How does Indonesia deal with Dementia?

As a developing country with the 4th largest population in the world, Indonesia has 18 million elderly population in 2019. Currently, Indonesia also entering an aging population period, where an increase in life expectancy followed by an increase in the number of elderly. Life expectancy in Indonesia increased from 68.6 years in 2004 to 73 years in 2019, while the number of elderly in Indonesia is expected to reach 77 million of population in 2050.

To anticipate dementia problem, The Indonesian Ministry of Health has launched the first National Dementia Plan in March 2016, accompanied by a pledge of $105,000 to support its implementation. This makes Indonesia as the first country in Southeast Asia to have a national strategy for managing Alzheimer’s disease and dementia.

People with Dementia Disease in Indonesia is expected to increase in the future

 According to the World Alzheimer Report, Indonesia was a country with the 8th most people with dementia in the world in 2015 with the amount of over 1,2 million people with dementia in Indonesia. By 2030 the number is expected to rise to nearly 2.3 million of people, where women will dominate the number.

 

Regarding the prevalence of dementia in Indonesia, until now, there is no national study on population based dementia prevalence data in Indonesia. Only 2 local studies of the prevalence of dementia in Yogyakarta (2016) & Bali (2018) found a higher amount than the prevalence of global dementia. Yogyakarta and Bali were chosen because they are among the regions with the largest elderly population in Indonesia.

Current Status of Dementia Care in Indonesia

 There are almost 9,000 Puskesmas in Indonesia (The community-based primary care centers), but only 42% provide general healthcare services for older people, and many doctors are unable to provide diagnostic services for dementia due to lack of training. The quality and range of services available is very different between urban and rural areas, many Pukesmas in rural areas are only able to provide very basic care.

At present, Indonesian has National Dementia Plan which focuses on improving the quality of life of people with dementia and their caregivers, raising awareness, and minimizing the risk of dementia. However, Access to dementia diagnosis and care is hampered by a prevalent belief in families that dementia is a normal part of ageing and lack of knowledge about the existence of treatments for some of the symptoms of dementia.

According to ALZI, currently, treatments that are used for people with Dementia in Indonesia are divided into 2, namely Pharmacotherapy (with medication) and Non Pharmacological Therapy (without medication). Donepezil dominates the medication because it has been covered by BPJS so it is easier to get by patients with lower economies. Whereas Group Cognitive Stimulation Therapy is only available in some elderly care facilities or in the community in research settings.

Dementia care has a significant cost in Indonesia

In 2015, the estimated cost for dementia in Indonesia reached USD 1,777, which placed Indonesia as the 2nd country with the most dementia expenditure in ASEAN. Whereas medical cost contribute largest proportion of the total cost for dementia care in Indonesia with USD 773 Million. According to survey by Alzheimer Indonesia to 189 Indonesian Dementia Caregivers in 2019, 66% of them spend IDR 1-5 Million per month for dementia care.

 

With the projected increase in dementia sufferers in Indonesia, as well as the high cost of handling dementia, the effective solutions for dementia sufferers that can bring significant cost savings is needed in Indonesia.

Hebronstar Insights
Muhammad, Arvito / Associate Expert