EJBR2021v11i1art65-74 ISSN 2449-8955 European Journal of Biological Research Review Article European Journal of Biological Research 2021; 11(1): 65-74 DOI: http://dx.doi.org/10.5281/zenodo.4320957 Ayurveda and Yoga practices: a synergistic approach for the treatment of Alzheimer’s disease Shailendra Kumar Mishra1, Sandeep Kumar Singh1,2 * 1 Indian Scientific Education and Technology Foundation, Lucknow-226002, India 2 Centre of Biomedical Research, SGPGI Campus, Lucknow-226014, India * Corresponding author: E-mail: sandeeps.bhu@gmail.com Received: 23 September 2020; Revised submission: 19 November 2020; Accepted: 09 December 2020 http://www.journals.tmkarpinski.com/index.php/ejbr Copyright: © The Author(s) 2021. Licensee Joanna Bródka, Poland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/) ABSTRACT: Alzheimer’s disease (AD) is an irreversible and progressive neurodegenerative disease which affects about over 30 million people worldwide. There is no suitable treatment for AD nowadays. The current scenario of the research in the field of the search for suitable therapeutic approaches for the treatment of Alzheimer’s disease should be a shift towards the combinatorial approach of Ayurveda and Yoga. This review is mainly focused on to adapt Ayurveda and Yoga approaches for the treatment of Alzheimer’s disease. Keywords: Neurodegenerative disease; Alzheimer’s disease; Ayurveda; Yoga; Therapeutic approaches. 1. INTRODUCTION Alzheimer’s disease (AD) is an irreversible and progressive neurodegenerative disease. Dementia is the leading cause of AD that affects about over 30 million people worldwide [1]. According to the world Alzheimer report 2018, new case of dementia develops in every three seconds around the world. AD is a major disease that has no effective ways to cure, reverse and slowdown of disease progression once symptoms start. AD is the multifactorial disease in which genetic and environment both involve [2] and progression of inflammation is significant cause of the pathogenesis of the AD [3]. In AD patients, there are three more common changes are appeared in the brain tissues as neurofibrillary tangle, neuritic plaques and senile plaques. AD affects the three mains processes that keep neurons healthy as communication, metabolism and repair. The degeneration of the nerve cells is responsible to cause the memory loss, personality changes and problems in routine workout etc. Many researchers are used multi-target strategies for the treatment of AD such as β-amyloid peptide aggregation inhibitors, γ and β-secretase inhibitors & modulators, anti-amyloid immunotherapy, tau hyperphosphorylation inhibitors (e.g. JNK3, CDK5, GSK3β & Fyn kinase), tau aggregation inhibitors, microtubules stabilization, anti-tau immunotherapy, AChE inhibitors, 5-HT6 antagonism, anti-diabetic/metabolic regulation therapies and Cdk5 inhibitors but these approaches have a limited success to cure the AD [4]. In this article, we have tried to collect an ample data that demonstrates Ayurveda and Yoga are significantly contributed in several distinctive treatment modalities for the Alzheimer’s treatment, in spite the use of above medicinal treatments. We have initially discussed about various ayurvedic medicinal therapeutics approaches that effective to prevent the AD progression and then discussed the several yoga practices which significant for AD’s treatment. Mishra & Singh Ayurveda and Yoga practices in treatment of Alzheimer’s disease 66 European Journal of Biological Research 2021; 11(1): 65-74 2. AYURVEDIC THERAPEUTIC APPROACHES IN AD In Ayurveda, various herbal formulations in which Rasayana is essential for management of mental and cognitive disorders including AD [5]. The Rasayana is mainly focused to enhance oxygenation that helps to promote neurogenesis by the homeostatic regulation re-establishment [6]. It can be noticed that the Ayurvedic medicinal therapeutics approaches are showed the same mechanisms to the modern medicine in a mechanistic study and effective to prevent the AD progression at some extent through various ways showing in Figure 1. They are bio-available and comparatively less toxic. Ayurveda drugs are not only modulated the neuro-endocrine-immune system but also provide rich source of antioxidant, strengthen cognitive power and memory and improve intellects [7]. Affluent sources of anti-oxidant, anti-amyloidogenic, anti-inflammatory, neuroprotective and immunomodulatory compounds are found in Ayurvedic nootropic herbs and formulations. The researchers have been found that these features are essential to modulate the neuro-immune activities, enhance memory, intellect, rejuvenate brain functions, allay neurodegenerative cascades of AD and improve quality life [8]. In recent times, some phytodrugs have been methodically tested in in-vivo and in- vitro models of AD and also in clinical trials. Ginkgo biloba, Curcuma longa, Withania somnifera, Angelica sinensis extracts have been found to regulate APP metabolism towards α-secretase pathway and even restrict the formation, extension and stabilization of Aβ fibrils. These studies might be provided significant lead for the discovering an appropriate medicine for AD [9]. For the treatment of AD, Ginkgo biloba has been under prevention trials [10, 11]. Some study has reported that three plants Buchanania axillaris Desr. (Anacardiaceae), Hemidesmus indicus Linn. (Apocynaceae) and Rhus mysorensis Heyne (Anacardiaceae) were identified as multifunctional therapeutics remedy for the treatment of AD [12]. It has found that Bramhi Ghrita has features like as improving cognition, anti-inflammatory properties, clearance of small channels, rejuvenator and blood purification that is perfect for clearing up the toxic metabolic byproducts in the brain and also work to stop neurodegeneration and to support neuroprotection [13]. Several studies have been shown that ayurvedic medicines play a vital role to treat the AD such as Gingko biloba for slow progression of AD, Galanthus caucasicus for treating memory impairments, Huperzia serrata for improving memory and mental functioning in AD patients, Catharanthus roseus for treating memory loss and mental impairments, Melissa officinalis for improving cognitive function and reducing the agitation, Curcuma longa (curcumin) increases phagocytosis of amyloid-beta that effectively clearing them from the brains of patients with AD and Withania somnifera (Ashwagandha) for stopping reverse and removing the neuritic atrophy and synaptic loss that is the main cause of neurodegeneration [14]. In recent years, some studies have been reported that AD disease could be treated by biomolecules extracted by plants such as kaempferol, is flavonoid, have been found to reduce the neurotoxic motor and cognitive impairments in AD flies [15] and oleanolic acid extracted from a Chinese herb, is pentacyclic triterpene, found to enhance Aβ induced memory loss and to restore synaptic plasticity in AD rats [16]. Various isolated compounds (alkaloids) have extracted from Esenbeckia leiocarpa (Rutaceae) [17], Coptidis rhizoma [18] and Corydalis cava (Fumariaceae) [19, 20] plants that were reported for acetylcholinesterase and butyrylcholinesterase inhibitory activity. Mishra & Singh Ayurveda and Yoga practices in treatment of Alzheimer’s disease 67 European Journal of Biological Research 2021; 11(1): 65-74 Figure 1. Synergistic neuroprotective effect of Ayurvedic herbs and Yoga practices on AD progression through various aspects. 3. ANTI-OXIDANT PROPERTY Anti-oxidant present in ayurvedic plants are scavenged the free radicals, which are played vital role in the progression of Alzheimer’s disease. Many ayurvedic herbs are contained wide range of bioactive compounds that have a strong anti-oxidant and neuroprotective properties (Table 1) such as Terminalia chebula [21], Passiflora incarnata [22], Typhonium trilobatum [23], Satureja cuneifolia [24], Anisomeles indica [25], Curcuma longa [26], Bacopa monnieri [27], Crocus sativus L. [28, 29] Macrosphyra longistyla [30], Cinnamomum zeylanicum [31], Melissa officinalis [32, 33], Caesalpinia crista [34], Camellia sinensis [35], Scoparia dulcis [35]. These medicinal plants can be a potent alternative drug for Alzheimer’s disease treatment. 4. ANTI-AMYLOIDOGENIC PROPERTY Natural extracts (e.g. polyphenols, alkaloids, cannabinoid) of medicinal plants that have shown anti- amyloidogenic activities which is crucial to potent drug discovery to treat the AD without any side effects. These medicinal plants are Grewia tiliaefolia [36], Cassia tora [37], Elettaria cardamomum [38], Caesalpinia crista [39], Perilla frutescens [40], Guettarda speciose [41], Dryopteris crassirhizoma [42], Dracoephalum moldavica L. [43], Bacopa monnieri (L.) Wettst [44], Perilla frutescens [45], Lawsonia inermis [46], Sargassum horridum [47] that involve in anti-amyloid activity (Table 1). 5. ANTI-INFLAMMATORY PROPERTY Various medicinal plants extract (polyphenols, alkaloids, cannabinoid) has shown anti-inflammatory activities in in-vitro/vivo experiments which is vital to develop a potential drug to treat the AD with no any Mishra & Singh Ayurveda and Yoga practices in treatment of Alzheimer’s disease 68 European Journal of Biological Research 2021; 11(1): 65-74 side effects. These medicinal plants are Terminalia chebula [21], Crocus sativus L. [28, 29], Lagerstroemia indica [48], Limonium spathulatum [49], Okinawa propolis [50], Corydalis dubia [51], Pancratium parvum [52] that reducing the inflammatory effects in brain tissues (Table 1). 6. NEUROPROTECTIVE PROPERTY Alkaloids, flavonoids and phenolic acids, secondary metabolites of plants, are played a major role in improving regeneration or inhibiting neurodegeneration [53]. The plants compounds with neuroprotective property are widespread in clinical use but many is undergoing in clinical trials for the treatment of AD include nerve growth factor, valproate and other GSK inhibitors, various nicotinic agonists, the CEP-1347 stress kinase inhibitor, minocycline as caspase inhibitor and metal chelators [54]. Bacopa monnieri (L.) Wettst [44], Grewia tiliaefolia [55], Vernonia amygdalina [56], Levisticum officinale [57], Schisandra chinensis [58], Withania somnifera [59], Ginkgo biloba [60], Kigelia africana [61] have the potentials of the neuroprotection through the improving regeneration of the neuron cells and inhibiting the neurodegeneration (Table 1). Table 1. Showing the name and type of herbal compounds used in in-vivo/in-vitro and their properties. Botanical name of medicinal plants Plant compound Type of study Activity References Terminalia chebula Phenolic In-vivo Antioxidant, Anti-inflammatory, Neuroprotective [21] Passiflora incarnata Butanolic In-vitro Antioxidant [22] Typhonium trilobatum Flavonoids In-vitro Antioxidant [23] Satureja cuneifolia Phenolic In-vitro Antioxidant [24] Anisomeles indica Polyphenol In-vivo Antioxidant, Anti-cholinesterase [25] Curcuma longa Hydroxynonenal In-vivo Antioxidant [26, 35] Bacopa monnieri Bacoside A, Bacoside B, Bacosaponins, Betulinic acid In-vivo Neuroprotective [27] Crocus sativus L. Carotenoid In-vivo Antioxidants, Anti-inflammatory, Neuroprotective [28, 29] Macrosphyra longistyla Tannins, Flavonoids, Phenolics, Terpenoids, Saponins In-vitro Antioxidant, Anti-cholinesterase [30] Cinnamomum zeylanicum Cinnamaldehyde Cinnamyl acetate In-vitro Antioxidant, Anti-cholinesterase [31] Melissa officinalis Rosmarinic acid In-vivo Antioxidant, Anti-cholinesterase, Anti-inflammatory [32, 33] Caesalpinia crista Methanolic In-vivo Antioxidant, Anti-cholinesterase, Neuroprotective Anti-amyloidogenic [34, 39] Camellia sinensis Catechin In-vitro Antioxidant [35] Scoparia dulcis Flavones In-vitro Anti-amyloidogenic [35] Grewia tiliaefolia Vitexin In-vitro Anti-amyloidogenic Anti-cholinesterase [36] Cassia tora Polyphenols In-vitro Antioxidant, Anti-cholinesterase [37] Elettaria cardamomum Alpha-terpinyl acetate In-vitro Antioxidant, Anti-cholinesterase, Neuroprotective Anti-amyloidogenic [38] Perilla frutescens Asarone In-vitro Anti-amyloidogenic [40] Mishra & Singh Ayurveda and Yoga practices in treatment of Alzheimer’s disease 69 European Journal of Biological Research 2021; 11(1): 65-74 Botanical name of medicinal plants Plant compound Type of study Activity References Guettarda speciose Iridoids, Phenolics In-vivo Anti-inflammatory, Anti-amyloidogenic [41] Dryopteris crassirhizoma Butanolic In-vitro Anti-amyloidogenic [42] Dracoephalum moldavica L. Flavonoids In-vitro, In-vivo Neuroprotective, Anti- amyloidogenic [43] Bacopa monnieri (L.) Wettst Phenolics, Flavonoids In-vivo Antioxidant, Anti-amyloidogenic [44] Perilla frutescens Luteolin, Rosmarinic acid, Flavonoids In-vitro Anti-amyloidogenic [45] Lawsonia inermis 1,2,4-trihydroxynaphthal -ene-2-O-β-D-glucopyranoside In-vitro Antioxidant, Anti-amyloidogenic [46] Sargassum horridum Fucosterol In-vitro Anti-amyloidogenic [47] Lagerstroemia indica Alkaloids, Phenolics, Flavonoids In-vitro Antioxidant, Anti-inflammatory [48] Limonium spathulatum Phenolics In-vitro Antioxidant, Anti-cholinesterase Anti-inflammatory [49] Okinawa propolis Flavonoids In-vivo Anti-inflammatory [50] Corydalis dubia Scoulerine In-vitro Anti-cholinesterase Anti-inflammatory [51] Pancratium parvum Flavonoids In-vitro Antioxidant, Anti-inflammatory [52] Grewia tiliaefolia Vitexin In-vitro Anti-cholinesterase Neuroprotective [55] Vernonia amygdalina Alkaloid In-vitro In-vivo Antioxidant, Neuroprotective [56] Levisticum officinale Polyphenol In-vivo Antioxidant, Anti-cholinesterase, Anti-inflammatory, Neuroprotective [57] Schisandra chinensis Lignan In-vitro In-vivo Neuroprotective [58] Withania somnifera Acrolein In-vitro Antioxidant, Anti-cholinesterase, Neuroprotective [59] Ginkgo biloba EGb761 In-vitro In-vivo Antioxidant, Anti-inflammatory, Neuroprotective [60] Kigelia africana Flavonoids In-vivo Antioxidant, Neuroprotective [61] 7. YOGA PRACTICES ARE VITAL IN AD Yoga is a non-religious mind-body approach of ancient India that integrates the spiritual, mental and physical components to improve the health and well-being [62, 63]. Yoga has several essential benefits and positive impactful for various body systems such as musculoskeletal system, cardiopulmonary, nervous and endocrine systems. Meditation has great potentials in stress reducing effects that is the beneficial for preventing cognitive and memory loss. Stress is depended upon the level of cortisol in body that responsible to progression of the Alzheimer’s disease, which can be regulated by a regular practice of meditation, however, very limited studies have been conducted with Alzheimer’s patients [64]. Some neurotransmitters secreted during the Yoga that provides the potential biological mechanism, which is responsible to improvement in AD neuropathology [65]. There has been found that long-term aerobic exercise has the potential to increase cognitive functioning and decreases in the hippocampal loss that help in prevention of the Mishra & Singh Ayurveda and Yoga practices in treatment of Alzheimer’s disease 70 European Journal of Biological Research 2021; 11(1): 65-74 AD [66] and the aerobic exercise may also a necessary part of the treatment for AD [67]. It can be noted that the aerobic training induces important beneficial effects on health that improving the executive function, attentional capacity, processing speed, episodic memory and procedural memory [68-70]. Several studies have been reported that physical exercise may be able to prevent and reverse these behavioral impairments in specific model of AD [70] and reducing the symptoms of dementia [71]. A recent study is presented that meditation may present themselves significant role for improving cognition and related outcomes in AD patients [72]. 8. CONCLUSION The current scenario of the research in the field of the search of suitable therapeutic approaches for the treatment of Alzheimer’s disease should be shift towards the combinatorial approach of Ayurveda and Yoga, the reason behind this is that, there is no side effect of anyone out of these two, while these must be beneficial for any type of human disease. Non-drug interventions like memory training, mental and social stimulation and physical exercise programs could be possibly improved people’s cognitive performance [73]. By going through different available literature on concern topic, we found that Ayurvedic therapeutic approaches and Yoga practices have been widely used for the health promotion, disease prevention and possible treatment of the Alzheimer’s disease. Many Ayurvedic formulations, they are bio-available, have been used for modifying the treatment of AD. They have many special features like less toxic, anti-oxidant, anti-amyloidogenic, anti-inflammatory, neuroprotective and immunomodulatory that are essential to discover appropriate potent drugs for the AD and also significant for reduction in the cost and time. Many studies have shown that yoga is vital for treating the neurodegenerative disorders by several combine yogic exercises. The combination of the Ayurveda and Yoga would provide significant outcome for noble strategy of the treatment of Alzheimer’s disease. These combinations might be proved to provide the better panacea for AD in future. Authors' Contributions: SKM and SKS designed the study, SKM collected the literature and information and draft the manuscript and SKS performed the proof reading and final editing. Both authors read and approved the final manuscript. Conflict of Interest: The authors have no conflict of interest to declare. Acknowledgements: This work was performed with resources from the Non-Government/Non-profit Organization; Indian Scientific Education and Technology Foundation, Lucknow, India and Indian Council of Medical Research (ICMR), New Delhi, India, REFERENCES 1. Zhou X, Ashford JW. Advances in screening instruments for Alzheimer's disease. Aging Med. 2019; 2(2): 88-93. 2. Zawia NΗ, Basha MR. Environmental risk factors and the developmental basis for Alzheimer's disease. Rev Neurosci. 2005; 16(4): 325-338. 3. Mishra SK, Singh SK. Alzheimer’s Disease and immune response: a brief overview. J Alzheimers Dis Parkinsonism. 2017, 7: 371. 4. West S, Bhugra P. Emerging drug targets for Aβ and tau in Alzheimer's disease: a systematic review. British J Clin Pharmacol. 2015; 80(2): 221-34. 5. Nishteswar K, Joshi H, Karra RD. Role of indigenous herbs in the management of Alzheimer's disease. Ancient Sci Life. 2014; 34(1): 3. Mishra & Singh Ayurveda and Yoga practices in treatment of Alzheimer’s disease 71 European Journal of Biological Research 2021; 11(1): 65-74 6. Joy J. The Ayurvedic perspective on the etiopathogenesis of neurodegeneration. J Health Edu Res Dev. 2015; 3: 137. 7. Sharma R, Amin H. Rasayana therapy: Ayurvedic contribution to improve quality of life. World J Pharmacol Res Tech. 2015; 4: 23-33. 8. Sharma R, Kuca K, Nepovimova E, Kabra A, Rao MM, Prajapati PK. Traditional Ayurvedic and herbal remedies for Alzheimer’s disease: from bench to bedside. Expert Rev Neurother. 2019; 19(5): 359-374. 9. Vyas S, Kothari SL, Kachhwaha S. Nootropic medicinal plants: therapeutic alternatives for Alzheimer’s disease. J Herbal Med. 2019; 2019: 100291. 10. Wang J, Tan L, Yu JT. Prevention trials in Alzheimer’s disease: current status and future perspectives. J Alzh Dis. 2016; 50(4): 927-945. 11. Singh SK, Srivastav S, Castellani RJ, Plascencia-Villa G, Perry G. Neuroprotective and antioxidant effect of Ginkgo biloba extract against AD and other neurological disorders. Neurotherapeutics. 2019; 16(3): 666-674. 12. Penumala M, Zinka RB, Shaik JB, Mallepalli SK, Vadde R, Amooru DG. Phytochemical profiling and in vitro screening for anticholinesterase, antioxidant, antiglucosidase and neuroprotective effect of three traditional medicinal plants for Alzheimer’s Disease and diabetes mellitus dual therapy. BMC Complem Altern Med. 2018; 18(1): 77. 13. Chaudhari KS, Tiwari NR, Tiwari RR, Sharma RS. Neurocognitive effect of nootropic drug Brahmi (Bacopa monnieri) in Alzheimer's disease. Ann Neurosci. 2017; 24(2): 111-122. 14. Jadhav RP, Kengar MD, Narule OV, Koli VW, Kumbhar SB. A review on Alzheimer's Disease (AD) and its herbal treatment of Alzheimer's Disease. Asian J Res Pharmac Sci. 2019; 9(2): 112-122. 15. Beg T, Jyoti S, Naz F, Ali F, Ali SK, Reyad AM, Siddique YH. Protective effect of kaempferol on the transgenic Drosophila model of Alzheimer's disease. CNS Neurolog Disord Drug Targets. 2018; 17(6): 421-429. 16. Wang K, Sun W, Zhang L, Guo W, Xu J, Liu S, Zhou Z, Zhang Y. Oleanolic acid ameliorates Aβ25-35 injection- induced memory deficit in Alzheimer's Disease model rats by maintaining synaptic plasticity. CNS Neurolog Disord Drug Targets. 2018; 17(5): 389-399. 17. Cardoso-Lopes EM, Maier JA, Silva MRD, Regasini LO, Simote SY, et al. Alkaloids from stems of Esenbeckia leiocarpa Engl.(Rutaceae) as potential treatment for Alzheimer disease. Molecules. 2010; 15(12): 9205-9213. 18. Jung HA, Min BS, Yokozawa T, Lee JH, Kim YS, Choi JS. Anti-Alzheimer and antioxidant activities of Coptidis rhizoma alkaloids. Biol Pharm Bull. 2009; 32(8): 1433-1438. 19. Chlebek J, Macáková K, Cahlíková L, Kurfürst M, Kuneš J, Opletal L. Acetylcholinesterase and butyrylcholinesterase inhibitory compounds from Corydalis cava (Fumariaceae). Nat Produ Commun. 2011; 6(5): 1934578X1100600507. 20. Novák Z, Chlebek J, Opletal L, Jiroš P, Macáková K, Kuneš J, Cahlíková L. Corylucinine, a new alkaloid from Corydalis cava (Fumariaceae), and its cholinesterase activity. Nat Prod Commun. 2012; 7(7): 1934578X1200700712. 21. Afshari AR, Sadeghnia HR, Mollazadeh H. A review on potential mechanisms of Terminalia chebula in Alzheimer’s disease. Adv Pharmacol Sci. 2016; 2016: 8964849. 22. Ingale SP, Kasture SB. Protective effect of standardized extract of Passiflora incarnata flower in Parkinson’s and Alzheimer’s disease. Ancient Sci Life. 2017; 36(4): 200. 23. Lopa SS, Hasan MK, Ahammed MS, Islam KM, Alam AK, Rahman MAA, et al. Typhonium trilobatum demonstrates both antioxidant and acetylcholinesterase inhibitory activities in vitro. Bangl Pharm J. 2019; 22(1): 92- 98. Mishra & Singh Ayurveda and Yoga practices in treatment of Alzheimer’s disease 72 European Journal of Biological Research 2021; 11(1): 65-74 24. Taslimi P, Köksal E, Gören AC, Bursal E, Aras A, Kılıç Ö, et al. Anti-Alzheimer, antidiabetic and antioxidant potential of Satureja cuneifolia and analysis of its phenolic contents by LC-MS/MS. Arab J Chem. 2020; 13(3): 4528-4537. 25. Uddin MJ, Abdullah-Al-Mamun M, Biswas K, Asaduzzaman M, Rahman MM. Assessment of anticholinesterase activities and antioxidant potentials of Anisomeles indica relevant to the treatment of Alzheimer’s disease. Orient Pharm Exp Med. 2016; 16(2): 113-121. 26. Thakur M, Virk R, Sangha PS, Saxena V. The Effects of turmeric on Alzheimer’s patients. J Food Sci Nutr Res. 2019; 2: 347-353. 27. Dubey T, Chinnathambi S. Brahmi (Bacopa monnieri): An ayurvedic herb against the Alzheimer's disease. Arch Biochem Biophys. 2019; 676: 108153. 28. Hatziagapiou K, Kakouri E, Lambrou GI, Bethanis K, Tarantilis PA. Antioxidant properties of Crocus sativus L. and its constituents and relevance to neurodegenerative diseases; focus on Alzheimer’s and Parkinson’s disease. Curr Neuropharmacol. 2019; 17(4): 377-402. 29. Finley JW, Gao S. A perspective on Crocus sativus L.(Saffron) constituent crocin: a potent water-soluble antioxidant and potential therapy for Alzheimer’s disease. J Agric Food Chem. 2017; 65(5): 1005-1020. 30. Elufioye TO, Chinaka CG, Oyedeji AO. Antioxidant and anticholinesterase activities of Macrosphyra longistyla (DC) Hiern relevant in the management of Alzheimer’s Disease. Antioxidants. 2019; 8(9): 400. 31. Tepe AS, Ozaslan M. Anti-Alzheimer, anti-diabetic, skin-whitening, and antioxidant activities of the essential oil of Cinnamomum zeylanicum. Indust Crops Prod. 2020; 145: 112069. 32. Liou KT, Shen YC, Chen CF, Tsao CM, Tsai SK. The anti-inflammatory effect of honokiol on neutrophils: mechanisms in the inhibition of reactive oxygen species production. Eur J Pharmacol. 2003; 475(1-3): 19-27. 33. Mahboubi M. Melissa officinalis and rosmarinic acid in management of memory functions and Alzheimer disease. Asian Pacif J Trop Biomed. 2019; 9(2): 47. 34. Ravi SK, Ramesh BN, Mundugaru R, Vincent B. Multiple pharmacological activities of Caesalpinia crista against aluminium-induced neurodegeneration in rats: relevance for Alzheimer’s disease. Environ Toxicol Pharmacol. 2018; 58: 202-211. 35. Kleinrichert K, Alappat B. Comparative analysis of antioxidant and anti-amyloidogenic properties of various polyphenol rich phytoceutical extracts. Antioxidants. 2019; 8(1): 13. 36. Sheeja Malar D, Beema Shafreen R, Karutha Pandian S, Pandima Devi K. Cholinesterase inhibitory, anti- amyloidogenic and neuroprotective effect of the medicinal plant Grewia tiliaefolia- An in vitro and in silico study. Pharm Biol. 2017; 55(1): 381-393. 37. Chethana KR, Senol FS, Orhan IE, Anilakumar KR, Keri RS. Cassia tora Linn.: a boon to Alzheimer's disease for its anti-amyloidogenic and cholinergic activities. Phytomedicine. 2017; 33: 43-52. 38. Chowdhury S, Kumar S. Alpha-terpinyl acetate: A natural monoterpenoid from Elettaria cardamomum as multi- target directed ligand in Alzheimer’s disease. J Funct Foods. 2020; 68: 103892. 39. Chethana KR, Sasidhar BS, Naika M, Keri S. Phytochemical composition of Caesalpinia crista extract as potential source for inhibiting cholinesterase and β-amyloid aggregation: significance to Alzheimer's disease. Asian Pac J Trop Biomed. 2018; 8(10): 500. 40. Lee JE, Kim N, Yeo JY, Seo DG, Kim S, Lee JS, et al. Anti-amyloidogenic effects of asarone derivatives from Perilla frutescens leaves against beta-amyloid aggregation and nitric oxide production. Molecules. 2019; 24(23): 4297. Mishra & Singh Ayurveda and Yoga practices in treatment of Alzheimer’s disease 73 European Journal of Biological Research 2021; 11(1): 65-74 41. Tan MA, Lagamayo MWD, Alejandro GJD, An SSA. Anti-amyloidogenic and cyclooxygenase inhibitory activity of Guettarda speciosa. Molecules. 2019; 24(22): 4112. 42. Joo HB, Kim JM, Park SY. Anti-amyloidogenic constituents from roots of Dryopteris crassirhizoma in Alzheimer's disease cellular model. Planta Med. 2016; 82(S 01): P472. 43. Liu QS, Jiang HL, Wang Y, Wang LL, Zhang JX, He CH, et al. Total flavonoid extract from Dracoephalum moldavica L. attenuates β-amyloid-induced toxicity through anti-amyloidogenesic and neurotrophic pathways. Life Sci. (2018); 193: 214-225. 44. Eze FN, Ingkaninan K, Prapunpoj P. Transthyretin anti-amyloidogenic and fibril disrupting activities of Bacopa monnieri (L.) Wettst (Brahmi) extract. Biomolecules. 2019; 9(12): 845. 45. Kim DJ, Kim MS, Kim S, Hwang KW, Park SY. Anti‐amyloidogenic effects of Perilla frutescens var. acuta on beta‐amyloid aggregation and disaggregation. J Food Biochem. 2017; 41(5): e12393. 46. Dhouafli Z, Ben Jannet H, Mahjoub B, Leri M, Guillard J, Saidani Tounsi M, et al. 1,2,4-trihydroxynaphthalene-2- O-β-D-glucopyranoside: A new powerful antioxidant and inhibitor of Aβ42 aggregation isolated from the leaves of Lawsonia inermis. Nat Prod Res. 2019; 33(10): 1406-1414. 47. Castro-Silva ES, Bello M, Rosales-Hernández MC, Correa-Basurto J, Hernández-Rodríguez M, Villalobos-Acosta D, et al. Fucosterol from Sargassum horridum as an amyloid-beta (Aβ1-42) aggregation inhibitor: in vitro and in silico studies. J Biomol Struct Dyn. 2020; 1-13: doi: 10.1080/07391102.2020.1729863. 48. Al-Snafi AE. A review on Lagerstroemia indica: A potential medicinal plant. IOSR J Pharm. 2019; 9(6): 36-42. 49. Mazouz W, Haouli NEH, Gali L, Vezza T, Bensouici C, Mebrek S, et al. Antioxidant, anti-alzheimer, anti-diabetic, and anti-inflammatory activities of the endemic halophyte Limonium spathulatum (Desf.) kuntze on LPS-stimulated RAW264 macrophages. South Afr J Bot. 2020; 135: 101-108. 50. Shahinozzaman M, Taira N, Ishii T, Halim MA, Hossain MA, Tawata S. Anti-inflammatory, anti-diabetic, and anti- Alzheimer’s effects of prenylated flavonoids from Okinawa propolis: an investigation by experimental and computational studies. Molecules. 2018; 23(10): 2479. 51. Wangchuk P, Sastraruji T, Taweechotipatr M, Keller PA, Pyne SG. Anti-inflammatory, anti-bacterial and anti- acetylcholinesterase activities of two isoquinoline alkaloids - scoulerine and cheilanthifoline. Nat Prod Commun. 2016; 11(12): 1934578X1601101207. 52. Patil DN, Yadav SR, Patil S, Bapat VA, Jadhav JP. Multidimensional studies of Pancratium parvum Dalzell against acetylcholinesterase: a potential enzyme for Alzheimer’s management. J Am Coll Nutr. 2020; 39(7): 601-618. 53. Kamran M, Kousar R, Ullah S, Khan S, Umer MF, Rashid HU, et al. Taxonomic distribution of medicinal plants for Alzheimer’s Disease: a cue to novel drugs. Int J Alzh Dis. 2020; 2020: 7603015. 54. Longo FM, Massa SM. Neuroprotective strategies in Alzheimer's disease. NeuroRx. 2004; 1(1): 117-127. 55. Sheeja Malar D, Beema Shafreen R, Karutha Pandian S, Pandima Devi K. Cholinesterase inhibitory, anti- amyloidogenic and neuroprotective effect of the medicinal plant Grewia tiliaefolia - An in vitro and in silico study. Pharm Biol. 2017; 55(1): 381-393. 56. Oboh G, Adedayo BC, Adetola MB, Oyeleye IS, Ogunsuyi OB. Characterization and neuroprotective properties of alkaloid extract of Vernonia amygdalina Delile in experimental models of Alzheimer’s disease. Drug Chem Toxicol. 2020; 1-10: doi: 10.1080/01480545.2020.1773845. 57. Amraie E, Pouraboli I, Rajaei Z. Neuroprotective effects of Levisticum officinale on LPS-induced spatial learning and memory impairments through neurotrophic, anti-inflammatory, and antioxidant properties. Food Funct. 2020; 11(7): 6608-6621. Mishra & Singh Ayurveda and Yoga practices in treatment of Alzheimer’s disease 74 European Journal of Biological Research 2021; 11(1): 65-74 58. Sowndhararajan K, Deepa P, Kim M, Park SJ, Kim S. An overview of neuroprotective and cognitive enhancement properties of lignans from Schisandra chinensis. Biomed Pharmacother. 2018; 97: 958-968. 59. Singh M, Ramassamy C. In vitro screening of neuroprotective activity of Indian medicinal plant Withania somnifera. J Nutr Sci. 2017; 6: e54. 60. Singh SK, Srivastav S, Castellani RJ, Plascencia-Villa G, Perry G. Neuroprotective and antioxidant effect of Ginkgo biloba extract against AD and other neurological disorders. Neurotherapeutics. 2019; 16(3): 666-674. 61. Falode JA, Akinmoladun AC, Olaleye MT, Akindahunsi AA. Sausage tree (Kigelia africana) flavonoid extract is neuroprotective in AlCl3-induced experimental Alzheimer’s disease. Pathophysiology. 2017; 24(4): 251-259. 62. Wahbeh H, Elsas SM, Oken BS. Mind-body interventions: Applications in neurology. Neurology. 2008; 70(24): 2321-2328. 63. Rogers KA, MacDonald M. Therapeutic yoga: symptom management for multiple sclerosis. J Altern Complem Med. 2015; 21(11): 655-659. 64. Mishra SK, Singh P, Bunch SJ, Zhang R. The therapeutic value of yoga in neurological disorders. Ann Indian Acad Neurol. 2012; 15(4): 247. 65. Hassan A, Robinson M, Willerth SM. Modeling the effects of Yoga on the progression of Alzheimer’s Disease in a dish. Cells Tissues Organs. 2018; 206(4-5): 263-271. 66. Brenes GA, Sohl S, Wells RE, Befus D, Campos CL, Danhauer SC. The effects of yoga on patients with mild cognitive impairment and dementia: A scoping review. Am J Geriatric Psychiatry. 2019; 27(2): 188-197. 67. Paillard T, Rolland Y, de Souto Barreto P. Protective effects of physical exercise in Alzheimer's disease and Parkinson's disease: a narrative review. J Clin Neurol. 2015; 11(3): 212-219. 68. Kramer AF, Colcombe S. Fitness effects on the cognitive function of older adults: a meta-analytic study - revisited. Perspect Psychol Sci. 2018; 13(2): 213-217. 69. Angevaren M, Aufdemkampe G, Verhaar HJJ, Aleman A, Vanhees L. Physical activity and enhanced fitness to improve cognitive function in older people without known cognitive impairment. Cochrane Database Syst Rev. 2008; 3: CD005381. 70. Smith PJ, Blumenthal JA, Hoffman BM, Cooper H, Strauman TA, Welsh-Bohmer K, et al. Aerobic exercise and neurocognitive performance: a meta-analytic review of randomized controlled trials. Psychosom Med. 2010; 72(3): 239. 72. Frederiksen KS, Gjerum L, Waldemar G, Hasselbalch SG. Effects of physical exercise on Alzheimer’s disease biomarkers: a systematic review of intervention studies. J Alzh Dis. 2018; 61(1): 359-372. 73. Chen Y, Zhang J, Zhang T, Cao L, You Y, Zhang C, et al. Meditation treatment of Alzheimer disease and mild cognitive impairment: A protocol for systematic review. Medicine. 2020; 99(10): e19313.