ILAS 2023: Unveiling the Challenges and Opportunities for Indonesia’s Aging Population

By Nadira Wulandari

 

The Indonesia Longitudinal Aging Survey (ILAS) 2023, published by the Asian Development Bank, SurveyMETER, and the Lembaga Demografi of the Faculty of Economics and Business at Universitas Indonesia, provides vital data on the aging population in Indonesia. Released on September 12, 2024, this groundbreaking survey aimed to generate insights necessary to inform healthcare and social security reforms in the country. The findings highlights the need for improved social protection, preventative healthcare, and the development of a care economy to better support Indonesia's aging population.

Research Design

The ILAS was conducted between May and June 2023, interviewing 4,084 individuals aged 45 and above across nine regions: West Sumatra, Lampung, West Java, Yogyakarta, East Java, Bali, South Kalimantan, South Sulawesi, and the Mollucas. These regions were selected due to their high percentage of older people (above or near 10%) as per the 2022 Older People Statistics by Statistics Indonesia. The sample consisted of 60.8% pre-older individuals (aged 45–59) and 39.2% older adults (aged 60+).
Multistage random sampling was used, taking into account socioeconomic factors, urban-rural differences, and age distribution in each area. Respondents were randomly chosen from 17 households with members aged 45 or older in each selected village. The sample size for each province was calculated with a 10% non-response rate and a 9% margin of error, based on a 95% confidence interval. The design effect used in the calculation was 2, a standard value for first-time surveys. 
Considering various population factors, the final sample size for ILAS 2023 was adjusted to 1,440 households, with 10 households surveyed in each enumeration area, distributed across 144 areas.

Questionnaires

The ILAS 2023 questionnaire was developed using insights from multiple studies, including the Malaysia Ageing and Retirement Survey, the Indonesian Family Life Survey, Sistem Informasi Lanjut Usia, and SurveyMETER’s COVID-19 study. The content was adapted to fit the Indonesian context and aligned with aging policy priorities. Additional questions were incorporated based on stakeholder input.
The questionnaire was divided into three key modules:
1.  Household Module   - Dwelling conditions     - Household food consumption and transfers     - Household non-food consumption and transfers (clothing, equipment, healthcare, education taxes)
2.  Individual Module   - Demographic details (birth, ethnicity, religion, marital status, language, education)     - Access to and ability to use technology and social media, and social inclusion     - Support from family and community (children, parents, relatives, friends, neighbors)     - Health status and risk behaviors     - Psychological well-being     - Daily living activities and cognitive function     - Employment, income, savings, and assets     - Time allocation
3.  Objective Health Measurement Module     - Blood pressure     - Weight and height     - Waist and hip circumference     - Grip strength     - Knee and arm circumference  

Assessment

The ILAS 2023 provides key insights into the living conditions, health, and socio-economic well-being of older adults in Indonesia. Below is a summary of its key findings:
Living Arrangements and Family Structure
More than half of older adults live in multigenerational households with family members. However, the number of older individuals living alone increases with age, particularly among women, 14% of whom reported living alone. Family structures are shifting, with the median number of children per family dropping from 4 to 2. The rising number of widows/widowers and increasing social and economic vulnerability of older women call for policies to support older people.
Physical Health and Functional Limitations
Although life expectancy has increased in Indonesia, a significant portion of these extra years is spent in poor health. Most older people (70%) and pre-older individuals (64%) suffer from diseases like hypertension and gastrointestinal disorders. Only 40% of hypertension cases had been diagnosed before the survey, indicating an underreporting of chronic illnesses. Smoking and cognitive impairment are also widespread, with 65% of older men still smoking, and 31% showing signs of cognitive decline. Regular health check-ups are uncommon, and long-term care services are needed for 11.6% of older adults.
Long-term Care
Around 11.6% of older individuals need long-term care due to functional limitations, especially those suffering from dementia or Alzheimer’s disease. Family members, primarily women, provide 74.3% of elderly care, although there is a growing willingness to accept and pay for home-care services (69% of respondents). Developing a robust care economy through partnerships is critical for the future.
Old-age Financial Security
Older adults rely on multiple income sources such as wages, family support, and government transfers, but few (8%-15%) receive pension income. Children’s transfers play an essential role in post-retirement income, with most older adults owning assets like homes or land. Government transfer programs remain vital for financial security, as pension coverage is low.
Employment and Retirement

A large proportion (69%) of older Indonesians are still working, primarily in informal sectors such as agriculture and low-value services. Employment decreases with age, but many older individuals intend to continue working as long as their health permits. The government should focus on improving labor protections and providing access to social insurance for older workers, especially those in the informal economy.
Social Engagement
Older adults’ participation in community activities is declining due to health and caregiving responsibilities. However, over 65% engage in volunteering or religious events. Social engagement efforts should be enhanced to combat isolation and promote mental well-being. Future generations of older people are likely to be more technologically savvy, which could help improve their social participation.
National Strategy for Aging
ILAS data contribute to monitoring progress toward Indonesia's *National Strategy for Aging*. While some targets, such as the percentage of independent older people, are being met, others, like reducing malnutrition, are falling short. The ILAS will support evidence-based aging policies and provide even more valuable insights when subsequent survey waves create a panel dataset for detailed analysis. 
In conclusion, ILAS 2023 presents a detailed picture of aging in Indonesia and highlights the need for targeted policies in health, financial security, social protection, and care services for the elderly.

About the Team

The ILAS 2023 research was conducted by a team from the SurveyMETER Research Institute and the Demography Institute at the Faculty of Economics and Business, University of Indonesia, with support from the National Planning Agency (BAPPENAS) and the Asian Development Bank (ADB). The research team was led by Ni Wayan Suriastini as survey director and team leader, with I Dewa Gede Karma Wisana overseeing survey design and database management. Other key team members included Paksi Walandouw as the quality control and knowledge management expert, Edy Purwanto as fieldwork and production manager, and Amalia Rifana Widiastuti as technical manager. Data analysis was handled by Ernis Asanti, Dwi Oktarina, Cici Permata Rusadi, and Abror Tegar Pradana, while Santi Wulandari, Ginanjar Dwi Pratiwi, Shifa Fauzia, and Anita Permata Sari served as data specialists.
Click Here to Download the ILAS 2023 Report 

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