic” literature says that life is *sacred and eternal* and according to this belief when the life particles interact with material elements, various events like birth, disease, old age and death result. In Rig Veda, desire for longevity and health (mental and eternal physical) is best exemplified in the much quoted Atharva Veda *suktam*: “*Pashyem sharadah shatam, Jivet sharadah shatam*” (let me see 100 autumns, let me live 100 autumn). 9 dehino ’smin yatha dehe kaumaram yauvanam jara tatha dehantara-praptir dhiras tatra na muhyati *BG 2.13*: Just as the embodied soul continuously passes from childhood to youth to old age, similarly, at the time of death, the soul passes into another body. The wise are not deluded by this. matra-sparshas tu kaunteya shitoshna-sukha-duhkha-dah agamapayino ’nityas tans-titikshasva bharata *BG 2.14*: O son of Kunti, the contact between the senses and the sense objects gives rise to fleeting perceptions of happiness and distress. These are non-permanent and come and go like the winter and summer seasons. O descendent of Bharat, one must learn to tolerate them without being disturbed.{STRESS-FREE}. nāsato vidyate bhāvo nābhāvo vidyate sataḥ ubhayorapi dṛiṣhṭo ’nta stvanayos tattva-darśhibhiḥ *BG 2.16*: Of the transient there is no endurance, and of the eternal there is no cessation. This has verily been observed and concluded by the seers of the Truth, after studying the nature of both. That which is the existence, cannot cease to exist nor the nonexistence can continue to exist. According to the Śhwetāśhvatara Upaniṣhad, there are three entities in existence: bhoktā bhogyaṁ preritāraṁ cha matvā sarvaṁ proktaṁ trividhaṁ brahmametat (1.12) [v13] kṣharaṁ pradhānamamṛitākṣharaṁ haraḥ kṣharātmānāvīśhate deva ekaḥ (1.10) [v14] sanyuktametatkṣharamakṣharaṁ cha vyaktāvyaktaṁ bharate viśhvamīśhaḥ (1.8) [v15] All these Veda mantras state that these three entities—God, the individual soul, and Maya—are all eternal.(SAT). 1. God is everlasting. Thus he is *sat* (eternally existing). Hence, a name for him in the Vedas is *sat-chit-ānand* (eternal-full of knowledge-ocean of bliss).(B*rahmam)(Paramatma)* 2. The soul is imperishable, and hence it is *sat*. However, the body will cease to exist one day, and hence it is *asat* (temporary). The soul is also *sat-chit-ānand*, but it is also *aṇu* (tiny). Hence the soul is *aṇu sat*, *aṇu chit*, and *aṇu ānand*. (Purusha)(Jeevatma) 3. The entity Maya from which the world has been made is eternal, or *sat*. However, all material objects we see around us came into existence and will be destroyed with time. Thus, they can all be termed as *asat*, or temporary. So while the world itself is *asat*, it is only the entity Maya that is *sat*. (Prakrti @ Maya) & ( Mitya). bhogaiśwvarya-prasaktānāṁ tayāpahṛita-chetasām vyavasāyātmikā buddhiḥ samādhau na vidhīyate *BG 2.44*: With their minds deeply attached to worldly pleasures and their intellects bewildered by such things, they are unable to possess the resolute determination for success on the path to God. (Straying away from the godliness attached to Bhogam, expands the morbidity.) trai-guṇya-viṣhayā vedā nistrai-guṇyo bhavārjuna nirdvandvo nitya-sattva-stho niryoga-kṣhema ātmavān (1) nirdvandvo (2) nitya-sattva-stho (3) niryoga-kṣhema ātmavān= Freeing yourself from dualities (kamya karma) , eternally fixed in Truth (sat & sattva guna), and without concern for material gain and safety,(sense perception) be situated in the self. All these will shrink the age. समो भूत्वा समत्वं योग उच्यते || 48||Equipoised in all respects.(2.48) पदं गच्छन्त्यनामयम् || 51|| they attain the state beyond all suffering.(2 51). *BG 2.52*: When your intellect crosses the quagmire of delusion, you will then acquire indifference to what has been heard and what is yet to be heard (about enjoyments in this world and the next). (compression of morbidity is not feasible.) स्थितप्रज्ञ स्तदोच्यते || 55|| transcendentally situated. (stable mind extends the mortality.) Who is a sthitha pragnan?; duḥkheṣhv-anudvigna-manāḥ sukheṣhu vigata-spṛihaḥ vīta-rāga-bhaya-krodhaḥ sthita-dhīr munir uchyate// *BG 2.56*: One whose mind remains undisturbed amidst misery, who does not crave for pleasure, and who is free from attachment, fear, and anger, is called a sage of steady wisdom. (mind control). krodhād bhavati sammohaḥ sammohāt smṛiti-vibhramaḥ smṛiti-bhranśhād buddhi-nāśho buddhi-nāśhāt praṇaśhyati *BG 2.63*: Anger leads to clouding of judgement, which results in bewilderment of memory. When memory is bewildered, the intellect gets destroyed; and when the intellect is destroyed, one is ruined. 10 In Ayurveda, Shushruta advocates for “swasthya vritta” (positive health) recommending “dincharya” (daily routine), “ritucharya” (seasonal routine), diet, exercise and virtuous conduct for positive heath. Spiritual dimensions of personality are recommended by “Upnishads.” 11 Every lifestyle has its positives and negatives. Following a particular lifestyle may be smooth as well as stressed. In ancient Indian situations people knew their specific roles to be performed during different stages of life and that left little room for development of psychogenic (exogenous) mental-health problems. Although biological (endogenous) mental-health problems were almost equally prevalent as “unmad” (mania); “avsaad” (depression); “sannipat” (delirium); “smritibhransh” (dementias); etc., as are today. A number of religions, sects, cults and the influences of the western world (like industrialization, urbanization, demographic movements) without any set patterns of lifestyle have become prevalent in the country. And, these factors are leading to conflicts and confusions and providing more opportunities to conflicts between soma, psyche and environment, which are leading to a variety of mental illnesses. 12 The lifestyle affects longevity and health in old age. The “Atharva-Veda,” believed that mental illness might result from divine curses and it also provides the description for mental illness like schizophrenia. In Vedic period, mental health was described in two well-known Ayurvedic scriptures, the “Charaka Samhita” by Charaka, and the “Sushruta Samhita” by Sushruta. Both of these scriptures have established roots in modern Indian medicine. 13 The Ayurvedic texts referred “smriti kshaya” and “medha kshaya” (deterioration in memory and intellect), which describes properties of dementia and Parkinson's disorders. {Rao AV. Ageing-Glimpses into ancient Indian texts. *J Indian Academy of Geriatrics. *2005}. Treatment measures are also provided for dementia in different herbal medicines which includes triphala, brahmi, amalaka (Indian gooseberry), amrit kalasa, etc. Ayurveda describes that mind (manas) is a link among the huge amounts of information gathered by five sense organs (indriya) which are processed by intelligence (buddhi) for delivering proper action (karma). Three states of mind are described: “sattva,” “rajas” and “tamas.” { Sodhi V, Goldsmith T. Rasayan herbs, sattvic food choices, and panchkarma therapies: Ayurvedic approaches to prevent and manage Alzheimer Disease. 2012.}. The satvic mind remains alert, enthusiastic, courageous, stable, and thus intelligent. “Rajas” described a mental state dominated by anger, passion, greediness, constant action, excessive work and anxiety, whereas tamasic mind tends to develop delusion and has been described as dull, ignorant and slow. Tamasic characteristics of AD include slow cognition, poor memory and difficulty in performing tasks. Rajasic imbalance (“sun downing”) is present during frustrated outbursts, periods of agitation. 14 *It is also described that health-related problems take place due to imbalance in nutritional intake*. Ayurveda advocates consumption of whole grain foods, fruits and vegetables for better mental health. Studies show that food with low amounts of life energy (prana) like over-ripened, overcooked, highly processed, frozen and refined food products should be avoided. 15 Lifestyles (dietary habits, mental exercise, social networking, etc) also have a role in preventing/developing cognitive disorders. Alzheimer's is more common in the community where elderly are socially isolated,] whereas it is less common, where supports are available. Physical activities also decrease the chances of AD. Yoga, meditation, exercises etc., help prevent cognitive disorders. Alternate nostril breathing is a good exercise to prevent AD. Ramayana and the Mahabharata the great epics describes several disordered states of mind and means of coping with them as well. { Psychiatry in ancient Indian texts: a review. Bhugra D Hist Psychiatry. 1992}. The fear of death or the despair of the absurd, ignorance of life's meaning (api varga in ayurveda) and the sadness secondary to loneliness were believed to be three common sufferings of old age. {Psychiatry, colonialism and Indian civilization: A historical appraisal. Sharma S Indian J Psychiatry. 2006}. 16 In ancient systems, diagnoses (nidana) of illnesses were based on cause, premonitory indications (purvarupa), symptoms (rupa), therapeutic tests (upashya) and natural history of the disease (samprapti).Keeping the body in good health and free from diseases were very much persuaded in ancient Indian thinking. Ayurveda believed “old age is the foundation of all wisdom, virtues, enjoyments (bhoga) and the source of all ‘purusharth’ (dharma, arth, kam and moksha).”[ Disease due to senile degeneration causing decline in memory and intelligence (smritikhasay and medhakhasay) are referred in modern time as AD and other dementias The health related problems were thought to be the result of divine curse, seasonal factors or bad deeds (*dosh bal, daiva bal* or *kal bal pravritti*). To maintain health, healthy ways of life (dincharya, ritucharya) were advocated by “Ayurveda.” Different mental-health conditions occurring in old age are also featured in Indian epics. {Indian culture and psychiatry. Gautam S, Jain N Indian J Psychiatry. 2010} 17 Decline in old age mental-health, however, is often the result of faulty lifestyle like smoking, alcohol intake, improper diet and lack of exercise as well as environmental and other external factors. Hence, this decline can be slowed down or even reversed at any age through the appropriate interventions to modify individual lifestyle or adverse environmental factors. The Indian model of the society has excellent concepts regarding the all round development of an individual with proper stress on the importance of caring for the ageing members of the family. Wisdom through the ages and ancient concepts has survived because of their sheer practicality and because they are capable of transforming society into something it should ideally be. The old age deserves the recognition and attention they have been deprived of. And going back to our Indian roots is the only way, which goes down deep enough to tackle every single-issue regarding elderly. KR IRS 281221 On Tue, 28 Dec 2021 at 10:26, Rangarajan T.N.C. <[email protected]> wrote: > *HEALTHY AGING WAS ONCE* thought to be a contradiction in terms. Enter > James Fries, a professor of medicine at Stanford University School of > Medicine. Early in his career, he foresaw a society in which the active and > vital years of life would increase in length, the onset of morbidity would > be postponed, and the total amount of lifetime disability would decrease. > At the heart of his vision is an emphasis on improvements in preventive > medicine and the untapped potential of health promotion and prevention. > Known as “compression of morbidity,” Fries’ hypothesis holds that if the > age at the onset of the first chronic infirmity can be postponed more > rapidly than the age of death, then the lifetime illness burden may be > compressed into a shorter period of time nearer to the age of death. > Evidence supporting this hypothesis thus must take two forms: first, that > it is possible to substantially delay the onset of infirmity; second, that > the accompanying increases in longevity will be comparatively modest. > > https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2424092/ > > -- You received this message because you are subscribed to the Google Groups "Thatha_Patty" group. 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