Overview of Ageing Research and

International Collaborations

Tri Budi W. Rahardjo,Tri Suratmi, Atik Kridawati, Dinni Agustin Centre for Ageing Studies Universitas Indonesia

Universitas Respati Indonesia

Centre for Ageing Studies UI and

Universitas Respati Indonesia’s Experiences

Presented in APRU Ageing in the Asia-Paciic Workshop 2017 for Junior Gerontologists

November 9-11, 2017, Hongo Campus, The University of Tokyo, Japan

Background and Objective

Indonesia, as the fourth most populous country, has the tenth largest elderly population

In 2020, the number of older people is estimated to have steadily increased to 28.82 million (11 % of the total population), while the under five population will gradually decrease in number

In 2050 it is estimated that the absolute number of 60+ will be around 80 million

Hence Research and services should be done through international collaborations

Objective of this review

To describe research activities those have been conducted, and to discuss the action research that should be conducted to enhance quality of life of older persons

Demography

Population Ageing

20152050

Sumber: WHO World Report on Ageing and Health, 2015

LIFE EXPECTANCY, UN PROJECTION 2015 REV( SM Adioetomo, 2016)

DEMOGRAPHIC PATTERNS

The changing pattern of population ageing across Indonesia's provinces, 2035

Source: Indonesia PopulationProjection 2010-2035

Health and Environment

Health profile, 2013

RISKESDAS (Basic Health Research 2013), the diseases found among the older persons in Indonesia include: hypertension, osteoarthritis, dental-oral problems, chronic obstructive pulmonary disease (COPD) and diabetes mellitus (DM) The conditions above require health and social service delivery

Health Profile of Indonesian Older Persons

NO HEALTH PROBLEM

Prevalences on age groups

55-64 yr 65-74 yr 75 + yr

1PENYAKIT PARU OBSTRUKTIF KRONIK 5,6 8,6 9,4

2 KANKER 3,2 3,9 5

3 DIABETES MELITUS 5,5 4,8 3,5

4 HIPERTENSI 45,9 57,6 63,8

5JANTUNG & PEMBULUH DARAH 2,8 3,6 3,2

6 GAGAL JANTUNG 0,7 0,9 1,1

7 STROKE 33 46,1 67

8 GAGAL GINJAL 0,5 0,5 0,6

9 BATU GINJAL 1,3 1,2 1,1

10 ARTHRITIS 45 51,9 54,8

11 GANGGUAN GIGI-MULUT 28,3 19,2 19,2 9

EQ-5D Cibubur

Institutional

Care

(35)

Cipayung

Institutional

Care

(39)

Cantayan

Community

Care

(73)

Total

(147)

% % % %

Five dimension

Low 34,3 33,3 6,8 20,4

High 65,7 66,7 93,2 79,6

VAS

Low 48,6 30,8 19,2 29,3

High 51,4 69,2 80,8 70,7

Quality of Life

SELF CARE

Having difficulties in self-care, women suffer more than older men do.

08/05/2013 SMAdioetomo/SEACmeeting 34

0.0

5.0

10.0

15.0

20.0

25.0

30.0

35.0

40.0

Some difficulties

Self Care Male

Self Care Female

0

5

10

15

20

25

30

35

40

60-64 65-69 70-74 75-79 80-84 85-89 90+

Severe difficulties

Self Care Male

Self Care Female

Older women are more likely to suffer severe difficulties in self-care. Long-term services will be highly needed by those who are bedridden. Therefore, it is important to focus on the availability of long-term

care and rehabilitation professionals in the near future. The total of them reached 5 to 10 percent?

KNOWLEDGE IMPROVEMENTON HEALTHY AND ACTIVE AGEING

47.83

4.35 8.70

26.09

8.70

91.30

26.09

78.26 82.61

30.43

43.48

56.52 52.17

95.65

56.52

91.30

-

20.00

40.00

60.00

80.00

100.00

120.00

Health Active AgeingDefinition

Time ofPreparation

TowardsHealthy and

Active Ageing

ActivitiesToward Active

AgeingPreparation

Disorders ofOlder Person

Preventable orNot

Diseases ofOlder Person

Preventable orNot

before

after

ATTITUDE IMPROVEMENTTOWARDS ACTIVE GEING

26.09

86.96

8.70

39.13

26.09

30.43

69.57

86.96

69.57

65.22

56.52

65.22

-

10.00

20.00

30.00

40.00

50.00

60.00

70.00

80.00

90.00

100.00

Routine Activities The Importance ofSpiritual activities

Spiritual Activities Social Activities Emotional Activities Leasure Activities

before

after

Readiness to be age friendly cities( SurveyMeter and CASUI, 2013)

Only 43 % of all AFC indicators have been covered by the cities

0

10

20

30

40

50

60

Jakarta Surabaya Bandung Medan Semarang Makasar Mataram

Yogjakarta Denpasar Balikpapan Payakumbuh Depok Surakarta Malang

5 Bigest cities Small citieslOil industry cityOther Big cities

THE PERCEPTION OF AGE CONCERN FACILITY

-

10.00

20.00

30.00

40.00

50.00

60.00

70.00

80.00

90.00

100.00

IEC

mat

eri

als

Vis

ual

itat

ion

spo

rt a

nd

exe

rcis

e

Lib

rary

Co

mp

ute

r

Gat

he

rin

g/m

eeti

ng

Cav

eta

ria

Pri

nte

d

Pri

nte

d a

nd

IT

An

ytim

e

Sced

ulin

g

Do

n't

kn

ow

Facility needed Delivery Schedule

30.43 26.09

43.48

8.70

-

78.26

95.65

13.04

21.74

65.22

13.04

THE DISTRIBUTION OF PRODUCTIVE ACTIVITIES

13.04

17.39

4.35

4.35 47.83

4.35

8.70

Sewing

Gardening

Animal Raising

Cooking

Merchandise

Singing

caring for grandchildren

Joint Research and Publications through education: PhD and Master’s programs

Ageing in Indonesia :dementia and memory study including ‘tempe’

consumption

N=719 participants from rural and urban Java (Jakarta, Citengah and Yogyakarta)

Aged 52 to 99 years of age, 68% women laboratory

010

203040

506070

8090

100

UK JakartaCintengah

Borobudur

65-69 70-74 75-79

80-84 85+

Regional differences

Percentage of people per district and per age stratum with cognitive impairment and problems in activities of daily living

Institutional Collaborations and Scientific Writing Workshops

• Loghborogh University(LU), UniversitasIndonesia (UI)

• Universitas RespatiIndonesia (URINDO)

• And other Universities in Jakarta

1. Soni, M., Hogervorst E., Rahardjo, T et al. 2014 Soy products and dementia Invited

review in press Maturitas,

2. *Hogervorst, E. (2013) Estrogen and the brain: does estrogen treatment improve cognitive function? Invited review for special issue Menopause International

3. *Hogervorst, E., Radhardjo, T-B., Jolles, J., Brayne, C., Henderson, V.W. (2012). Gender differences in verbal learning in older participants. Aging Health 8(5). Invited paper special issue, 493-507

4. *Hogervorst, E. (2012). Prevention of dementia with sex hormones: can androgens be an alternative to improve cognition in postmenopausal women. Minerva Medica(invited paper for special issue Oct;103(5):353-9

5. Arifin, Evi Nurvidya and Aris Ananta. “The Past Three Population Censuses: A Deepening Ageing Population in Indonesia”. In Christophe Z. Guilmoto and Gavin Jones (Eds.) Contemporary demographic transformations in China, India and Indonesia.New York, USA: Springer.

01/04/11

The Examples of Publications2012 - 2016

The Examples of Publications/cont

6. *Arifin, E., Braun, K., Hogervorst, E. (2012). Three pillars of active ageing in Indonesia. Asian Population Studies, 8(2):48-56.

7. *Clifford, A., Bandelow, S., Hogervorst, E. & Rahardjo, T.B. (2012). A Cross-sectional Study of Physical Activity and Health-Related Quality of Life in an Elderly Indonesian Cohort. BJOT. invited

8. Kridawati, Hardinsyah, A. Sulaeman, R. Damanik, A. Winarto, TBW. Rahardjo, E. Hogervorst. (2013). Tempe and Tofu Flours May Have Positive Effect on Cognitive Function. Annals of Nutrition and Metabolism 63(suppl1) 213–214. e-ISSN 1421–9697

9. A. Kridawati. (2013). Nutrition: Tempe, Tofu and Healthy Ageing. Prosiding:Nutrition, Growth-Development and Ageing. ISBN 978-602-98441-4-6 (Page. 33-41)

01/04/11

Other Research Collaborations

• Social Protection with CEPAR University of New South Wales /APRU Population ageing Research Hub

• Utilization of returners of care givers, with Nagasaki University

• Health and Social Delivery, is still in the process of proposal development, with WHO Kobe

Joint Educations and Training Programs with ACAP, AABC

and Keishin Gakuen Educational

International Visiting Professors

• Prof Takeo Ogawa

• Ass Prof. Donghee Han

• Ass Prof. Reiko Ogawa

• Prof Eef Hogervorst (9 PhD Students)

• Prof. Yuko Hirano

• Prof Prathung

• Prof. Peter Devey

Seminar, Workshops and Student Exchange

Seminar and workshops

•

Sakura Science Program

2015, 2016, 2017

Training for care givers (Takeo Ogawa, AABC 2013)

Level 1

Level 2

Level 3

Level 4

Level 5

Level 6

Level 7

Level 8

Basic

L2Beginners Training

L3Graduate of

Training School

L4 Certified Care

Worker

L5

L6

L1

L7

Health & Social Care (Award, Certificate, Diploma)

Senior Care Worker-Residential Services for People with Dementia (Diploma)

Health and Social Care (Management) (Higher National Diploma)

Commissioning, Procurement & Contracting for Care Services (Diploma)

Entry (Award)

Health & Social Care (Award, Certificate, Diploma)

Commissioning, Procurement & Contracting for Care Services (Diploma)

Level 5

Level 2

Level 3

Level 4

Level 1

Level 6

Level 7

Level 8

EU U.K. Japan Social Care in U.K.

Elder Pal

Personal Care

Assistant

Home Care Assistant

Nurse Aide

Doctor

Master

Bachelor

Associate Bachelor

Hawaii

Alten

pfleger

G

Training in Indonesia

SMA + Pendidikan vokasi diploma caregiver/ Akademi Komunitas (2 tahun) + Uji Kompetensi

SLTA IPA & IPS (3 tahun)

SMK Kesehatan (3 tahun)

Pendidikan vokasi caregiver

1 tahun + Uji Kompetensi

SMK Caregiver (4 tahun)

Caretaker dengan pengalaman 3 tahun

Caregiver Informal (Relawan) + Pelatihan

Uji Kompetensi

Sertifikat Partisipasi

Pelatihan/ level 1

Sert

ifik

at c

areg

iver

lev

el 3

Sert

ifik

at

care

give

r

leve

l 4

Collaboration in Community and LTC Training Programs

Yuks Berlatih konsentrasi

Sebutkan warna pada tulisan berikut …

Action research that should be done

A Public-Health Framework for Healthy Ageing (WHO,2016)

Long-term Care:

Environments:

High and Stable Capacity Declining Capacity Significant Loss of Capacity

Health Service:

FunctionalAbility

Intrinsic Capacity

Prevent chronic conditions or ensure early detection

and control

Promote capacity-enhancing Behaviours

Support capacity-enhancing behaviours

Manage advanced chronic conditions

Remove barriers to participation, compensate for loss of capacity

Ensure a dignified late life

Demographic transition; the impact of population aging on health problems that require health service delivery and health insurance

Assessments on the needs and demand for service delivery from the society

The gap between theneeds and alsothe demandand the servicedelivery, also itsrelation to theinsurance forthe elderly

Existingconditions of thehealth and social delivery for olderpersons in thecommunity, and health deliverysystem includingexisting UHC

Service delivery configuration that promote quality of life and address coordination between health and social sectors

Implemention of a comprehensive health service delivery with adequate UHC,andEnvironment

Funding for UHC and model in delivering public funding for health service delivery

Optimalquality of life of olderpersons

Conceptual Framework:Conceptual Framework:Conceptual Framework:

Conceptual framework of action reseach

Integrated community based, health and social services

as part of age friendly community to improve the quality of life of the elderly would be an action research in

Citengah and Depok, Indonesia as a recommendation of Junior Gerontology Workshop

Ｍｏｄｉｆｉｃａｔｉｏｎ ofＭｉｗａｄａｉ ＳｃｈｏｏｌＤｉｓｔｒｉｃｔ Ｍｏｄｅｌ

Age Friendly Neighborhoods,

Community care for elderly

SUMMARY

Ageing Population in Indonesia has been considered Research collaboration through international collaborations:1. with Loughborough University has been conducting

supported by the British Council; 2. with CEPAR /APRU, ongoing3. with Nagasaki University, on going Developing a standard of training has been conducted with

AABC, supported by Japan Foundation and Toyota Foundation Joint education and student exchange /JST Program has been

conducted regularly with AABC and URC Action research based on recommendation by Junior

Gerontology workshop supported by APRU and others

Our Highest appreciation to Institute of Gerontology University

of Tokyo, APRU and AABC