Indonesia

At the primary care level, the core screening tools are the Mini-Mental State Examination (MMSE) and the AD8 Informant Questionnaire, which relies on a carer’s report of cognitive changes. If a person is referred to the secondary care level (hospitals), the assessment is expanded to include the Montreal Cognitive Assessment (MoCA) and the Clock-Drawing Test (CDT). The MoCA-Indonesian Version (MoCA-INA) has been validated as a culturally-adapted tool and is noted for being more sensitive than the MMSE in detecting mild cognitive impairment. Currently in development is the Brief Cognitive Screening Battery-Indonesian Version (BCSB-INA), a tool specifically designed to be language-neutral and visual-based. It assesses multiple cognitive domains using picture naming and memory tasks, and initial studies have shown it to have good reliability and validity, positioning it as a key tool for more equitable screening in the future. Although the Brief Cognitive Screening Battery Indonesian Version (BCSB-INA) is a promising instrument, current evidence remains limited to localized research settings, and it has not yet been adopted or recommended for regular use at the national level in Indonesia. Therefore, detailed discussion of this tool may be premature at this stage.

The PERDOSSI clinical guidelines position structural imaging as a key element in the dementia diagnostic workup. Although disparities in healthcare access between urban and rural areas persist in Indonesia, CT and MRI scanners are now available in most major cities across the country, with access in remote and rural regions remaining limited. Due to general disparity in healthcare access between urban and rural areas in Indonesia, the availability of CT and MRI scanners are heavily concentrated in urban hospitals on islands like Java and Bali. In June 2025, the country’s first domestic CT scanner assembly line was launched. According to different media sources, this initiative is part of a broader government strategy to localize the production of priority medical devices. The Ministry of Health has set an ambitious target to procure and distribute 300 new CT scanners across the archipelago by 2027, with the explicit goals of reducing import dependency, lowering costs, and expanding population access to modern diagnostics. The availability of positron emission tomography (PET) scans for routine clinical Alzheimer’s disease diagnosis in Indonesia is extremely limited, verging on non-existent. While some high-end private hospital networks, such as Siloam Hospitals, list PET scans as part of their neurological service offerings, this is typically for oncology or other conditions.

Genetic screening, such as testing for apolipoprotein E (APOE), and blood-based biomarkers are not commonly performed for at-risk patients. This also includes mutations of the APP, PA1 and PS2 genes. Companies offer tests for the APOE gene, which can identify the ε4 variant associated with an increased risk for late-onset Alzheimer’s disease. This testing is not included in the national clinical practice guidelines for dementia diagnosis.

The national guidelines acknowledge that cerebrospinal fluid (CSF) analysis for key proteins (Aβ42 and tau) can aid in diagnosis at the tertiary care level. However, their routine use in clinical practice remains unclear, mostly due to the invasive nature of the required lumbar puncture, complex sample handling protocols, and the absence of in-country clinical labs offering validated, standardized assays that detect levels of Aβ42 and tau. Biomarker testing for Alzheimer’s disease is not yet routinely available or implemented in clinical practice in Indonesia.

The available infrastructure, including memory clinics for diagnosis, specialized residential homes, day care centres, and professional home care services, is concentrated in the Jakarta metropolitan area and a handful of other major cities like Surabaya and Yogyakarta:

1. Adiyuswa Senior Day Care – RSJ Dr. Radjiman Wediodiningrat, Lawang (East Java) A specialized day care clinic within a psychiatric hospital that offers structured support for individuals diagnosed with dementia.
2. RUKUN Senior Living – Dementia Day Programs (Jakarta & Sentul, West Java) Operated in partnership with Alzheimer’s Indonesia (ALZI): Cipete, South Jakarta: Dementia Day Program with state-based activities, snacks, and wellness monitoring.
Sentul, Bogor: Offers day-long programming (9 AM–3 PM), including social engagement, monitoring, and caregiving support.
3. Siloam Hospitals – Memory & Aging Centre (MAC) Located within one of Indonesia’s largest private hospital chains, MAC: Offers diagnosis, treatment, and integrated care services for dementia. Also serves as a research and development centre for dementia-related care models. Established in April 2016 to integrate person care with clinical innovation
4. Electronic Memory Clinic (EMC) – by PT Eisai Indonesia & PERDOSSI A pioneering digital cognitive screening and stimulation platform: Designed to streamline screening, analyse cognitive assessments, and deliver non-pharmacological therapy modules. Offered free to medical professionals, deployed in over 275 medical institutions and serving 400 doctors across Indonesia as of 2023.

Palliative care for dementia is almost non-existent, as the field is primarily focused on oncology in a few urban hospitals. Many healthcare providers outside big hospitals lack training in palliative care; there are workforce shortages (few specialists certified in palliative care).

The national drug formulary (Fornas) only covers one primary Alzheimer’s disease drug, Donepezil. If a person requires other standard medications like Rivastigmine or Memantine, the family must pay entirely out-of-pocket. In cases where a physician determines that a drug not listed on the Fornas is medically necessary for a person, it can be prescribed on a limited basis. However, this requires special approval from the hospital’s internal medical committee or its director, making it an exceptional process rather than a routine alternative.

Official statements indicate that medical rehabilitation programs can be utilized by the national insurance users. This suggests that therapies like occupational or physical therapy could be covered if they are prescribed by a specialist as part of a comprehensive treatment plan within a public hospital.

The national health insurance provides no direct financial support or subsidies for carers. Crucially, the insurance excludes long-term services like in-home assistance and respite care, which are fundamental to dementia management.

Alzheimer’s Indonesia (ALZI) is the go-to-source national level non-profit organization that has the objective to improve quality life for people living with dementia and family carers. ALZI is the central pillar of family carers support system, advocacy, care treatment and awareness raising on dementia and healthy ageing offering vital services such as educational sessions and risk reduction prevention sessions (brain gym and traditional poco poco dance exercise), carer support groups (Caregivers Meeting), counselling, a helpline (Careline), and dementia care skills training. In 2024, ALZI supported by Atma Jaya Catholic University launched the ALZI Academy and Healthy Ageing Centre at Atma Jaya University aiming to provide integrated support for family carers in Jakarta. Several psychology and medical students from Atma Jaya Catholic University are committed and have been involved in grass roots community-based services including contributing their knowledge and skills in early detection screening, research and educational sessions, assessing the stress burn out level of family carers, assisting in the meaningful engagement with Person with Dementia and supporting the monthly World’s Alzheimer’s Month events since 2013. ALZI chapters exist in 20 cities in Indonesia and diaspora groups in 8 countries, currently having nearing 20,000 followers and hundreds of volunteers. There is an intergenerational movement on dementia care as well in Indonesia that was pioneered by ALZI and Atma Jaya. In 2025 ALZI’s launched ALZI Care the first ever online platform services involving Care Navigators to support families journey of caring supported by the Embassy of Ireland in Jakarta. These psychosocial interventions are proven to reduce carer load and improve the quality of care.

Two studies showed that, in Indonesian society, there is a cultural and religious obligation for families to care for their aging relatives. This responsibility falls predominantly on family members, especially women with many families not following these caring roles.

National Strategy for the Management of Alzheimer and Other Dementia Diseases: Towards Healthy and Productive Older Persons is built upon three main objectives aimed at enabling healthy and productive aging:

1. Mainstream brain health: Integrate efforts to achieve healthy brains into all levels of national development, using a life-cycle approach.
2. Improve service quality: Enhance the quality of services available for individuals living with cognitive impairment and dementia.
3. Strengthen management: Reinforce the managerial and administrative capacity to optimize all efforts related to brain health.

The strategy outlines seven key action steps that form its implementation framework:
1. Public awareness: Launch campaigns to raise public awareness and promote healthy lifestyles to reduce dementia risk.
2. Human rights advocacy: Advocate for the human rights of people living with dementia and their carers.
3. Access to services: Ensure the public has access to information and quality services for dementia care.
4. Early detection and management: Implement systems for early detection, diagnosis, and holistic management of cognitive disorders.
5. Strengthen human resources: Establish a sustainable system to train and strengthen the professional healthcare workforce.
6. Cognitive health program: Create a national cognitive health program based on a life-course approach.
7. Research: Support the implementation and application of research on cognition and dementia.

Atma Jaya Cognitive & Aging Research centre has conducted a cohort study which combined standard neuropsychological tests with advanced biological markers, including blood sample analysis for the APOE gene, measurement of BDNF plasma levels, and functional assessments like olfactory tests and pupillary response tests to improve diagnostic accuracy for mild cognitive impairment. The university was also the key Indonesian partner for the international STRiDE project, which conducted studies on dementia prevalence and policy impact.

University of Indonesia (UI) collaborates with University College London to establish Jakarta as a research site for the FTD Prevention Initiative, a global effort to study the rare frontotemporal dementia. This project connects the underrepresented Indonesian population to international clinical trials for new treatments and involves sharing advanced brain scanning protocols and translating cognitive assessment apps into Bahasa Indonesia. Furthermore, UI’s Neuroscience and Brain Development research cluster is developing a national Brain Bank, a critical piece of infrastructure that will support advanced postmortem research into the molecular causes of neurodegenerative diseases.

A multidisciplinary team of Gadjah Mada University (UGM) has conducted promising research on a functional beverage made from Javanese chili kombucha. Their lab-scale study found that bioactive compounds like piperine could provide neuroprotective benefits by inhibiting an enzyme linked to Alzheimer’s disease, and tests on animal models showed it helped maintain spatial memory. In the realm of diagnostics, UGM students have also reported the development of an “Electronic Tongue”, a novel technological approach for Alzheimer’s disease detection.

Airlangga University, through its Dementia and Aging Care Research Centre (DACRC), focuses on developing community-oriented and technology-driven solutions. A notable innovation is their collaboration with technology institutes to create VR-based dementia education tools, offering a modern approach to training healthcare students and carers. The DACRC also develops practical applications for community use, such as a “Care Quality Application” designed to strengthen elderly care services.