Dementia and dependency vs. proxy indicators of the Active Ageing Index in Indonesia

Dementia prevalence is increasing worldwide and developing countries are expected to carry the highest burden of this. Dementia has high care needs and no current effective long-term treatment. However, factors associated with active ageing (e.g., longer employment; participation in society; independent, healthy and secure living; and enabling environments to allow people to remain psychosocially and physically active) could help maintain independence in older people for longer. We investigated proxy indicators of the Active Ageing Index (AAI), which were offset against dementia and dependency (assessed by Instrumental Activities of Daily Living or IADL) in multi-ethnic urban (Jakarta) and rural (Sumedang and Borobudur) health care districts on Java, Indonesia. Dementia was assessed using validated cognitive dementia screening tests, the IADL and carer reports. Dementia and dependency prevalence showed large interregional differences and were highest in rural Borobudur. Dementia and dependency were associated with an older age, lower education (for dementia), worse physical health (for dependency) and not engaging in psychosocial activities, such as attending community events, reading (for dementia) and sport activities (for dependency). By supporting active ageing activities in Puskesmas (primary health care centers) and improving access to medical care, rural areas could possibly reduce dementia and dependency risk. Our follow-up study planned in 2021 should illustrate whether recent relevant policies have rendered success in these areas. Using active ageing indicators could focus policies to support regions with targeted interventions to compress care needs in older people.

Activities of Daily Living, active ageing index, dementia

10.3390/ijerph18168235

1660-4601

Hogervorst, Eef

d3cb1ae1-86b7-47d4-84b2-d124fddb0c30

Schröder-Butterfill, Elisabeth

b10e106a-4d5d-4f41-a7d2-9549ba425711

Handajani, Yvonne Suzy

ce79656a-4c33-4d30-a1d1-cd96b90a21aa

Kreager, Philip

76780e0b-9ce5-4e02-9d60-005e7aab8534

Rahardjo, Tri Budi

86bf2624-104f-4f3f-96ef-f65c4d0f4486

4 August 2021

Hogervorst, Eef

d3cb1ae1-86b7-47d4-84b2-d124fddb0c30

Schröder-Butterfill, Elisabeth

b10e106a-4d5d-4f41-a7d2-9549ba425711

Handajani, Yvonne Suzy

ce79656a-4c33-4d30-a1d1-cd96b90a21aa

Kreager, Philip

76780e0b-9ce5-4e02-9d60-005e7aab8534

Rahardjo, Tri Budi

86bf2624-104f-4f3f-96ef-f65c4d0f4486

Hogervorst, Eef, Schröder-Butterfill, Elisabeth, Handajani, Yvonne Suzy, Kreager, Philip and Rahardjo, Tri Budi (2021) Dementia and dependency vs. proxy indicators of the Active Ageing Index in Indonesia. International Journal of Environmental Research and Public Health, 18 (16), [8235]. (doi:10.3390/ijerph18168235).

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Accepted/In Press date: 28 July 2021

Published date: 4 August 2021

Additional Information: Funding Information: Acknowledgments: We would like to thank all staff, in particular: Vita Priantinadewi, the Centre for Ageing Studies Universitas Indonesia, Yudarini Priotomo, the Centre for Health Research, Univeritas Indonesia, Linda Kusdhany from the Faculty of Dentistry, Univeritas Indonesia, Tanto and Yono from the University of Respati Yogyakarta and all participants from SEMAR. We are indebted to the Alzheimer’s Research Trust and Newton Foundation/British Council for funding our studies, as well as Loughborough University and Universitas of Diponegoro, Respati and Indonesia for their generous support of this study and without whom this study would not have been possible. Funding Information: With our estimates of almost 2 million older people affected by dementia by 2025, this means that at least 4 million of people over 60 years of age and/or 2 million of their children, who could still substantially contribute to the Indonesian economy, can then no longer do so. Targeted public health interventions and support could possibly offset this risk in individuals and communities. Author Contributions: Conceptualization, E.H., E.S.-B., Y.S.H., P.K. and T.B.W.R.; Data curation, AE.uHth. oarndCoTn.Btr.Wib.uRt.i;oFnosr: mCaolnacnepaltyusailsi,zaEt.iHon.,,YE.S.H.H.,. Ea.nSd.-BT..,BY.W.S..HR..;, FPu.Kn.d ainngdaTc.qBu.Wisi.Rtio.; nD, aEt.aHc.,uEra.Sti.o-Bn.,, EP..HK.. aanndd TT.B.B.W.W.R.R.;.;I nFvoermstiagl aatnioanly, sEi.sH, .Ea.Hnd.,YT..SB.H.W. .aRn.;dMTe.Bth.Wod.Rol.o; gFyu,nEd.Hin.g, Pa.cKq.uainsidtioTn.B, .WE.H.R..,; EP.rSo.j-eBc.t, Pa.dKm. ainnidst Tra.Bti.oWn,.RE..;H In. vanesdtiTg.aBt.iWon.R, E.;.RHe.saonudr cTe.sB,.TW.B.R.W.; .MR.e;tShuopdeorlvoigsiyo,nE,.EH..H, P. a.Kn.d aTn.dB .TW.B.R.W.; .VRa.l; iPdraotijeocnt, administration, E.H. and T.B.W.R.; Resources, T.B.W.R.; Supervision, E.H. and T.B.W.R.; Validation, E.H. and T.B.W.R.; Visualization, T.B.W.R.; Writing—original draft, E.H., P.K. and T.B.W.R.; Writing—review and editing, E.H., E.S.-B., Y.S.H. and T.B.W.R. All authors have read and agreed to the published version of the manuscript. Funding: This research was funded by Economic and Social Research Council. Funding: This research was funded by Economic and Social Research Council. Institutional Review Board Statement: Ethical approval (University of Indonesia, Jakarta; Lough-Institutional Review Board Statement: Ethical approval (University of Indonesia, Jakarta; Lough-borough University, UK R06/P21), governmental and local permits had been obtained prior to study-onset. ‘The Committee agreed to issue clearance to proceed but noted that Investigators needed to check that they were covered by the University’s insurance, as the fieldwork was to be undertaken overseas’ (28 March 2008, Loughborough University UK). Publisher Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

Keywords: Activities of Daily Living, active ageing index, dementia