Safety and efficacy of ayush rasayana A and B in improving functionality of the elderly – A single-arm multicenter study

Background: As per Ayurvedic classics, Ras?yana is a term used for unique therapeutic measures intended to improve cognition, memory, physical strength and delay the degenerative processes. Ayush Rasayana A & B are developed from extracts of herbs pertaining rasayana property. Aims & Objectives: To assess the safety and effectiveness of ‘Ayush Rasayana A and B’ in improving physical endurance, quality of life and cognition of elderly. Materials and Methods: This is an open label, single arm, multi-centre study among 256 apparently healthy elderly between 60?75 years. Ayush Rasayan A was given for 6 days and Ayush Rayana B for 180 days. The effect of the trial drug was seen on functional capacity, quality of life and cognitive function and, safety of the intervention was assessed through haematological and biochemical tests, clinical examination and incidence of adverse events. Results: Significant improvement in 6 minute walk test and HMSE score was observed at 187th as compared to baseline (p<0.0001). Quality of life of the participants especially in domains of physical health, social relationship and environment also improved at the end of intervention period (p<0.0001). The haematological and bio-chemical parameters showed no significant changes as compared to baseline and no adverse events were observed during the study. Conclusion: Ayush Rasayana A and Ayush Rasayana B, both were well tolerated by all the participants. This ayurvedic intervention can be safely given to apparently healthy elderly to improve their functionality, quality of life and cognition. However, a randomized controlled trial is warranted to substantiate the efficacy of this drug.

Fluoroscopic coronary calcification and exercise stress test in asymptomatic elderly Asian-Indians.

OBJECTIVE: Provide preliminary data on prevalence and functional significance (association with atherosclerotic risk factors and stress test positivity) of fluoroscopically detected CAC (Coronary Artery Calcification) in asymptomatic elderly Indian-Asian. DESIGN: Prospective observational study. SETTING: Outpatient services at 1000-bed tertiary care hospital in Northern India. PATIENTS: 100 sedentary elderly (>60 years) Asian-Indian subjects (70 males, 30 females, age 65.9 +/- 5.1 years) with no history of CAD (asymptomatic). METHODS: CAC assessment was done using high intensity cine fluoroscopy and semi quantitative CAC scoring (scores 0-3) in all subjects (n = 100). Risk factor profile (diabetes, hypertension, smoking, serum lipids, body-mass index, waist-hip ratio) documented for all subjects. In 50 (the latter half of 100) consecutive subjects (29 males and 21 females, age 64.2 +/- 4.9 years), exercise stress test (treadmill test, TMT) was also done using standard Bruce protocol. RESULTS: 92% (84.8-96.1, 95% CI) had fluoroscopic calcification and there was no significant association of higher CAC scores and risk factors, except for a positive trend with serum total cholesterol (p = 0.086). 20% (11-33.2, 95% CI) tested positive on exercise stress test and a positive trend (OR = 7.2, 95% CI = 0.8-63, p value = 0.067) with higher CAC scores was seen. CONCLUSION: High prevalence of fluoroscopic CAC and stress test positivity was observed in asymptomatic elderly Asian-Indians. The newly observed positive trend with increasing total cholesterol levels and stress test positivity highlights the importance of fluoroscopic CAC in asymptomatic elderly and should be corroborated with larger studies.