Upload
vuthu
View
230
Download
2
Embed Size (px)
Citation preview
Yoga for Healthy Aging
Manjunath N. K., Ph.D.,Professor and Head
Anvesasa Research LaboratoriesS-VYASA, Bengaluru
Aging – a natural consequence
• Predictable
• Inevitable
• Progressive
• Variable
Population
(In Millions)
% of Population Over
65
Population over 65
(Numbers in million)
2000 2030 2000 2030 2000 2030
China 1262 1483 7.0 16.0 88 237
India 1014 1437 4.6 9.0 47 129
USA 276 351 12.6 20.0 35 70
Indonesia 225 313 4.5 10.9 10 34
Brazil 173 203 5.3 13.2 9 27
Russia 146 133 12.6 20.5 18 27
Japan 127 117 17.0 28.3 22 33
Thailand 61 71 6.4 16.4 4 12
France 59 62 16.0 24.0 9 15
UK 60 61 15.7 23.5 9 14
S.Korea 47 54 7.0 19.5 3 11
Malaysia 22 35 4.1 9.4 1 3
Australia 19 23 12.4 21.1 2 5
Singapore 4 9 6.8 14.8 1 1
Table 1: Population Aging in Selected Countries
Australian trends
Source: Department of Sustainability and Environment 2004a
Demographic Trends
Three major demographic trends are apparent
1. ↓ Fertility Rates
2. Improved health care systems
3. ↑ Life Expectancy
Reference: Kalache & Keller, 2003
Healthy agingLow risk and high functional capacity
• low probability of disease and disease-related disability
• high capacity for cognitive and physical functioning
• active engagement with life including interpersonal relations
Wellness
Physical
Activity
Spiritual
Health
Social
Harmony
Healthy
Relationships
Healthy
Lifestyle
Nutrition
Mental
Health
Use of CAM in the elderly
• A survey in North America:
Most commonly used CAM interventions –
* Yoga / Meditation (64%)
* Chiropractic (61%)
* Herbal medicine (54.8%)
* Massage Therapy (35.7%)
* Acupuncture (33%)
Reasons for CAM usage
* Pain relief (54.8%)
* Improve quality of life (45.2%)
* Maintenance of health and fitness (40.5%)
Reference: Williamson et al., 2003
Use of CAM by elderly in Australia
Most commonly used CAM interventions –
* Meditation
* Chiropractic
* Herbal medicine
* Massage Therapy
Reasons for CAM usage
* Psychological wellbeing
* Improve quality of life
* Maintenance of health and fitnessReference: Zhang et al., 2007
Common health issues
• Gait and Balance
• Sleep
• Cognition (memory)
• Depression
• Arthritis
• 1041 articles in Pubmed
Gait and balance
• Major reason for falls and immobility
• Musculoskeletal system to nervous system regulate
• Aging process influences both
• Yoga has demonstrated the ability to reverse the same
• Prevention of falls will be a major contribution
Gait and Balance
• Selected Balancing postures along with loosening and strengthening exercises along with better attention and awareness through meditation improved
– Ability to get up from a chair without support
– Initiate quick walk with long steps
– Speed of walking
– Balancing
Med Sci Monit. 2007;13(12):LE19-20
Styles studied
• Integrated Yoga S-VYASA
• Iyengar Yoga
• Mindfulness
• Isha Yoga
• Relaxation response and exercise
Depression
• Socialization through group Yoga
• Dynamic Yoga for the elderly
• Keertan Yoga (Bhakthi yoga)
• Lectures on Philosophy of Yoga
• Reduced:
– Depression scores
– Improved positive approach to life
– Improved coping abilities
Journal of Gerontological Nursing, 3(2):17-23.
Styles studied
• Integrated Yoga Module S-VYASA
• Sudarshan Kriya Yoga
• Sahaja Yoga
• Mindfulness
• Keertan Yoga
Sleep• Elderly spend more time awake in the bed than
sleeping
• Both quality and quantity of sleep gets affected due to medical, psychological and aging related changes in the brain
• Yoga improved:– Time taken to fall asleep
– Number of hours slept
– Feeling of being rested in the morning
– Number of awakenings in the night
Indian Journal of Medical Research, 121: 683-690
Self rated sleep and Depression scores
References:
Manjunath & Telles, 2005; Manjunath & Telles, 2007
Arthritis in the elderly
• Older people most often have
Osteoarthritis,
Rheumatoid arthritis, or gout.
• Osteoarthritis (OA) is the most common type of arthritis in older people. OA starts when tissue, called cartilage, that pads bones in a joint begins to wear away.
Pain and inflammation
Deformities
Yoga and Arthritis
• Improvement in hand grip strength in rheumatoid arthritis patients following yoga training Indian Journal of Physiology
and Pharmacology, 2001
British Journal of Rheumatology, 1994
Quality of life improved in osteoarthritis patients following yoga training
International Journal of Yoga, 2011
• Yoga program for elderly showed reduction in pain and stiffness
International Journal of Yoga therapy, 2010
• Yoga may help sedentary individuals with arthritis safely increase physical activity, and improve physical and psychological health
The Journal of Rheumatology, 2015
Aging and Mental AgilityAlzheimer's and Dementia
The best gift we are bestowed with
The ability to Remember
The ability to forget
Alzheimer’s Disease
• An irreversible, progressive brain disorder
• Slowly destroys memory and thinking skills, and
• Eventually the ability to carry out the simplest tasks.
• In most people with Alzheimer’s, symptoms first appear after 65 and most common after 85
• Alzheimer’s disease is named after Dr. AloisAlzheimer In 1906
• A Psychiatrist from Germany
Prevalence
• Alzheimer's disease is currently ranked as the sixth leading cause of death in the United States, but recent estimates indicate that the disorder may rank third, just behind heart disease and cancer, as a cause of death for older people.
• 1 in 10 above 65 years and 1 in 2 after 85 years are known to suffer from Alzheimer’s
Dementia
• Alzheimer’s is the most common cause of dementia among older adults.
• Loss of cognitive functioning thinking,
• Remembering,
• Reasoning
• and behavioral abilities
• to such an extent that it interferes with a person’s daily life and activities.
Changes in the brain
The process
• Amyloid plaques
• Neurofibrillary tangles
• Loss of neuronal connections and cell death.
The 4 fold issue
• Aging related memory loss
• Mild cognitive impairment
• Alzheimer’s Disease
• Dementia
Even being honest may not work
Google brain
Am J Geriatr Psychiatry 17:2, February 2009
Prevention through Yoga
Smruthi
• Smruthi one of the Citta Vruthi’s
• Anubhuthavishaya Asmpramosha ha Smruthihi
• Dhyayatovishayan pumsaha……..Smruthi bramshatbuddhi nashaha……..Pranashyathe
• Vasanas and Samskaras
DHÁRANA - SINGLE THOUGHT
CANCALATA - MULTIPLE SUBJECTS
MULTIPLE
THOUGHTS
EKAGRATA - SINGLE SUBJECT
DHÁRANA
(MIND)
(INTELLECT)
(MEMORY)
MULTIPLE THOUGHTS
Yoga in Alzheimer's Disease
• Stress increases cortisol which is toxic to hippocampal
cells (normal memory function)
• A stress induced hypercortisolemia can aggravate
Alzheimer's
• Regular practice of meditation produces stress reduction
that reduces serum cortisol. Hence, provide benefit in
patients with Alzheimer's
[Ann Indian Acad Neurol. 2012;15(4): 247–54.]
Yoga in Age Related Degeneration
In Elder:
• Cortisol & adrenocorticotropic
hormone (ACTH) raised
• Brain-derived neurotropic factor
(BDNF), serotonin & dopamine
lowered
Yoga:
• Significantly reduces cortisol; ACTH
• Increases serotonin, dopamine &
BDNF
• Hence, Yoga helps in prevention of
age-related degeneration
• [Age (Dordr). 2014;36(4):9683.]
• Yoga is a promising intervention for
neurodegenerative diseases.
[Integr Med (Encinitas). 2014;13(3):33-9.]
• Long-term Sahaja Yoga
Meditation:
– Inceases overall grey matter
volume
– Regional enlargement in several
right hemispheric cortical &
subcortical brain regions
– Associated with sustained
– attention, self-control,
compassion & interoceptive
perception.
• [PLoS One. 2016;11(3):e0150757.]
• Yoga practitioners have stronger
functional connectivity within
basal ganglia cortico-thalamic
feedback loops than non-
practitioners
[Front Hum Neurosci. 2015;9:137.]
During meditation: it became
localized to the right inferior
frontal cortex/right insula and
right middle/superior temporal
cortex.
– Right inferior frontal activation
was directly associated with the
subjective depth of the mental
silence experience.
[J Altern Complement Med.
2015;21(3):175-9.]
• Yoga produces acute increases
in thalamic GABA levels &
improvements in mood and
anxiety
[J Altern Complement Med.
2010;16(11):1145-52.]
Structural changes in the brain
• Increased thickness in cortical areas related to attention as well as increased subcortical gray matter in right insula and hippocampus in long-term meditators
Neuroreport. 2005 Nov 28;16(17):1893-7.
Volume of hippocampus increases
Voxel based morphometric analysis of the effects of yoga practice in healthy elderly (demonstrates significant increase in bilateral hippocampus gray matter volume after 6 months of yoga practice [indicated by the yellow circle]) Indian J Psychiatry. 2013 Jul; 55(Suppl 3): S394–S396.
Brain areas active during meditation
• Evoked Potential studies – Diencephalon
• Imaging studies –– Anterior Cingulate
– Dorso-lateral Prefrontal Cortex
– Regions of limbic systems
– Int J Psychophysiol. 2011 May;80(2):103-11
– J Altern Complement Med. 2010 Dec;16(12):1253-8
• Yoga is as effective as memory enhancement
training in improving functional connectivity
in relation to verbal memory performance in
subject with mild cognitive impairment
[J Alzheimers Dis. 2016;52(2):673-84.]
History
Dr. Alzheimer noticed changes in the brain tissue of a woman who had died of an unusual mental illness. Her symptoms included:
• memory loss,
• language problems, and
• unpredictable behavior.
he examined her brain and found many abnormal clump and tangled bundles of fibers
The Nobel Prize in Physiology or Medicine 2009
Elizabeth H. Blackburn, Carol W. Greider Jack W. Szostak
Discovery of how chromosomes are protected by telomeres and the enzyme telomerase
Telomeres and aging
Life style modification and telomere activity
Telomerase activity is associated with complex changes in lifestyle
Cell Biology International (2011) 35, 1079–1083
Telomerase and meditation
• 30 meditators (mindfulness)
• 6 hours daily for 3 months
• ↑ Telomerase activity in retreat participants compared to controls
• ↑ Perceived Control, ↓ Neuroticism, and ↑ in both Mindfulness and Purpose in Life were greater in the retreat group (p < 0.01)
Psychoneuroendocrinology, 2011
Yoga
↑ Positive Emotions (Narasimhan L, 2011)
↓ Il-6; TNF-α (Kiecolt-Glaser, 2010)
↓ Oxidative stress (Sinha S, 2007)
↑ Adiponectin (Packard C, 2011)
Parasympathetic predominance (Nagarathna R, 2008)Maintain Telomere
Length (Li QZ, 2005) Inhibits Hypothalamus & Limbic System (Rothuizen J, 1991)
Promote Weight reduction (Jain SC, 1993)
Regulates Blood Sugar & BP (Gokal R, 2007)
• Carbohydrate intolerance, osteoporosis and high blood pressure - modified by behavioral and life style interventions such as exercise, diet, and stress reduction
• Neurobehavioral aging, including cognitive decline – Exercise, Yoga and meditation,
Reference: Schneider et al., 2002; Finch, 1987
Exercise, lifestyle management and relaxation
Yoga and Tai-chi
• A preventive health care program (Haber,
1983)
• A randomized controlled trial (Blumenthal et al., 1991)
• Heart rate variability (Bowman et al., 1997)
Few practices
4. Interventions
a. YOGA(1 hour 15 minutes/ day for 6 days/ week for 6 months)
Breathing exercises (10 min.)
Loosening exercises (5 min.)
Asanas (physical postures) (20 min.)
Pranayamas (regulated breathing) (10 min.)
Relaxation techniques (15 min.)
Meditation (15 min.) OR
Bhajans (devotional session) (15 min.)
Lectures on philosophy and practice of yoga (30 min. / month)
Joint Loosening exercises
Postures
Sun Solutation
Forward bending
Twisting
Supine stretch
Guided relaxation with imagery
• Progressive muscle relaxation
• Breath awareness and chanting
• Imagery and resolve
• Being happy
Pranic energization
• Feeling the subtle energy
• Moving it to remove blockages
• Energizing
Meditation
• Mindfulness – Being aware
• Dwelling upon positive thoughts
• Remembering enjoyable moments of life
• Being connected with family and friends
• Actively engaging in mental tasks
Integrated Yoga Module
Summary
• Yoga brings in:
• Self imposed Lifestyle modification featured by:– Physical activity
– Slow, deep breathing
– Healthy diet habits
– Relaxation
– Positive mental attitude
– Philosophy of life
You don’t stop laughing when
you grow old, you grow old
when you stop laughing
……………. George Bernard Shaw
…………Bhagavad-Gita
Life is short, live itLove is rare, grab itAnger is bad, dump itFear is awful, face itMemories are sweet, cherish it