1

Welcome

2

Advancement in medical science

Decline in mental health

Thrust area - Mental health care

3

WHO predicts by 2025, about 75% population- people aged

60 years and older People with dementia will almost double every

20 years 42.3 million in 2020 and 81.1 million in 2040.   Prevalence of MCI in India is about 14.89%

Increasing risk - COGNITIVE IMPAIRMENT

4

Ayurveda is a lifestyle Preventive domain Treatment domain

Ayurveda

5

Mild Cognitive Impairment (MCI) An Ayurvedic Preventive Approach

ScholarDr.NAYANA.SMD ScholarMano vijnan avum manas rogaDept of kayachikitsaVPSV Ayurveda CollegeKottakkal

GuideDr.JITHESH.MAssociate ProfessorVPSV Ayurveda College

6

Cognitive decline

Affects memory ,thinking and reasoning

Transition stage

What is MCI?

7

Presence of cognitive complaint

Absence of dementia

Change from normal functioning

Decline in any area of cognitive functioning

Diagnostic criteria

8

Amnestic (memory impairment)

Non amnestic (non memory cognitive domains)

Subtypes of MCI

9

Mini mental status examination

Modified MMSE

Diagnostic tools

10

Apoptosis or programmed cell death of neurons

Insufficient nootropic factors

Failure to establish neuronal connections

MCI-Pathogenesis

11

Increasing age

Decreased mentally stimulating activities

Other medical conditions

Risk factors

12

Alzheimer's disease or other type of dementia.

Studies suggest 6 to 15% develop dementia every year

Fate of MCI

13

Depression Irritability and aggression Affects QoL Anxiety Apathy

Associated Mental disturbances

14

Treatments for Alzheimer’s disease

Antioxidants 

 Cholinesterase inhibitors

 Donepezil 

Adverse effects

Present trends in treatment in modern medicine

15

NEED FOR AYURVEDIC INTERVENTION

16

Concept of Jnanotpathi- Perception Attention Comprehension

Concept of medha, budhi and smruthi

Ayurvedic perspective of cognition

17

The highest form of budhi-acts at subtle levels.

Grahana sakthi (grasping power)

Dharana sakthi (retention power)

Medha

18

Discriminating power

Smrithi drushta (seen) shrutha (heard) anubhuta (experienced)

Budhi

19

Smrithibudhi Hraasa (memory intellect decline)

Smrithibhramsa (memory derangement)

CHRONOLOGICAL DETERIORATION

MEDHA - 4th decade

BUDDHI- 9th decade

MCI -Ayurvedic view

20

INTELLECTUAL ERROR

 Aaharaja –dietary factors

Viharaja- Lifestyle factors COGNITIVE IMPAIRMENT Manasika-psychic factors

21

COGNITIVE NEUROREHABILITATION

NOOTROPIC AGENTS

NEUROPLASTICITY

NEUROREHABILITATION

Intervention -Approach

22

Medhya rasayana

Centella asiatica (Mandookaparni)-juice

Glycirriza glabra (yashti madhu)-powder with milk

Tinospora cordifolia (guduchi)-paste

Clitoria ternatea (sankhupushpi)-paste

Nootropic agents

23

Centella asiatica

Effect of Centella asiatica on cognition and oxidative stress in an intra cerebro ventricular streptozotocin model of Alzheimer’s disease in rats ( Veerendra kumar et al)

24

Glycyrrhiza glabra

Concept of Nootropic drugs(Pharmacognosy review, Reena kulkarni et al)

25

Tinospora cordifolia

Preventive trial on progression of mild cognitive impairment through cognitive enhancement by guduchi satva (DR.JADHAV AVINASH BHAGVAT RAO)

26

Clitorea ternatea

Concept of Nootropic drugs(Pharmacognosy review, Reena kulkarni et al)

27

Bacopa monnieri

Effect of Bacopa monnieri on animal models of Alzheimer’s disease and pertubed central cholinergic markers of cognition in rats (Bhattacharya et al)

28

Withania somnifera

Pharmacology Biochemistry and Behaviour, SK Bhattacarya et al, Adaptogenic activity of Withania somnifera – an experimental study using rat model of chronic stress, vol 75, pp547-555

29

Nardostachys jadamansi

Concept of Nootropic drugs(Pharmacognosy review, Reena kulkarni et al)

30

Acorus calamus

Concept of Nootropic drugs(Pharmacognosy review, Reena kulkarni et al)

31

Withania somnifera(aswagandha)

Nardostachys jadamansi(jadamanchi)

Acorus calamus(vacha)

Bacopa monneiri(brahmi)

Nootropic agents…

32

Preventive trial on progression of mild cognitive impairment through cognitive enhancement by guduchi satva

(DR.JADHAV AVINASH BHAGVAT RAO)

Clinical efficacy of Guduchyadi Medhya Rasayana on Senile Memory Impairment (DR.M S BAGHEAL et al)

Relevant studies

33

Polyherbal preparation of ghee

Naladadi ghritha

Kalyanaka ghritha Ghee- Site specificity

Nootropic drugs…ghritha

34

• Ability of the brain to shape itself according to experience

• Physical change on a neuronal level

Neuroplasticity

35

Budhimedhakara gana- susrutha acharya

“Satataadhyayana vaada paratantra avalokanamTadvidya aacharya seva cha budhimedhakaro gana”

Continuous learning Engaging in debates Studying other sciences Learning from experts

Tips to stimulate neuroplasticity

36

In a broader sense we can include the techniques

Brain games Learning new languages Playing musical instruments Cross words

Neuroplasticity …

37

Panchakarma therapy

Snehapana, Virechana, Sirovasthi, Sirodhara, Nasya

Yoga

Meditation

Neurorehabilitation

38

Nasya

39

Sirovasthi

40

Sirodhara

41

Vitalizer of psyche and soma Socio-behavioural conducts for moral or

mental hygiene

Effective preventive principles for psychological disorders

Achara rasayana

42

Achara Rasayana in three dimensions:

Personality

Social Relationship

Physical Health

Mode of action

43

Need of promotion of mental health

Early management of MCI

Conclusion

44

Nootropic drugs-medhya rasayana

Brain exercises

Panchakarma procedures

Ayurveda as a treatment…

45

Adoption of good behavioral conducts -achara rasayana

Timely intervention of lifestyle diseases

Periodic intake of medhya rasayana

Active involvement in intellectually stimulating activities

Preventive…..

46