Indonesia is the world’s fourth most populated country. Its large population (over 257 million people in 2015) is relatively young compared to other countries in South East Asia. However, even with the relatively low proportion of older people compared to other countries, Indonesia is still ranked eighth in the world in terms of the overall number of older people.
There are no locally generated estimates of the prevalence of dementia in Indonesia so far. Using data from comparable countries, the World Alzheimer Report 2015 estimated that in 2015 there were just over 556,000 people with dementia in Indonesia. By 2030 the number of people is expected to rise to nearly 2.3 million.
Despite the increasing importance of dementia, and its growing impact on society, dementia has been a low priority health issue in Indonesia. However, the Indonesian Ministry of Health launched the first National Dementia Plan in March 2016, accompanied by a pledge of $105,000 to support its implementation. The Plan focuses on improving the quality of life of people with dementia and their caregivers, raising awareness, reducing stigma and minimising the risk of dementia.
Diagnosis and healthcare pathways
While there are some specialist dementia healthcare services in Indonesia, these are currently available to very few people. The community-based primary care centres (Pukesmas) in principle provide diagnostic and continuing care through GPs. However, only 42% Pukesmas provide general healthcare services for older people, and many GPs are unable to provide diagnostic services for dementia due to lack of training. Access to diagnosis and care is also hampered by a prevalent belief that dementia is a normal part of ageing and lack of knowledge about treatments for some of the symptoms of dementia.
Other care and support
There is a strong sense of filial obligation, and families of people with dementia are the main providers of care. There is a very strong cultural preference for care to be provided in the family setting and some wealthier families are in a position to pay informal care workers.
It is expected that, as the size of the middle class rises, as well as migration, the number of these “paid informal carers” will increase. It will be important to include the training of these paid informal carers in dementia policy.
Read in more detail: World Alzheimer Report 2016