AGING: ONE VIEW: DR. SHRINIWAS KASHALIKAR

We have to distinguish the handicap or dysfunction that results from the diseases; and the changes resulting from the natural process of aging that takes place in the absence of diseases.

We 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 changes, which take place after forty and fifty; in the absence a history of gross or major diseases or accidents; roughly represents the true aging and is generally attributed to two basic facts

1) Genetic program, which decides the range of the longevity of life for a specific species and determines the time dependent loss in structure and function characterizing senescence and death and 2) Accumulation of injuries or micro insults:

Since very little is understood in this respect; there are many theories based on these two tenets meant to explain aging. Since they focus on a specific change, they are inadequate in isolation; but together they do give us some insight into the process of aging.

THEORIES OF AGING:

A] The Error Catastrophe Theory:
Random increase in errors of protein synthesis i.e. defects in the processes involved in protein synthesis called transcription and translation. But aging processes seem to be posttranslational (i.e. after the proteins are completely synthesized) 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. Thus there is possibility of that errors are not causes but merely coexisting with aging processes.

B] Somatic mutation theory:
This suggests that there is age associated increase in chromosomal aberration. This is suggested to give rise to 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. If this were so, we would expect lipid peroxidation at cellular level, which is not demonstrated in aging. Further, the antioxidants which we expect to delay aging are not proved to do so!

D] Ionizing radiations and such other environmental factors may cause cell injury. This could be so; but the cause and effect relationship and the quantitative aspects; are not yet demonstrated to cause aging by themselves!

E] Cellular dysfunction in tissues such as CNS, endocrine and immune system; influences other systems and causes aging! Thus decreased synthesis, increased breakdown, decreased receptor number, decreased Hormone-Receptor (HR) combination, decrease in HR internalization etc may be responsible for aging.

These are merely physiological interactions (associated with aging) amongst tissues; and cannot be called mechanisms or causes of aging.

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 expedite or aggravate (though do not constitute the basic mechanisms or causes as such) the aging process; and are described; in my books viz. “Stress: Understanding and Management” and Conceptual Stress: Understanding and Management”.


CHANGES DURING AGEING:
Overall changes in the body are loss and graying of hair starting with the temporal hair (side buns), drying and wrinkling of skin, loss of teeth, decrease in reaction time, 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. Broadly speaking, maximum capacity, tolerance, peak performance and reserve are reduced.
The details of the changes can be enumerated as follows.

Matrix:
Collagen becomes stable, more rigid, more insoluble due to 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 and 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, and becomes more susceptible to injury.

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 (Formation of red blood cells and white blood cells); is reduced.

Gastrointestinal tract (GIT):
*Enamel, dentin and cement of teeth show decline. There is loss of teeth due to caries, periodontal infection and reduced masticatory efficiency.
*Weakness of cricopharyngeus (Muscle of swallowing), reduction in pressure gradient and inability to relax the lower esophageal sphincter cause dysphagia (difficulty in swallowing).
*Age related atrophy of inner lining of stomach called mucosa causing achlorhydria (absence of digestive acid in stomach).
*Pancreatic lipase (fat digesting enzyme secreted by pancreas) is reduced causing streatorrhoea (presence of fat in the stools).
*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 in the liver 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 of liver is great; the liver function tests are in normal limit.

The immune system:
There is decrease in the T cell activity, Antibody (AB) production; but increase in the presence of auto anti bodies.
The auto-antibodies are increased due to reaction with the antigens (which were previously recognized as “self” and not reacted with)! This is called reduced tolerance to “self” antigens.

There is susceptibility to infections.

Since immunological - surveillance is believed to eliminate neoplastic cells (cancer cells); there is higher incidence of cancer.

Following stress of bereavement; there is steep decline in cell mediated immunity (T cells) and this is one of the causes of infections leading to the death that follows the death of spouse or any other near and dear one.

Reproductive system:
The hormonal secretion reduces and there is stoppage of ova formation, ovulation in females and there is gradual reduction in the spermatogenesis (formation of sperms) causing reduction in the sperm count in males.

Females show a distinct and identifiable change in the form of menopause; whereas such change is not distinct in males.

There is reduction in sexual performance in terms of number masturbations and number of intercourses in a given time and reduction in the functions such erection, ejaculation and the climax. The infatuation about sex may be increased and provoked by pornographic and or sexually romantic atmosphere even as the sexual performance is dwindled.

Central nervous system and special senses:
There is atrophy of the brain and neuronal loss associated with 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. But, 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 hypo-kinesia seen in old age.

There is deficit in autonomic responses leading to postural hypo-tension and impairment of temperature regulation.

There is difficulty in getting sleep as well as there is tendency to wake up during night and waking up early.

There is development of Presbyopia (age related difficulty in focusing on the near object), cataract, rise in intraocular pressure; Presbyacusis (age related difficulty in understanding speech and localization of sound) decline in perception of smell and taste.

Endocrine system:
There is decrease in the functioning of sympatho-adrenal axis and there is reduced tolerance to stress. In other words, there is inappropriate production of adrenaline, noradrenalin, cortisol etc.

Cardiovascular system:
Aging is associated with atherosclerosis. But even in those without atherosclerosis; there is still reduction in the elasticity of aorta (indicating overall changes in connective tissue); leading to increase in systolic and pulse pressure; but not in diastolic pressure. In addition; there is also atherosclerosis, atrophy of myocardium, accumulation of lipofuscin, fibrosis, deposits of amyloid, diminish in contractility relaxability, decrease in ventricular compliance, stenosis of aortic and incompetence of mitral valves, reduction in pacemaker cells, responses to sympathetic as well as parasympathetic stimulation also reduce (this causes postural hypotension).
Maximal Heart Rate during exercise is reduced in aged but cardiac output is maintained by increasing stroke output.

Respiratory System:
The alveoli (the air pockets in the lungs) become flatter and narrower and ducts enlarge. Alveolar walls become thin, capillaries decrease in number causing reduction in diffusion, surface area decreases by 4 % every decade after the age of 30 and the 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 (degree of expansibility) 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. The response to hypoxia and hypocapnia (reduced carbon dioxide) are reduced.

Thus ventilation, diffusion and regulation are all impaired in elderly individuals.

Muscles:
There is atrophy, reduction in contractility, decrease in tone, hernia and rupture of inter-vertebral disc etc.

Excretory system:
As a result of aging; the kidneys reduce in size and their blood flow and rate of formation of urine reduces by 10 % per decade after 30, nephrons (urine forming tubules) and their secretory and absorptive functions; reduce and fibrous tissue increases. Kidney vessels show age related changes irrespective of hypertension (high blood pressure).

It has been hypothesized that due to high protein diet there may high solute load on the renal capillaries leading to chronic dilatation of the capillaries leading to extravasation of macromolecules in renal glomeruli leading to mesangial reaction causing renal damage.

PSYCHOLOGICAL CHANGES
Frustration, depression, fear, anxiety, insecurity, loneliness, vacuum, dejection, self pity, sadness; are some of the hallmarks of old age.
This is because;
1. With aging there is increasing restriction on the kind of accustomed enjoyments (e.g. sexual); and this can lead to frustration or depression.
2. The realization of the increased chances of death; (due to observation of the deaths of the contemporaries); causes alarm, concern, anxiety and excessive fear of death, diseases and debility.
3. Due to lack of job after retirement or physical inability there is always a sense of insecurity.
4. Lack of the children's company due to their being increasingly independent gives a feeling of unwantedness and loneliness, especially due to children going abroad or away from home for their jobs.
5. Since most of the people of younger age groups; have their own pre-occupations we the elderly are left out.
6. Due to generation gap; 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 and leads to vacuum, dejection, self pity and sadness. Thus overall we tend to become increasingly melancholic in old age.

ECONOMIC CHANGES
The aging almost always associated with reduced income and increasing economic dependence on the others. The medical expenses also swell!

SPIRITUAL CHANGES
We begin to visit temples and participate in SATSANG. This is because we want a certain kind of solace which we 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!

When we are aging; we become somewhat disinterested and indifferent towards life. But this is not detached attitude described in Geeta. We get detached because; we cannot participate or oppose the activities of young generation! Thus; this is actually reluctant acceptance of defeat!

Sometimes we develop ascetic thoughts due to losing interest in the routine life because we are tired of responsibilities and dynamism required; for a job or a profession. Even as this engenders reduction in income; it is not a spiritually oriented selflessness and sacrifice. It is only fallout of mental apathy.

Sometimes we lose interest in the surroundings due to decreasing sensory perception and decreased mobility. We become shy about our deficiency. So we avoid socialization. Gradually we become increasingly self centered and selfish. We become over-concerned about ourselves and less sensitive to others' problems. We become more rigid, adamant and at times obstinate; in an attempt to assert ourselves; and become unreasonable and erratic.

The courage, alertness, enthusiasm and other physical and mental faculties which are extremely important to undertake spiritual pursuit i.e. growth of consciousness; are considerably diminished in old age; unless the spiritual quest has been integral part of life right from childhood.

Is this a complete picture of aging?

No!

For the complete we have to refer to, “Aging: A holistic view”!

STRESS AND BREAST FEEDING: DR. SHRINIWAS KASHALIKAR

After decades of thinking and working; I have begun to realize that the Total Stress Management; has certain very important merits as mentioned below.

The gurus (called, mauli (mother), have been our saviors in true sense; doing much more than Total Stress Management; by feeding the divine sap of NAMASMARAN (remembrance and reorientation to one’s true self); to generations after generations for millennia.

Total Stress Management is practicable for maximum people, except perhaps; the extreme cases; such as embryos, newborn, comatose, sleeping, mentally challenged or individuals with seriously debilitating and/or painful disorders. But in any case; it is; directly or indirectly; beneficial to the whole universe.

It does not have any undesirable side effects.

It is not painful or discomforting.

It is never a nuisance to others, including those; who belong to other religions, faiths or ideologies etc.

It does not involve intellectual surrender, though in the course of time it demands growing out of subjective rationality into unprejudiced objectivity.

It is not conducive to dependence, parasitism, lethargy, indolence, passivity, inaction and discord in society.

It is natural, like blossoming of a plant; and emanation of the fragrance; and not coercive.

It is conducive to growth and evolution; enhancing dynamic harmony within an individual and within universal life.

In simple words, Total Stress Management is like breast feeding, which plays; “the life building and life blossoming role”; without the baby realizing it! We have the golden opportunity; to study and practice Total Stress Management; and blossom with the billions in the world; primarily through the respective governments, though other agencies might also help!

STRESS PHALA AND MAYA: DR. SHRINIWAS KASHALIKAR

One of the major causes of stress; is inability to cope with the failures, rejections, lack of any kind of achievement in the form of effects, results, fruits (phala) of our action. Failure are insulting to our intellectual esteem, hurting to our deep seated concerns or humiliating to our physical dignity.

We feel hurt if our ideology, faith, love are defeated; and besides us; our near and dear ones are criticized. We get agitated even if our pets, our possessions are underrated!

Thus not the poverty (deprivation), disease and loss per se, but the implication that that we are undeserving, incapable, lowly or sinners; causes agony!

The “karma-phala-tyaga” i.e. detachment from the result or fruit of our action; thus is actually; the detachment; from our thoughts, emotions, instincts and body; i.e. everything subjective or personal (MAYA)!

The aphorism of the saints is that; the degree of steadfastness and happiness in NAMASMARAN; irrespective of any “result or fruit”, is the indicator of the evolution, development, or progress of a sadhaka. NAMASMARAN is everything for them! Even the social dreams are left to follow just as the day follows the sunrise!

But even as we talk about this ideal; most of us (including leaders with a mission of a dream society) appear to be motivated and engaged in a variety of (constructive and destructive) administrative, creative, artistic, technological, intellectual activities; and vacillating between pleasure and pain; with gains or losses and successes and failures.

But that is exactly what is MAYA; according to saints, who advise us to be steadfast in the practice of NAMASMARAN; even as the people continue in their activities; according to their stages of development; and the trillions of our body cells continue in anabolic and catabolic activities!

Aerobic exercise provides cardiovascular conditioning.

Aerobic exercise provides cardiovascular conditioning. The term aerobic actually means "with oxygen," which means that breathing controls the amount of oxygen that can make it to the muscles to help them burn fuel and move.

Benefits of aerobic exercise:

Improves cardiovascular conditioning
Decreases risk of heart disease
Lowers blood pressure
Increases HDL or "good" cholesterol
Helps to better control blood sugar
Assists in weight management and/or weight loss®
Improves lung function
Decreases resting heart rate

Exercise safety:

It is recommended that you talk with your physician before you start an exercise program. Ask what, if any, limitations you may have. People who suffer from diabetes, hypertension, heart disease, arthritis, pulmonary conditions, or other health conditions may need additional safety guidelines for exercise.

Note: If you develop symptoms during exercise including, but not limited to, unusual shortness of breath; tightness in the chest; chest, shoulder, or jaw pain; lightheadedness; dizziness; confusion; or joint pain, you should stop exercising immediately and contact your physician.

What are some examples of aerobic exercise?

Lower impact aerobic exercise includes:

Swimming
Cycling
Using an elliptical trainer
Walking
Rowing
Using an upper body ergometer (a piece of equipment that provides a cardiovascular workout that targets the upper body only)

Higher impact aerobic exercise includes:

Running
Jumping rope
Performing high impact routines or step aerobics

How often and for how long should I do these exercises?

The American Heart Association recommends that everyone reach a minimum of 30 minutes of some form of cardiovascular exercise 5 to 7 days per week. This can be broken up into 10-minute time periods. This means that taking three walks of 10 minutes each would let you reach the recommended minimum guideline for reducing the risk of heart disease, diabetes, hypertension, and high cholesterol. You would also burn the same number of calories as you would if you walked for the full 30 minutes at one time.

The American College of Sports Medicine recommends a minimum of three sessions of 30 minutes of the total should be made up of moderate to vigorous exercise to improve cardio-respiratory fitness and help manage weight.

It is appropriate to do aerobic exercise every day. There is no need to rest in between sessions unless you are at an extreme level of training, such as preparing for a marathon, or if you experience reoccurring joint pain. If joint pain is a limiting factor, it would be appropriate to alternate less painful exercises with those that may cause joint pain or to discontinue the painful exercise altogether.

Explanation of intensity:

The intensity is determined by how hard you are working. The intensity of the exercise is determined by what your goals are, what limitations you have, and your current fitness level.

Heart rate and exercise:

Your heart rate increases in direct correlation with the intensity of the exercise. Heart rate levels can vary significantly from one person to another based on fitness level, genetics, environment, and exercise tolerance. If you wish to train based on heart rate, contact your health care provider to determine what the appropriate range is for you. Some medications, most often blood pressure drugs, control heart rate, making it impossible to determine exercise intensity in this way. Ask your physician to determine if you are on any of these medications.

Monitoring intensity in other ways:

How can you know if you are working in the right intensity? Using an RPE (Rate of Perceived Exertion) chart can help you to determine the appropriate intensity. The scale shown below is from one to 10. One is very light, such as walking to the refrigerator for a glass of milk. Ten would be a very significant level, representing maximal exercise. Ten would be indicative of not being able to take another step without fear of collapse. It is not recommended for anyone to work at a rate of ten without strict supervision by a healthcare provider. Moderate intensity is the level of exercise that is most recommended, and can be determined by a rating between a three and a five.

Warming up and cooling down:

Every session of aerobic exercise should include a warm-up and cool-down. The warm-up period should not include static stretching, but should instead be a gradual increase in pace and intensity of the exercise. This allows for the body to increase blood flow to the muscles, and decreases the likelihood of a muscle or joint injury. The warm-up should last between 5 and 10 minutes. The cool-down session should last a similar amount of time as the warm-up, with the pace gradually decreasing. Stretching exercises would be appropriate after aerobic exercise.

Progression of aerobic exercise:

Progression to higher intensities of exercise should be based on individual exercise tolerance. There are three methods for challenging aerobic fitness:

Increase the speed
Increase the resistance
Increase the duration

Any of these methods, or a combination of these methods, will improve aerobic fitness.

HOROSCOPE AND NAMASMARAN: DR. SHRINIWAS KASHALIKAR

While reading book NAMACHINTAMAI, by Mr. Ramachandra Krishna Kamat (Editor; of the revered treatise on the divine life of 14th century incarnation Shri Dattatreya; Shri Narasimha Saraswati viz. Shri Gurucharitra), and other books on NAMASMARAN; I found a reference, which indicates that; the practice of NAMASMARAN; goes on purifying the various 12 houses in the horoscope. Shri Tembe Swami (Paramahansa Parivrajakacharya Shri Vasudevananda Saraswati Maharaj) has upheld this conviction.

I also found in the biography of Shri Gondavalekar Maharaj (Shri Brahmachaitanya Maharaj from Gondavale; Maan taluka, Satara district, Maharashtra State, India); by Prof. Shri. K. V. (Baba) Belsare; that Shri. Gondavalekar Maharaj has stated that; NAMASMARAN takes us beyond the influence of stars and planets; and it also takes us beyond time.

In view of our curiosity or worry about future; and the help we seek during difficulties; on the basis of horoscope; we have this free guidance of spiritual masters and mystics; to study and explore the potentials of NAMASMARAN; and share our findings with the others.