2025-
2026
Samenvatting
REVAKI bij
ouderen
PAUL-HENRY DURANT
,INHOUDSOPGAVE
Praktijk ........................................................................................................................................ 4
Vergrijzing en vallen ..........................................................................................................................4
Hedendaagse kine bij (ver)ouderen ....................................................................................................5
Principes .........................................................................................................................................5
1 Leeftijd ......................................................................................................................................5
2 Ageisme .....................................................................................................................................5
3 Hollistisch .................................................................................................................................6
4 Collateral damage ......................................................................................................................6
5 Doelen .......................................................................................................................................6
6 multidisciplinair .........................................................................................................................7
Posturale controle ........................................................................................................................7
BILAN ..............................................................................................................................................7
1 Anamnese .................................................................................................................................7
2 Inspectie....................................................................................................................................7
3 testing .......................................................................................................................................8
Posturale controle .......................................................................................................................10
Sensorisch systeem ....................................................................................................................... 10
Vestibulum ................................................................................................................................. 10
Visus .......................................................................................................................................... 10
Gehoor ....................................................................................................................................... 10
Proprioceptie – somatosensoriek ................................................................................................. 11
Motorisch systeem ......................................................................................................................... 11
Houding ..................................................................................................................................... 11
Mobiliteit .................................................................................................................................... 11
Kracht ........................................................................................................................................ 14
Evenwicht................................................................................................................................... 23
Uithouding.................................................................................................................................. 27
Snelheid ..................................................................................................................................... 27
4TD................................................................................................................................................ 29
Definitie ..................................................................................................................................... 29
Tijd............................................................................................................................................. 29
Tikken ........................................................................................................................................ 29
Tegenhouden.............................................................................................................................. 30
Trekken en duwen ....................................................................................................................... 31
Aandachtspunten bij (ver)ouderen ................................................................................................... 32
Theorie........................................................................................................................................33
Epidemiologische transitie .............................................................................................................. 33
Fysieke activiteit ............................................................................................................................. 33
Gezondheidsbevorderende FA ..................................................................................................... 34
Oud en verouderen ......................................................................................................................... 34
Assessment based practice ............................................................................................................ 35
ABP inleiding .............................................................................................................................. 36
Fysieke fitheid ................................................................................................................................ 36
Kracht & senioren ....................................................................................................................... 37
Posturale controle & evenwicht ................................................................................................... 45
Mobiliteit .................................................................................................................................... 51
1
, Uithouding.................................................................................................................................. 55
Cognitie ..................................................................................................................................... 58
Profiel van de oudere ...................................................................................................................... 58
Physiscal frailty........................................................................................................................... 58
Immobiliteit voorkomen .................................................................................................................. 68
Gevolgen van hospitalisatie ......................................................................................................... 68
Oorzaken van functionele achteruitgang ...................................................................................... 68
Complicaties van immobilisatie ................................................................................................... 70
Voeding en ondervoeding ................................................................................................................ 74
Gevolgen van ondervoeding ......................................................................................................... 75
Oorzaken van ondervoeding ........................................................................................................ 75
Ondervoeding vormen ................................................................................................................. 76
Oorzaken verminderde voedselinname: ....................................................................................... 76
Preventie en behandeling ............................................................................................................ 77
Majeure cognitieve stoornis – dementie ........................................................................................... 79
Dementie = ontgeesting .............................................................................................................. 79
Pathofysiologie ........................................................................................................................... 81
Risicofactoren dementie ............................................................................................................. 84
Erfelijkheid dementie .................................................................................................................. 84
Waarom dementie vroegtijdig herkennen? .................................................................................... 85
Diagnose .................................................................................................................................... 85
Meedelen van de diagnose .......................................................................................................... 85
Behandeling Ziekte van Alzheimer ................................................................................................ 85
Behandeling Vasculaire dementie ................................................................................................ 86
Gedragsstoornissen ....................................................................................................................... 86
BPSD (Behavioral & psychological symptoms of dementia ............................................................ 86
delirium ......................................................................................................................................... 89
Disturbance in attention/awareness ............................................................................................ 89
Additional disturbance in cognition .............................................................................................. 89
Pathogenese .............................................................................................................................. 89
Risicofactoren ............................................................................................................................ 90
Vormen van delirium ................................................................................................................... 90
Symptomen ................................................................................................................................ 91
Diagnose .................................................................................................................................... 91
Behandeling ............................................................................................................................... 91
Gevolgen .................................................................................................................................... 92
Prognose .................................................................................................................................... 92
Depressie ...................................................................................................................................... 92
Voorkomen ................................................................................................................................. 93
Herkennen van depressie ............................................................................................................ 93
Symptomen ................................................................................................................................ 93
Specifieke vormen van depressie ................................................................................................. 93
Differentiaaldiagnose .................................................................................................................. 93
Behandeling ............................................................................................................................... 93
Zelfdoding bij ouderen ................................................................................................................. 94
Prognose van depressie .............................................................................................................. 94
Determinanenten van veroudering ................................................................................................... 94
Vergrijzing: oorzaken ................................................................................................................... 94
Levensverwachting ..................................................................................................................... 94
Definitie van veroudering ............................................................................................................. 95
Determinanenten van biologische veroudering ............................................................................. 95
Endogene mehcanismen: genetisch ............................................................................................ 95
Hallmarks of ageing .................................................................................................................... 96
2
, Interventies tegen veroudering ..................................................................................................... 97
Normale veroudering stelsels .......................................................................................................... 98
Cardiovasculair stelsel ................................................................................................................ 98
Pulmonaal stelsel ..................................................................................................................... 100
Centraal zenuwstelsel ............................................................................................................... 100
Geheugen................................................................................................................................. 101
PErifeer zenuwstelsel ................................................................................................................ 101
Autonoom zenuwstelsel ............................................................................................................ 101
Slaap ....................................................................................................................................... 101
Visus: morfologische veranderingen .......................................................................................... 102
Oor .......................................................................................................................................... 102
Digestief stelsel: smaakzintuig................................................................................................... 102
Digestief stelsel: maag .............................................................................................................. 103
Digestief stelsel: dikke darm of colon ......................................................................................... 103
Digestief stelsel: pancreas ........................................................................................................ 103
Hematologisch stelsel .............................................................................................................. 103
Musculair stelsel: sarcopenie .................................................................................................... 104
3
2026
Samenvatting
REVAKI bij
ouderen
PAUL-HENRY DURANT
,INHOUDSOPGAVE
Praktijk ........................................................................................................................................ 4
Vergrijzing en vallen ..........................................................................................................................4
Hedendaagse kine bij (ver)ouderen ....................................................................................................5
Principes .........................................................................................................................................5
1 Leeftijd ......................................................................................................................................5
2 Ageisme .....................................................................................................................................5
3 Hollistisch .................................................................................................................................6
4 Collateral damage ......................................................................................................................6
5 Doelen .......................................................................................................................................6
6 multidisciplinair .........................................................................................................................7
Posturale controle ........................................................................................................................7
BILAN ..............................................................................................................................................7
1 Anamnese .................................................................................................................................7
2 Inspectie....................................................................................................................................7
3 testing .......................................................................................................................................8
Posturale controle .......................................................................................................................10
Sensorisch systeem ....................................................................................................................... 10
Vestibulum ................................................................................................................................. 10
Visus .......................................................................................................................................... 10
Gehoor ....................................................................................................................................... 10
Proprioceptie – somatosensoriek ................................................................................................. 11
Motorisch systeem ......................................................................................................................... 11
Houding ..................................................................................................................................... 11
Mobiliteit .................................................................................................................................... 11
Kracht ........................................................................................................................................ 14
Evenwicht................................................................................................................................... 23
Uithouding.................................................................................................................................. 27
Snelheid ..................................................................................................................................... 27
4TD................................................................................................................................................ 29
Definitie ..................................................................................................................................... 29
Tijd............................................................................................................................................. 29
Tikken ........................................................................................................................................ 29
Tegenhouden.............................................................................................................................. 30
Trekken en duwen ....................................................................................................................... 31
Aandachtspunten bij (ver)ouderen ................................................................................................... 32
Theorie........................................................................................................................................33
Epidemiologische transitie .............................................................................................................. 33
Fysieke activiteit ............................................................................................................................. 33
Gezondheidsbevorderende FA ..................................................................................................... 34
Oud en verouderen ......................................................................................................................... 34
Assessment based practice ............................................................................................................ 35
ABP inleiding .............................................................................................................................. 36
Fysieke fitheid ................................................................................................................................ 36
Kracht & senioren ....................................................................................................................... 37
Posturale controle & evenwicht ................................................................................................... 45
Mobiliteit .................................................................................................................................... 51
1
, Uithouding.................................................................................................................................. 55
Cognitie ..................................................................................................................................... 58
Profiel van de oudere ...................................................................................................................... 58
Physiscal frailty........................................................................................................................... 58
Immobiliteit voorkomen .................................................................................................................. 68
Gevolgen van hospitalisatie ......................................................................................................... 68
Oorzaken van functionele achteruitgang ...................................................................................... 68
Complicaties van immobilisatie ................................................................................................... 70
Voeding en ondervoeding ................................................................................................................ 74
Gevolgen van ondervoeding ......................................................................................................... 75
Oorzaken van ondervoeding ........................................................................................................ 75
Ondervoeding vormen ................................................................................................................. 76
Oorzaken verminderde voedselinname: ....................................................................................... 76
Preventie en behandeling ............................................................................................................ 77
Majeure cognitieve stoornis – dementie ........................................................................................... 79
Dementie = ontgeesting .............................................................................................................. 79
Pathofysiologie ........................................................................................................................... 81
Risicofactoren dementie ............................................................................................................. 84
Erfelijkheid dementie .................................................................................................................. 84
Waarom dementie vroegtijdig herkennen? .................................................................................... 85
Diagnose .................................................................................................................................... 85
Meedelen van de diagnose .......................................................................................................... 85
Behandeling Ziekte van Alzheimer ................................................................................................ 85
Behandeling Vasculaire dementie ................................................................................................ 86
Gedragsstoornissen ....................................................................................................................... 86
BPSD (Behavioral & psychological symptoms of dementia ............................................................ 86
delirium ......................................................................................................................................... 89
Disturbance in attention/awareness ............................................................................................ 89
Additional disturbance in cognition .............................................................................................. 89
Pathogenese .............................................................................................................................. 89
Risicofactoren ............................................................................................................................ 90
Vormen van delirium ................................................................................................................... 90
Symptomen ................................................................................................................................ 91
Diagnose .................................................................................................................................... 91
Behandeling ............................................................................................................................... 91
Gevolgen .................................................................................................................................... 92
Prognose .................................................................................................................................... 92
Depressie ...................................................................................................................................... 92
Voorkomen ................................................................................................................................. 93
Herkennen van depressie ............................................................................................................ 93
Symptomen ................................................................................................................................ 93
Specifieke vormen van depressie ................................................................................................. 93
Differentiaaldiagnose .................................................................................................................. 93
Behandeling ............................................................................................................................... 93
Zelfdoding bij ouderen ................................................................................................................. 94
Prognose van depressie .............................................................................................................. 94
Determinanenten van veroudering ................................................................................................... 94
Vergrijzing: oorzaken ................................................................................................................... 94
Levensverwachting ..................................................................................................................... 94
Definitie van veroudering ............................................................................................................. 95
Determinanenten van biologische veroudering ............................................................................. 95
Endogene mehcanismen: genetisch ............................................................................................ 95
Hallmarks of ageing .................................................................................................................... 96
2
, Interventies tegen veroudering ..................................................................................................... 97
Normale veroudering stelsels .......................................................................................................... 98
Cardiovasculair stelsel ................................................................................................................ 98
Pulmonaal stelsel ..................................................................................................................... 100
Centraal zenuwstelsel ............................................................................................................... 100
Geheugen................................................................................................................................. 101
PErifeer zenuwstelsel ................................................................................................................ 101
Autonoom zenuwstelsel ............................................................................................................ 101
Slaap ....................................................................................................................................... 101
Visus: morfologische veranderingen .......................................................................................... 102
Oor .......................................................................................................................................... 102
Digestief stelsel: smaakzintuig................................................................................................... 102
Digestief stelsel: maag .............................................................................................................. 103
Digestief stelsel: dikke darm of colon ......................................................................................... 103
Digestief stelsel: pancreas ........................................................................................................ 103
Hematologisch stelsel .............................................................................................................. 103
Musculair stelsel: sarcopenie .................................................................................................... 104
3
