Healthy Aging

The following sections are included:

• Contents

• Contributors

• Preface to Series

• Preface to Volume 4

Modern medicine has developed along a deductive pathway which advocates the identification of the cause of a disease entity, thence create a technique to clear the pathology. Chemical drugs are often involved in this process of target-shooting, which has been very successful when a disease has a single straightforward cause.

Aging involves complicated degenerative changes which cannot be corrected by simple removal or counteractions. Aging is affecting large populations and has become a public health problem. Developing multiple methodologies counteracting aging is an important issue for health providers. A new stream of clinicians has started special aging clinics in Europe and United States to give special services to the elderly who complain about fatigue, loss of energy and general malaise. This group assumes that those aging syndromes are the result of subtle hormonal deficiencies or subclinical toxic states. Basing on the “bullet-shot” theory, specific hormonal supplements or detoxications for the problems. The efficacy of this approach has to be proven. On the other hand, Oriental medicine advocates prevention of disease and degeneration before symptoms are felt. This can be done with active but non-strenuous exercise training, careful choice of a balanced diet and psychosocial means to maintain an internal harmony. To facilitate this practice of natural healing and disease prevention, practitioners of Chinese medicine have used a variety of herbs, either as accompanying ingredients in daily cooking or as specific broths. The Oriental way of natural healing demands a fervent personal commitment and is recommended for all those being challenged with aging.

The thoughts of “Treating Disease before Its Onset” has been valued, enriched and developed by generations of CM doctors to be a major theory guiding daily health care, disease prevention and treatment in TCM systems. In this new century, as the public opinion of healthcare and medical mode transforms and with the advent of global crisis in medical care, the National Outline for Medium- and Long-Term Science and Technology Development states that “with an emphasis on prevention, more effort should be put in the prevention and treatment of diseases to integrate health promotion and disease prophylaxis and treatment.” According to this outline, the focus of medical care should shift from disease treatment to prophylaxis. In November 2007, the “CM Treating Disease before Its Onset Project” was initiated and its underlying theory is drawing ever-increasing attention. This article, by analyzing the idea of “Treating Disease before Its Onset,” aims to discuss the inheritance and carrying forward of experiences from famous CM doctors, so as to popularize the thought and promote public health conditions.

The theory of “Preventive treatment of disease” is from Huangdi Neijing. The connotation is extensive; such precautionary and forestall kind of prevention ideology has been a far-reaching influence to the later generation. It is an essential basic theory of Traditional Chinese Medicine. Accompanied with new conception of health, it enhances the practical implication of the “Preventive treatment of disease” theory and will become the most promising prospect for development in this century. “Preventive treatment of disease” should not be worded generally, rather, it mainly refers to taking advance measurement to prevent disease from occurring, developing, evolving, and recrudescing. “Preventive treatment of disease” covers ‘prevention before diseases’ and ‘preventing disease from exacerbated’. ‘Prevention before diseases’ is again sub-divided into ‘self-regulation during disease-free’ and‘prevention on pathogenic factor’ which is prevention before any disease occurs. ‘Preventing disease from exacerbated’ is also sub-divided into ‘early treatment’, which is to prevent the diseases prior its aggravation, to calm the non-pathogenic viscera in advance to prevent disease prior its development; and to prevent the disease from recrudesce and sequela.

Aging is associated with numerous physiologic and psychosocial changes and with increased needs for medical care. Older adults are usually affected by two or more chronic diseases; are ill longer; have longer hospital stays; and hence, greater physical, mental and financial burdens. Complementary and alternative medicines (CAM), especially in the form of herbal medicines and botanical dietary supplements, are options that are being increasingly used by adults, including elderly consumers over 60 years of age, to treat or prevent a wide array of ailments such as chronic pain, arthritis, high cholesterol, insomnia, anxiety, Alzheimer disease, dementia, benign prostatic hyperplasia, and cardiovascular diseases. There are currently thousands of traditional medicines (TM) and other CAM herbal products available as such therapeutic agents worldwide. Yet, of the nearly 2000 herbal medicines listed in the Cochrane Controlled Trials Register as of June 2009, most of the clinical trials focus on a single plant herbal or phytomedicine. Hence, in this review, we will concentrate on single herb products that have been documented to have some clinical evidence of efficacy and/or safety for the treatment of diseases associated with aging. Space limitations, however, will not allow us to discuss every herbal product useful for this group of the population. In this review, the following herbs and their potential medical uses will be presented as examples of herbal medicine of potential relevance to the aging population. The examples presented are Boswellia (potentially useful for the management of arthritis, bronchial asthma, Crohn's disease, and ulcerative colitis), Echinacea (treatment and prevention of upper respiratory infections), Ginkgo (treatment and prevention of dementia), Ginseng (adaptogen for the maintenance and restoration of health, among other chronic conditions), Hawthorn (potential cardiovascular adjunct), Huperzia (Alzheimer's disease), Pygeum (Benign Prostatic Hyperplasia), and Saw Palmetto (Benign Prostatic Hyperplasia).

Chinese herbal medicines have been used to treat age-related diseases for a long time. Some Chinese medicines are also being used as functional food items in daily cooking for health maintenance and disease prevention purposes. This article provides an overview of the theories and principles underpinning the application of Chinese functional foods for health maintenance, especially in an aged population. The pathophysiology of aging is reviewed from a Chinese medical perspective, and the decline of kidney essence, the reduction of visceral functions and the accumulation of pathogenic products such as phlegm turbidity and blood stasis are identified as the basic mechanisms that drive the aging process. Accordingly, herbs with the functions of tonifying kidney essence, strengthening the qi and blood, resolving phlegm and invigorating blood circulation are the main ingredients for anti-aging applications. According to China's Ministry of Health, 87 Chinese herbs can be used as edible food items. Another 113 Chinese herbs can be classified as health promotion ingredients. These two categories of herbs are collectively called Chinese functional foods. The use of these Chinese functional foods for health promotion should conform to the basic principles of Chinese medicine. A number of functional food formulas are cited as examples to illustrate the application of Chinese functional ingredients for promoting health conditions among old people.

Huangdi Neijing called the natural life time of human beings “heavenly age” it was taken as the age that human beings should live and was the highest standard of long life. Modern people, beginning from middle or old age, are influenced not only by the living environment but also by their intrinsic factors and the incidence of many diseases have increased significantly, so that “living to the heavenly age” of human beings is affected. The knowledge about aging in Traditional Chinese Medicine is very rich and it has established a complete series of principles and methods, contributing much to the health care of human beings. This chapter recommends in brief, the drugs and formulae of anti-aging and prolongation of life; and also the procedures of health maintenance and hygiene promotion used in Traditional Chinese Medicine.

People in different societies have known tremendous of indigenous medicinal plants since prehistoric time. Among these societies, Chinese people have discovered thousands plants of medicinal properties since thousands of years. They have used them in their food and prescriptions to invigorate their body functions and to treat different ailments, respectively. Since the middle of last century, great attention has been paid globally to medicinal plants trying to use their active ingredients as an alternative medicine. During this period, many molecular ingredients have been identified and isolated from these plants by the aid of modern analytical tools. More recently, some of these molecular substances have been shown to exert neuroprotective effects against a number of neurodegenerative disorders by modulating certain CNS targets. This chapter will address and discuss the effect of the most popular Chinese herbs and their active ingredients against age-related neurodegenerative diseases with special references to Alzheimer's and Parkinson diseases.

Sleep is an essential and universal process for human being. There are progressive changes in sleep architecture, quality and quantity with advancing age. In addition, elderly has increased number of co-morbid illnesses that could further exacerbate their sleep changes. Insomnia is one of the commonest sleep problems in elderly, with a prevalence rate ranged from 23% to 38%. It is more common among female and highly co-morbid with physical and mental illnesses. Various factors contribute to insomnia including genetic, stress, physical and mental conditions, cognitive and neurobiological hyperarousal response. Hence, an integrated approach focusing on both insomnia and co-morbid illnesses is important when managing insomnia in elderly. In western medicine, in addition to pharmacological treatment there is concrete evidence that non-pharmacological approach such as sleep hygiene and cognitive behavioral therapy has promising results in the integrated treatment of insomnia. Traditional Chinese Medicine (TCM) and other alternative medicines such as acupuncture are other widely adopted treatment modalities. There has been a longstanding historical record of usage of various TCM formulae in treating insomnia or similar condition. Emerging evidence from modern practices suggested that some TCM formulae are effective in combating insomniac symptoms, such as the popular formula, Suan Zao Ren Tong. However, further clinical studies with modern scientific principles are needed in the study of TCM in the treatment of insomnia with respect to their safety and efficacy.

Objective: To evaluate the therapeutic effect of Bufeiyishen Granule on chronic obstructive pulmonary disease (COPD) through clinical and experimental studies.

Methods: In the clinical study, 62 stable COPD patients were divided into treatment group and control group, treated for six months, and observed for changes of lung function and number of acute exacerbation. In the experimental study, 105 rats were randomly divided into seven groups (control group, stable model group, acute exacerbation model group, high-dose group, low-dose group, Flumucil group, and Yupingfeng group), and measured for routine blood test, artery blood gas, bronchoalveolar lavage fluid (BALF), lung function, pathological changes and matrix metalloproteinases (MMPs) at measurement points.

Results: In the clinical study, forced expiratory volume in one second, maximum mid-expiratory flow rate, peak expiratory volume and FEV1% were increased significantly (p < 0.05, p < 0.01), and the number of acute exacerbations was remarkably decreased (p < 0.01) in treatment group, but no obvious changes were found in control group. The experimental study showed higher leukocyte and neutrophil counts in the peripheral blood, bronchial BALF in the acute exacerbation model group, together with elevated levels of blood gas PaCO₂, MMP-9 and MMP-2, and worse lung function and blood gas PaO₂ as compared to the control and stable model groups; the low-dose group could improve the above changes.

Conclusion: Bufeiyishen Granule could improve the lung function in stable COPD patients and decrease the number of acute exacerbation. Animal models of stable COPD and acute exacerbation state were successfully created. Bufeiyishen Granule could also improve the changes of MMPs in COPD.

Dental diseases in the elderly are usually chronic and often complicated by general illness and medications. An alternate approach to study geriatric dental disease is proposed. Relating oral diseases to systemic functional systems with TCM theory provide a more holistic view of both local and general pathological factors. Cross-referring TCM theory with modern research show evidence that dental diseases are in close association with general condition. Saliva is found to be an importance interface between systemic functions and oral environment. It can serves as an indicator or diagnostic aid for many systemic conditions.

Exercises involving stretching and control breathing are among the most important measures for the maintenance of health and natural healing according to the ancient Chinese Classic on Medicine. Meditation is another essential component in the pursuit of health.

Qi Gong and Tai Chi are the most common body training practices requiring the tripartite combination of stretching, controlled breathing and meditation. The physiological basis of the practices are described in this chapter. While carefully planned clinical investigations have been performed to show the physiological benefits of Qi Gong and Tai Chi, the perfect scientific explanations are still remote. This tripartite combination of stretching, control breathing and meditation can help stimulate infrequent neurological activities and its versatility will encourage this practice in all health-conscious individuals.

Yoga is an ancient Indian way of life which includes specific practices, postures, voluntarily regulated breathing, meditation and philosophical principles. In India research on the effects of yoga began in the 1920s and continues today. While studies on the physiological effects of different practices are the most numerous (but have not been described here as they do not have direct applications), there is also research on the applications of yoga. The most common application is as a form of add-on therapy for a wide range of disorders. These studies have attempted to assess whether yoga is useful or not, and in some cases possible mechanisms have also been studied. Other applications (for example in adaptation to unusually stressful environments) and the use of yoga for stress management are also mentioned. This review has attempted to cover a wide range of applications of yoga practice in different parts of the country. Though there is a possibility that some studies may have been omitted the review shows that the applications of yoga in health are many and varied and are being actively explored.

The following sections are included:

• Index