HEALHY AGING

CONCEPT OF
HEALTHY
AGING
DR.
SHRINIWAS
KASHALIKAR
Before we consider the healthy aging, let us first
consider in brief the concept of HOLISTIC
HEALTH for healthy living!
HOLISTIC HEALTH
Holistic health in adult human beings is nothing
else but ongoing movement towards increasingly
accurate perception, appropriate feelings and
precise actions, with increasing pleasure, power,
prosperity and profundity.
Perception, feelings and actions are also
expressed by terms Cognition, Affect and
Conation respectively.
A] Cognition
In short, cognition means processing [appraisal]
of a huge variety of sensations impinging on us.
You can appreciate the importance of this
faculty if you consider the two important facts
viz. 24 hours of the day and twelve months of
the year, every one of us gets sensory inputs in
the form of physical, instinctual, emotional and
intellectual stimuli, which may be painful or
pleasurable in the form of a variety of personal,
familial, social, national and international events.
Cognition involves sensing, interpreting,
memorizing, questioning, pattern finding,
analyzing, correlating, synthesizing,
contemplating, understanding, appreciating and
hypothesizing on the basis of this information
input.
2] Affect
Affect means the effect of the variety of stimuli
which, may impinge on us. The affect is in a
way, “sandwiched” between cognition or
perception of stimuli and the conation or
response.
In general it involves the activity of various parts
of nervous, endocrine and metabolic changes.
The affect is usually experienced as a]
confidence, enthusiasm, pleasure, happiness,
love, attraction, patience, comfort etc. or b]
sadness, jealousy, hatred, depression, inhibition,
diffidence, loneliness, listlessness, impatience,
discomfort etc.
3] Conation or action i.e. response
Conation is the response of an individual. This
can speaking, writing, listening, watching, and
other interactions usually referred to as behavior.
In traditional parlance this was called fulfillment
of four PURUSHARTHAs, viz. DHARMA,
ARTHA, KAAMA and MOKSHA through
practice of SWADHARMA.
DHARMA refers to accuracy in perception,
affect and conation. This leads to ARTHA i. e.
acquisition of material gains, followed by
KAAMA i. e. satisfaction of the mundane
desires [DHARMA AVIRUDDHAH KAAMAH
i. e. the desires which are not against the
DHARMA i.e. principles of global welfare.].
KAAMA is followed by MOKASHA i. e.
liberation from all sorts of bonds.
In short it must be appreciated that for most of us
holistic health refers to ever increasing and
appropriate satisfaction of physical, instinctual,
emotional, intellectual needs and fulfillment and
happiness arising from it.
Healthy Aging:
By the word ageing we generally think of an
unpleasant process associated with dysfunction
and disability. We think of a phenomenon full of
dependence and helplessness. It seems to
indicate only cumulative wear and tear due to
micro insults and time dependent programmed
loss of structure and function. It seems to imply
physical, psychological, intellectual and social
incapacitation. It seems to involve choking of
charm, routing of romance, decay of dreams,
annihilation of aspirations and end of new
beginnings. It seems to be an entity that signals
us to wind up every thing get ready to quit this
world- the world that we so much long to live in.
So let us study what is underlying this process of
ageing. But before we do that we have to
distinguish it from the handicap or dysfunction
that results from diseases and the changes
resulting from diseases and the natural process
of ageing, i.e. one which would take place in the
absence of diseases.
One can appreciate that such distinction is quite
difficult. Most of us suffer from ailments such as
infections, malignancies, diabetes, IHD, as well
as environmental onslaughts in the form of
ultraviolet radiation, heat, cold, pollution, food
additives, allergic substances, physical and
chemical injuries etc apart from psychological
inflictions!
But still the ageing that results in absence history
of gross or major diseases roughly represents the
true ageing and is generally attributed to two
basic facts
1] Genetic program:
Decides the range of the longevity of life for a
specific species and determines genetic program
by virtue of which there is time dependent loss
in structure and function. Genes program
senescence and death.
2] Accumulation of injuries or micro insults:
Since very little is understood in this respect
there are many theories based on these two
tenets to explain the ageing. Since they focus on
a specific change, they are inadequate. But
together they do give us some insight into the
process of ageing.
2] THEORIES OF AGEING:
A] The Error Catastrophe Theory:
Random increase in errors of protein synthesis
i.e. defects in transcription and translation. But
these seem to be post translational modifications.
Further, in senescent cells accumulation of
misspelled proteins is not found and Induction of
synthesis of erroneous proteins experimentally
does not give rise to ageing.
B] Somatic mutation theory:
This suggests that there is age associated
increase in chromosomal aberration.
This is suggested to give rise progressive
increase in inefficient cells leading to organ
dysfunction.
C] Free radical theory:
Accumulation of metabolic waste products and
radical mediated cell damage e.g. hydroxy
peroxide, aldehydes and ketones, superoxide
radical, singlet oxygen and hydrogen peroxide..
Lipid peroxidation at cellular level is not
demonstrated in ageing.
And antioxidants are not as yet proved to be
useful in delaying ageing.
D] Ionizing radiations and such other
environmental factors may cause cell injury.
E] Cellular dysfunction in tissues such as CNS,
endocrine and immune system and influence
other systems. Thus decrease in synthesis,
increased breakdown, decrease in receptor
number, decrease in H-R combination, decrease
in HR internalization etc.
F] Sedentary jobs, late night parties, noise,
crowding, stress of highly competitive life,
uncertainty of socio-political surroundings,
consistent and protracted denial of the
recognition and appreciation in life, habits such
as excessive smoking, lack of enjoyable job, lack
of promotions and incentives in jobs etc. and the
plethora of stressors either not thought of or not
given due importance and hence not mentioned
in the text books; immensely influence the
aging process; and are described; in my books
viz. “Stress: Understanding and
Management” and Conceptual Stress:
Understanding and Management”.
3] VARIOUS CHANGES TAKING PLACE
DURING AGEING PROCESS
Overall changes in the body are decrease in the
height, increase in the length of nose, increase in
the length of ears, decrease in the circumference
of neck, decrease in the circumference of thighs,
osteoporosis, bending of the vertebral column
causing kyphotic deformity, reduction in the
periorbital fat causing sinking of the eyes etc.
a] PHYSIOLOGICAL CHANGES
Broadly speaking, maximum capacity, tolerance,
peak performance and reserve are reduced.
I] Matrix:
Collagen becomes stable, more rigid, more
insoluble and also reduction in its content and
increase in its degradation. In addition there are
changes in proteoglycans and plasma proteins.
This is due to damage due cross linking, less
formation of collagen, reduction in the elastin.
Fascia, tendons, ligaments, bones, joints, and
peripheral vascular disease become rigid. Skin
becomes dehydrated, devoid of subcutaneous
fact and less elastic thus skin becomes wrinkled,
dry, pale due to reduction in capillary bed, more
susceptible to injury.
II] Blood:
Red bone marrow is replaced by yellow bone
marrow in the long bones first, flat bones and
then vertebrae. Physiological reserve capacity
for erythropoiesis and leucopoiesis is reduced.
III] Gastrointestinal tract:
Teeth : Enamel, dentin and cement all show
decline. Loss of teeth due to caries, periodontal
infection and reduced masticatory efficiency.
Weakness of cricopharyngeus, reduction in
presure gradient and inability to relax the lower
esophageal sphincter cause dysphagia.
Stomach: Age related atrophy of mucosa causing
achlorhydria. Pancreatic lipase reduced causing
streatorrhoea.
Motility of GIT is reduced: Hence there is
tendency towards constipation. In Ayurveda this
is categorized under VAATA VRIDDHI.
Intestinal lactase activity is reduced and villi are
reduced and absorption is reduced.
Liver cells reduce in number fibrous tissue
increases and size of liver cells increases.
Protein synthesis and microsomal mixed oxidase
activity required for metabolism of drugs and
steroids become less. Thus functions are reduced
but since the reserve is great the tests are in
normal limit.
IV] The immune system:
shows decrease in the T cell activity, decrease in
AB production and presence of auto anti bodies
due to reduced tolerance to antigens formerly
recognized as self. There is susceptibility to
infections. Since immunological -surveillance is
believed to eliminate neoplastic cells there is
higher incidence of cancer. Following stress of
bereavement there is steep decline in cell
mediated immunity and this causes death
following death of spouse or any other near /
dear one.
V] Reproductive system:
The hormonal secretion reduces and there is
stoppage of ova formation, ovulation in females
and there is gradual reduction in the
spermatogenesis causing reduction in the sperm
count.
Females show a distinct and identifiable change
in the form of menopause where has such change
is not distinct in males.
VI] Central nervous system and special senses:
Atrophy of the brain and neuronal loss.
Accumulation of lipofuscin and loss of synapses
and dendrites. Cholinergic deficit is
demonstrated in Alzheimer's disease and
Dopamine defect is demonstrated in Parkinson's
disease. Milder form of cholinergic deficit may
be responsible for commoner forms of senile
dementia and milder form dopaminergic deficit
may be responsible for milder form of hypokinesia
seen in old age.
There is deficit in autonomic responses leading
to postural hypo-tension and impairment of
temperature regulation
Decrease in sleep: There is difficulty in getting
sleep as well as there is tendency to wake up
during night and waking up early.
Presbyopia, cataract, rise in intraocular pressure.
Presbyacusis i.e. difficulty in hearing causes
difficulty in understanding speech and
localization of sound.
Sense of smell and taste also decline with age
but are not studied adequately perhaps because
they do not cause serious functional deficits.
VII] Endocrine system: There is decrease in
sympathoadrenal axis and there is reduced
tolerance to stress.
VIII] Cardiovascular system:
In those where there is no atherosclerosis, there
still reduction in elasticity of aorta. Increase in
systolic and pulse pressure. But no change in
diastolic pressure.
Atherosclerosis, Atrophy of myocardium,
Accumulation of lipofuscin, Fibrosis, Deposits
of amyloid, Contractility of heart is diminished,
contraction and relaxation time are increased,
Decrease in ventricular compliance, stenosis of
aortic and incompetence of mitral valves,
Number of pacemaker cells is reduced and so,
responses to sympathetic as well as
parasympathetic stimulation reduce and this
causes postural hypotension.
Maximal HR during exercise is reduced in aged
but cardiac output is maintained by increasing
stroke output.
IX] Respiratory System:
Microscopic changes:
The alveoli become flatter and narrower and
ducts enlarge. Walls of the alveoli become thin,
capillaries decrease in number. Alveolar surface
area decreases by 4 % every decade after the age
of 30. Pulmonary blood vessels show age related
increase in wall thickness.
Functionally there is decrease in total and timed
vital capacity. Increase in residual volume. Due
to reduced elastin lung compliance increases but
compliance of the total respiratory system
decreases due rigidity of chest wall after the age
of 60 years.
Due to loss of elastic recoil the pressure which
has to be built during expiration from the alveoli
so that air from alveoli forces open the airways,
is decreased. Due to this there is tendency of the
airways to collapse. This tendency to collapse
increases during expiration when expiration
must become active.
Due to decrease in capillaries there is reduction
in diffusion.
The response to hypoxia and hypocapnia are
reduced.
Thus ventilation, diffusion and regulation are all
impaired in elderly individuals.
X] Muscles :
Atrophy, reduction in contractility, decrease in
tone, cataract, hernia and rupture of intervertebral
disc etc.
XI] Excretory system :
Kidneys reduce in size, renal plasma flow and
GFR reduces 10 % per decade after 30, nephrons
and their secretory and absorptive functions
reduce and fibrous tissue increases. Kidney
vessels show age related changes irrespective of
hypertension.
It has been hypothesised that due to high protein
diet there may high solute load on the renal
capillaries leading to chronic dialation of the
capillaries leading to extravasation
macromolecules in renal glomeruli leading to
mesangial reaction causing renal damage.
b] PSYCHOLOGICAL CHANGES:
Frustration, depression, fear, anxiety, insecurity,
loneliness, vacuum, dejection, self pity, sadness
are some of the hallmarks of old age.
With ageing there is increasing restriction on the
kind of enjoyments one is accustomed to and this
can lead to frustration or depression.
The increasing chances of death especially due
death of the contemporaries cause alarm,
concern, anxiety and fear of death, diseases and
debility.
Due to lack of job after retirement or physical
inability there is always a sense of insecurity.
Lack of the children's company due to their
being increasingly independent gives a feeling of
loneliness. This can happen due to children
going abroad or away from home for their jobs.
Since most of the people of younger age groups
have their own pre-occupations the elderly are
left out. More over the ideas, choice, preferences
and other areas of interests differ and hence the
elderly are cut off from younger generation. This
distance gradually increases with advancing age.
This leads to vacuum, dejection, self pity and
sadness.
Thus overall the old people tend to become
increasingly melancholic.
d] ECONOMIC CHANGES
The ageing almost always associated with
reduced income and increasing economic
dependence on the others.
c] SPIRITUAL CHANGES:
In India we find that there is an increasing
tendency to visit temples and SATSANG. This is
because they want a certain kind of solace which
they do not get from day to day life and routine
activities. This is also to fill the vacuum created
due to retirement, and to get company of those
who sail in the same boat.
This has given to a widely prevalent yet totally
wrong notion that the spiritual pursuit should be
undertaken at old age.
But the courage, alertness, enthusiasm and other
physical and mental faculties which are
extremely important to undertake spiritual
pursuit [i.e. growth of consciousness]
considerably diminish in old age.
Old people become some what disinterested and
indifferent towards life. But this should not be
taken as detached attitude described in Geeta.
Old people are generally detached because they
accept that they cannot do anything to either
prevent things which they do not like, or to make
things happen which they like. Thus their
detachment is out of giving up, or acceptance of
defeat.
Some elderly individuals develop ascetic
thoughts due to losing interest in the routine life
because they are tired of responsibilities and
dynamism required for their job or profession.
This may mean reduction in income. But this has
nothing do with financial sacrifice. It is only
fallout of exhaustion.
It is not a spiritual virtue of selflessness.
Some individuals lose interest in the
surroundings due to decreasing sensory
perception and decreased mobility. They become
shy about their deficiency. So they avoid
socialization. Gradually they become
increasingly self centered and selfish. They
become over-concerned about themselves and
less sensitive to others' problems. They become
more rigid, adamant and at times obstinate. In an
attempt to assert themselves; they become
unreasonable and erratic.
But the impression, which we get from the
foregoing, is quite inadequate and therefore
wrong. Further it is dangerously pessimistic and
depressing. The horror of ageing, as made out to
be by merely observing certain physical or
psychological changes without realizing that
there is a vast difference between the ageing
of the animals and that of the human beings,
only creates fear about ageing. As a result;
instead of helping the aged; we expedite the
process of ageing and its ill effects; not only in
the elderly; but also in the younger minds by
creating fear psychosis. I have coined new terms
for it viz. gerontophobia, and
genrontoneurosis.
The depressing notion about ageing; fails to
notice the fact that while ageing, a person
accumulates not merely micro insults and
injuries but simultaneously accumulates a
variety of experiences, associated with
increasingly appropriate and accurate
interpretation of those experiences and
increasingly accurate responses to challenges
in life.
Ageing is also associated with greater and
greater degree of fulfillment, satisfaction, and
contentment due to achievements in life, success
in the aims / ambitions / aspirations. In the lesser
fortunate ones it is associated with happiness of
having procreated and seen children and grand
children grow. It is associated with experience of
their love. Even in the least fortunate ones it
incorporates the satisfaction that one has lived
[has not died young!].
Further it has be realized that while ageing the
aged individual gradually learns the inevitable
nature of ageing and death and hence gradually
learns to accept them uncomplainingly and
gracefully.
Age is respected in Indian culture. Thus age
brings extra care and respect to the individual.
He or she gets more services and comforts in
preference to the younger lot.
Let us clearly and definitely understand and
appreciate without any ambiguity that the
meaning of the word ageing is not merely
becoming old but also developing and
maturing. Aging is actually your passage
through the body full of wonderful learning and
blossoming! It is a passage of merging with your
true self! But it is essential to catch and hold on
to this thread of wisdom of pursuing your true
self right from childhood through the practice
NAMASMARAN with topmost priority, beside
other physical measures described in fitness and
yoga guides. This can help us overcome our fear
of old age and help the aged people to help
themselves also and others and improve the
quality of everyone's life aged as well as; to be
aged.
BUT WHAT IS NAMASMARAN?
Namasmaran means; remembering the name of
God, Guru, great souls; such as prophets and
holy objects such as planets and stars. It may be
remembered silently, loudly, along with music,
dance, along with breathing, in group or alone,
either with counting by rosary (called
SMARANI or JAPAMALA) or without
counting. The traditions vary from region to
region and from religion to religion.
However the universal principle underlying
NAMASMARAN is to reorient your
physiological being with your true self. In fact
while reorienting with true self you aim
to establish and strengthen the bond or
connection; between; your physiological
being; with your true self. You aim at
reunification with yourself!
Since remembering your true self is the pinnacle
of or culmination of individual
consciousness, and individual consciousness is
the culmination of every activity in life,
remembering any name of God or Guru (any
symbol of your true self) is equivalent to
opening the final common pathway for the
individual consciousness associated with
every possible activity to get funneled into or
unified with objective or cosmic
consciousness.
Thus NAMASMARAN is in fact the YOGA of
YOGA in the sense that it is the
culmination of consciousness associated with
every possible procedure and technique in
the yoga that you are familiar with. It is the
YOGA of YOGA because it is the
culmination of consciousness associated with all
the activities in the universe, which it
encompasses as well! It is YOGA of YOGA
because everybody in the world irrespective
of his/her tradition and the beliefs; would
eventually, ultimately and naturally reach it
it; in the process of liberation. Even so called
non believers also would not “miss” the “benefit
of remembering the true self through one symbol
or another”!
Just as NAMASMARAN is YOGA of YOGA it
is meditation of meditation also! It is the natural
and ultimate climax of every form of meditation.
These facts however have to be realized with
persistent practice of NAMSMARAN and
not blindly believed or blindly disbelieved with
casual approach!
In short NAMSMARAN is super-bounty of
cosmic consciousness for every individual to
realize it (cosmic consciousness)! This is truly a
super-bounty because a person who
experiences it, rises above mercenary,
commercial and even professional and
charity planes and manifest super- transactions
in his or her life!
These are just few observations to give rough
idea about what is NAMASMARAN.
NAMASMARAN is an ocean of bliss. Its true
meaning is beyond description in words and has
to b experienced, most preferably, by billions!
References are available for free download on
www.superliving.net and www.scribd.com
Dr. Shriniwas Janardan Kashalikar
101- A-24, HAPPY VALLEY,
TIKUJINIWADI, THANE (WEST), 400610
MOBILE NO. 99679 13301
RES. NO. 40121970
www.superliving.net