Exploring the preventive potentials of Ayurveda in Dementia

‘Expanded version of poster presentation of the same topic by the students at Pragathi 2017, seminar conducted by department of Kaya Chikitsa and Panchakarma at KLE Ayurvedic Medical College, Belgaum’

We all need to think to do the activities of our daily living. The thought process keeps operating within the brain, uninterruptedly. The thought process in turn would govern our living. There are certain diseases which meddle with this thinking process and will hit badly on our daily routine. One among them is Dementia.

Dementia is a term used to define ‘decline in mental ability to think and processing the thoughts in a healthy way’. This affects our daily life.

Dementia is a broad category of brain diseases that cause a long-term and often gradual decrease in the ability to think and remember that is great enough to affect a person’s daily functioning. It includes Alzheimer’s disease, vascular diseases of the brain, Lewy Body dementias etc. The statistics are alarming. Roughly 46.8 million people worldwide lived with dementia by 2015 and the numbers are expected to reach about 747 million in 2030.

Though the medical system is busy finding effective interventions for dementia, no strong, reliable and proven cure exists for this condition. For time being, prevention of dementia seems to be the best and ultimate step towards dealing with this disease.

Why effective treatment is not possible in dementia?

Treating dementia has its own lacunas.

  • Possibility of only rehabilitation
  • Availability of cognitive enhancers and not cure drugs
  • Arresting the progress is difficult when the disease is advanced
  • Many cases go unidentified until severe cases are brought to clinics

These, on the other hand are also the tools for tackling dementia. We can deal with dementia in a better way if –

  • Identifying the cases early
  • Trying to arrest the progression by administering cognitive enhancers and preventive modalities
  • Rehabilitating, reassuring and working in compassion with the ailing ones

The modern method of treatment depends on various factors.

Except for the treatable types; however, benefit is generally small. Cognitive and behavioral interventions may be appropriate. There is some evidence that educating and providing support for the person with dementia, as well as to the caregivers and family members of the patient improves outcomes. Exercise programs are beneficial with respect to activities of daily living and potentially improve dementia.6

Ayurveda has assuring results in prevention and cure of many diseases. In this article we shall explore the preventive potentials of Ayurveda in dealing with Dementia.

Possible Ayurvedic interventions towards prevention of Dementia

  1. Primary prevention

Primary prevention of dementia includes consumption of healthy food and essential life style modifications.

Ahara, the food factor – Ahara or food is one of the supporting pillars of health. We live by what we live. Food contributes majorly towards comprehensive body-mind health. The patients of dementia should be advised to consume food at proper time keeping in mind about the quality and quantity of foods suitable for them. Stale, junks, incompatible, unpleasing and unwholesome foods and erroneous food combinations should be avoided. Hence Ayurveda is very concerned in regards of intake of food in disease of dementia the below mentioned ways can be adapted. Among the important brainy foods, ghee is the most important one. Ghrita or ghee is a good anti-oxidant and should be recommended on daily basis. Ghrita is also said to be one among the Nitya Rasayanas i.e. daily rejuvenators or health promoters, which includes mind and body health. Ghee, as food inclusion and as medicated ghee is highly effective in preventing dementia.  

Nidra, the sleep factorNidra or sleep, as an activity of daily living, forms an important protocol of our life. Proper quality and quantity of sleep will keep the brain functions intact, healthy and balanced. Sleep imbalances and erroneous sleep practices, will lead to damage of brain cells apart from affecting the overall physical and mental health in a bad way. Inadequate sleep will lead to vata vitiation which in turn will cause many psycho-somatic illnesses. People who have insomnia for many months or years may develop many brain related diseases in future, including dementia. Therefore good sleep should be an essential recommendation to the patients of dementia. This will be one of the key preventive strategies.

Dinacharya, the timetable of day to day lifeDinacharya is one of the best basic fundamentals of Ayurveda. It teaches us about daily living. It is a scheduled and disciplined daily regimen which everyone should follow to maintain good body-mind health. It includes many activities like getting up early in the morning, brushing, bathing, wearing clean and tidy clothes, prayers, getting massages etc. Regular practice of these activities not only keeps one fit and health but also will guard the body and mind from many diseases like dementia. Getting up in morning following the daily routine only helps the body to be at its best form. For patients of dementia, it can be used as preventive tool as far as the progression of the disease is concerned. When healthy people and those prone to dementia practice this, it will come in handy towards prevention of dementia.

Easy and effective therapies – Abhyanga i.e. herbal oil massages, Prathimarsha nasya i.e. a subtype of nasal medication which can be practiced daily, MurdhaTaila i.e. oil treatments over the head to control vata and Vyayama i.e. regular physical exercises to one’s own capacity are all effective tools which help in preventing dementia.

Achararasayana, the behavioural scienceAchara Rasayana is a group of activities which includes foods (like ghee, milk etc) and behavioural activities which define our personality. Since they are explained in the context of Rasayana, they act as tissue rejuvenators, anti-ageing remedies, immunity enhancers and best preventive medicines. Regularly following achara rasayana would not only build up one’s character but also will help in prevention of many diseases related to body and mind, including dementia. Even those suffering from mild to moderate dementia shall be advised to follow achara rasayana.

  1. Secondary prevention

When the disease has started to progress, the damage will be considerably more. Here only food and lifestyle corrections will not be of much help. In this stage it is important to include disease modifying medicines into the protocol. The patient should be advised to follow the medication as told by the doctor and also to have routine and periodical check up so that the progression of dementia can be halted.

Important medications include many effective formulations mentioned in the context of Rasayanas. Some effective formulations which could be used for prevention of Dementia or its progression are –

  • Bhallataka Rasayana
  • Pippali Rasayana
  • Triphala Rasayana
  • Naladadi Ghrita
  • Dhawanthra Ghrita
  1. Tertiary prevention

If dementia has reached its 3rd phase of progression and if the disease is affecting and damaging the mind and thought processing in more severe way, more effective medicines in the form of Medhya Rasayanas i.e. brain health promoters, intellect promoters and brain immunity enhancers need to be prescribed. These medicines will stop the progression of the disease and prevent further brain damage. Medhya Rasayanas can be used as effective preventive medicines in all stages of dementia. In this stage, more vigorous approach is needed. We can include cleansing treatments in the form of Panchakarma treatments according to the involvement of morbid dosha or doshas.

Genetic linkage and possible health issues in Dementia  

Dementia also has a genetic linkage. Likewise, dementia is also associated with complicated health conditions like Alzheimer’s disease, hypertension, obesity, dyslipidaemia and diabetes mellitus at one or the other stage of its progression. The mentioned conditions may also be associated with dementia.

Charaka has told about how the body and mind are interrelated to each other. The diseases at physical plane will include the mind at later time and vice versa. In one of the sub-sections of Rasayana chapter, i.e. Pranakameeya Rasayana Pada, Acharya Charaka explains that excessive consumption or exposure to etiological factors like gramya ahara (substandard diet), improper lifestyle practices like daily indulgence in sex, alcohol, day sleep, excessive exercise and extremes of mind expressions like fear, anger, grief, greed, infatuation etc will lead to bad effects like shithila mamsa (laxity and weakness of muscles), rakta vidaha (vitiation and burning of blood), ojo kshaya (diminution of fluid responsible for loss of immunity etc). Such a person suffers from many psycho-somatic diseases like tiredness, exhaustion, stupor, lack of enthusiasm, incapability of performing physical and mental works, loss of memory, intelligence and complexion etc. Dementia can be considered as a part and parcel of these manifestations.

Results of Ayurvedic preventive measures in the management of Dementia

Primary prevention

Intake of Proper food, following Dinacharya and Sadvritta etc increases the vitality of the person and helps in preventing in the occurrence of dementia. A number of factors can decrease the risk of dementia. A group of efforts is believed to be able to prevent a third of cases and include early education, treating high blood pressure, preventing obesity, preventing hearing loss, treating depression, being active, preventing diabetes, not smoking, and preventing social isolation.6

Secondary prevention

– Early and repetitive screening of patients helps in early interventions and to prevent the progression of the disease.

– Psychological therapies for dementia include tentative evidence for reminiscence therapy, some benefit for cognitive reframing for caretakers, unclear evidence for validation therapy, and tentative evidence for mental exercises, such as cognitive stimulation programs for people with mild to moderate dementia.6

– MMSE4 (Mini-Mental State Examination) has to be done to know the status of the disease apart from diagnosis; this will help in early treatment and prevention of dementia and also to halt its progression.

– Use of highly effective compounds like Bhallataka Rasayana will boost the metabolism and help in preventing the progression of dementia. Regular use of rasayanas and beneficial compounds like Agasthya Rasayana, Naladadi Ghrita etc will be handy.

Tertiary prevention

Below mentioned have provided appreciable results in preventing the progression of dementia.

  • MedhyaRasayana – Rasayana such as Mandookaparni, Brahmi, Yashtimadhu, Shankhapushpi,etc are preventive and curative apart from being Rasayanas in the management of dementia
  • Anti-oxidant activity
  • Cognitive enhancement
  • Nootropic

Golden Tips

  1. Avoid direct prescription
  2. Focus on early diagnosis by early symptoms.
  3. Treatment by cognitive enhancers.

REFERENCE

https://www.alz.co.uk/research/WorldAlzheimerReport2015.pdf

http://press.thelancet.com/dementia.pdf

  1. Norton, Sam; Matthews, Fiona E; Barnes, Deborah E; Yaffe, Kristine; Brayne, Carol. (2014). “Potential for primary prevention of Alzheimer’s disease: an analysis of population-based data”. The Lancet Neurology. 13 (8): 788–794.
  2. Textbook of Medicine by K V Krishna das, 6th edition volume 2, chapter no. 200,dementias and metabolic encephalopathy,page 1366 publishers Jaypee
  3. Agnivesha’sCharaka Samhita text with English Translation and Critical Exposition based on CakrapaniDatta’s Ayurveda Dipika,byBhagwan Dash volume 3,Chikitsa Sthana ,Chp 1- 2nd pada/3rd sholka publishers Chowkhamba Krishna Das
  4. Rao BS, Gupta KK, PujithaKaranam p, AnushPeruri ; Alzhemier’s disease: An interactome of many diseases- Annuals of Indian Academy of Neurology 2014,17,48-54

6.https://en.m.wikipedia.org/wiki/Dementia#/editor/0

Categories – #Dementia #Ayurveda #Prevention #Rasayana

Tags / Key Words – #Ayurveda, #Dementia, #Prevention, #Rasayana #AcharaRasayana, #Cognitive, #Ghrita, #Nidra, #Vata, #Dinacharya, #Charaka

Article By
Sowmya PillaiDipshi ShettyPallavi HegdeSuja Priya S PrabhuShwetha Padiyar
4th year BAMS students, ALN Rao Memorial Ayurvedic Medical College, Koppa
Guided by (Article idea and expansion) Dr Raghuram Y S, Reader, Dept. of Kayachikitsa, ALN Rao Memorial Ayurvedic Medical College, Koppa

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