The Effect of Volunteer-Engaged Lifestyle Optimisation Via ICOPE on Sarcopenia in Older Adults (VELO-S)

April 30, 2026 updated by: Prof. Yu, Doris Sau Fung, The University of Hong Kong

The Effect of Volunteer-Engaged Lifestyle Optimisation Via ICOPE on Sarcopenia in Older Adults (VELO-S): A Randomised Controlled Trial

Sarcopenia prevention and management are highly prioritised goals in the Healthy Ageing agenda. The study aims to: 1) evaluate the effects of the digital-enhanced, volunteer-engaged collaborative care pathway to improve sarcopenia, reduce fall risk, and increase health-related quality of life (HRQL) among community-dwelling older adults with risk of, or diagnosed with, sarcopenia; 2) evaluate whether the volunteers who received health coach capacity training and supported the intervention experienced health benefits across time; 3) explore the engagement experiences and perceived effects of elderly participants with sarcopenia during the program; 4) evaluate the intervention implementation process and effects from the perspectives of social care workers.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Detailed Description

Population ageing is accelerating worldwide, and the widening gap between life expectancy and healthy life expectancy is increasingly driven by late-life declines in physical function and mobility. Sarcopenia-an age-related, progressive syndrome characterised by reduced skeletal muscle strength and mass/quality with impaired physical performance-has become a key modifiable determinant of frailty, falls, disability, hospitalisation, and mortality among community-dwelling older adults. Using the Asian Working Group for Sarcopenia (AWGS) criteria, a systematic review and meta-analysis of studies in China reported a pooled prevalence of 12.9% among community-dwelling older adults. In Hong Kong, approximately 9% of adults aged 65 and above are diagnosed with sarcopenia, indicating a substantial community burden. Beyond functional loss, sarcopenia is associated with increased healthcare utilisation and costs, evidence suggests higher risks of hospital admission and longer length of stay among older adults with sarcopenia, contributing to considerable economic impact.

Contemporary consensus definitions (e.g., EWGSOP2 and AWGS) identify low muscle strength as the central feature, with muscle quantity/quality and physical performance used to confirm diagnosis and grade severity, which aligns management with interventions targeting strength, function, and nutritional status. Accordingly, guideline-based care emphasizes two key modalities: optimizing nutrition-particularly adequate protein intake to support muscle protein synthesis and, where indicated, correcting vitamin D deficiency-and implementing exercise programs centered on progressive resistance training, often complemented by functional and balance components to improve mobility and reduce falls risk. Evidence further suggests that combined exercise and nutritional strategies can outperform single-modality approaches for improving outcomes relevant to sarcopenia, including strength and physical performance.

Despite substantial evidence supporting lifestyle interventions, particularly exercise and nutritional optimization-for improving sarcopenia-related outcomes, these benefits are often time-limited in practice. When structured program support ends, the effective intervention "dose" commonly declines (e.g., reduced training frequency/intensity and weaker adherence to dietary targets), and improvements in strength, function, and overall physical performance may attenuate accordingly. This pattern is consistent with real-world evidence indicating that sustained benefits depend heavily on continued participation and adherence, with lower adherence associated with smaller functional gains than those observed under supervised or trial conditions. Therefore, for a progressive and chronic condition such as sarcopenia, the key challenge is not only initiating behavior change but ensuring that exercise and dietary practices are maintained and embedded into daily routines so that benefits can persist.

The above evidence underscores a key gap in sarcopenia management: many interventions and service models have limited capacity to sustain lifestyle behavioural changes over time. Maintenance requires that evidence-based recommendations be translated into routinised daily practices, supported by (i) person-centred assessment and tailoring, (ii) empowerment and goal-oriented self-management, and (iii) ongoing social reinforcement (peer/volunteer support) with timely follow-up. The WHO Integrated Care for Older People (ICOPE) framework provides a pragmatic structure to operationalise these requirements through intrinsic capacity assessment, personalised care planning, and continued community follow-up.

To address the above gaps, the VELO-S project proposes a 12-week, volunteer-engaged lifestyle optimisation programme grounded in WHO ICOPE and delivered through an ICOPE-based critical pathway for nutrition and exercise. VELO-S is enabled by a digital platform that contains an exhaustive checklist of person-centred risk factors and corresponding, precise lifestyle activity recommendations for each care pathway (nutrition and physical activity). After baseline screening, trained social care workers conduct care mapping to identify each participant's key barriers and preferences, select relevant risk factors within the platform, and generate a tailored set of recommended lifestyle actions. A simple personalised report summarising risk factors and agreed actions can then be produced (electronic or hard copy) for participants and the matched health coach, supporting shared understanding, goal-oriented follow-up, and iterative adjustment. In parallel, VELO-S incorporates goal-oriented empowerment and volunteer-enhanced interactive lifestyle empowerment workshops to strengthen motivation, social support, and practical capability for maintaining nutritional and activity changes, thereby targeting the sustainability mechanisms required to deter sarcopenia progression in community-dwelling older adults.

This overall study aims to evaluate the effects and implementation of VELO-S among community-dwelling older adults with pseudo-sarcopenia or sarcopenia.

The objectives of this study are to (1) examine the effectiveness of a 12-week VELO-S intervention compared to an attention control in improving appendicular skeletal muscle mass, handgrip strength, physical mobility function, risk of sarcopenia, frailty, nutrition, physical activity, and health-related quality of life among community-dwelling older adults with sarcopenia risk or sarcopenia at 12 weeks post-intervention and 24 weeks follow-up; (2) to examine changes in health-related quality of life and mental health among volunteers who participated in the health coach capacity training at 12 weeks post-intervention delivery and 24 weeks follow-up, compared to baseline; (3) to explore the engagement experiences and perceived effects of elderly participants with sarcopenia during the program; (4) to explore the perspectives of social care workers on their experience on intervention effects and implementation process.

Study Type

Interventional

Enrollment (Estimated)

200

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

  • Name: Doris Sau Fung YU, PhD
  • Phone Number: 852-3917-6319
  • Email: dyu1@hku.hk

Study Locations

  • Hong Kong
      • Hong Kong, Hong Kong
        • The University of Hong Kong
        • Contact:
          • Doris Sau Fung YU, PhD
          • Phone Number: 852-3917-6319
          • Email: dyu1@hku.hk

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  1. aged 60 or above
  2. Pseudo-Sarcopenia as indicated by a score on SARC-CaIF ≥11, OR sarcopenia according relative BIA-based appendicular skeletal mass/ height (Men: <7 kg/m2; women: <5.7 kg/m2), OR handgrip strength on dominant hand (male <28 kg, female <18 kg) (Chen et al., 2025)
  3. the ability to use a smartphone, electronic tablet, or computer
  4. consent to participate

Exclusion Criteria:

  1. having medical conditions contradictory to physical activity including unstable cardiovascular and orthopaedic conditions
  2. engaging in other structured health promotion program involving physical activity and nutritional enhancement

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Prevention
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Volunteer-Engaged Lifestyle Optimisation via ICOPE for Sarcopenia program (VELO-S)
This digital program incorporates a 12-week, volunteer-engaged lifestyle optimisation programme grounded in WHO ICOPE and delivered through an ICOPE-based critical pathway for nutrition and exercise.
Behavioral: Volunteer-Engaged Lifestyle Optimisation via ICOPE for Sarcopenia program (VELO-S)
A series of interactive lifestyle empowerment workshops will be conducted at community centres to translate the care plan into sustainable behavioural changes. In addition to one session for individualised care planning, five 90-minute, bi-weekly, in-person, volunteer-enhanced interactive workshops led by nurses will be delivered to equip older adults with knowledge and practical skills to manage sarcopenia. Before interactive workshops, a brief orientation and strategic planning session will focus on the health coach's role, introduce participants to them, and pair each participant with a coach. Participants will be assisted by a corresponding health coach throughout the 12-week intervention workshop.
Active Comparator: Attention control
To control for the non-specific effects of receiving attention and social interaction on outcomes, participants in the attention control group will receive a comparable duration and frequency of contact and engagement to those in the intervention group. The attention-control group will receive six sessions delivered in a small-group format. The six sessions will be delivered topics that unrelated to sarcopenia, including social health, mental health, cognitive health, insomnia and medication safety. Educational materials will be distributed to participants. Participants will be invited to attend the sessions either by a face-to-face meeting or by telephone call (around 60 minutes) with the research team to talk about the aforementioned topics, ensuring comparable exposure to social engagement and attention.
Behavioral: Attention control
The attention control group receives six session meeting covering topics unrelated to sarcopenia, it will be delivered in a small-group with comparable duration and frequency of contact and engagement to those in the intervention group

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Appendicular skeletal muscle mass index (ASMI)
Time Frame: Baseline (T0), 3 months (T1), and 6 months (T2)
Appendicular skeletal muscle mass index (ASMI) measured by Bioelectrical impedance analysis (BIA)
Baseline (T0), 3 months (T1), and 6 months (T2)
Handgrip Strength
Time Frame: Baseline (T0), 3 months (T1), and 6 months (T2)
Handgrip strength will be measured by a hydraulic hand dynamometer from dominant hand, taking the highest value among 3 measurements. Low muscle strength is defined if male <28kg, and femal <18kg.
Baseline (T0), 3 months (T1), and 6 months (T2)
Short Physical Performance Battery (SPPB)
Time Frame: baseline (T0), 3 months (T1), and 3 months (T2)
Physical function will be measured by the Short Physical Performance Battery (SPPB), which combines balance test, gait velocity and chair stand. SPPB score ranges from 0-12, higher score better physical performance. Low physical function is defined by SPPB score ≤9.
baseline (T0), 3 months (T1), and 3 months (T2)

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Sarcopenia and calf circumference scale (SARC-CalF)
Time Frame: Baseline (T0), 3 months (T1), and 6 months (T2)
Sarcopenia and calf circumference scale (SARC-CalF) includes 5 items (strength, assistance with walking, rising from a chair, climbing stairs, Falls, calf circumference). The score ranges from 0 to 20 points, with a score ≥ 11 points suggestive of sarcopenia.
Baseline (T0), 3 months (T1), and 6 months (T2)
Timed Up and Go (TUG) test
Time Frame: Baseline (T0), 3 months (T1), and 6 months (T2)
Measured by the Timed Up and Go Test in unit of second. A shorter completion time indicates better mobility and balance.
Baseline (T0), 3 months (T1), and 6 months (T2)
The Mini Nutritional Assessment (MNA)
Time Frame: Baseline (T0), 3 months (T1), and 6 months (T2)
Measured by the Mini Nutritional Assessment (scores range from 0 to 30), with a lower score indicating a higher risk of malnutrition.
Baseline (T0), 3 months (T1), and 6 months (T2)
11-item Edmonton Frail Scale
Time Frame: Baseline (T0), 3 months (T1), and 6 months (T2)
The Edmonton Frail Scale (EFS) is scored from 0 to 17, with higher scores indicating greater frailty. An EFS score ≥ 8 is generally used as the cutoff for frailty. Scores 6-7 flag patients who are at risk.
Baseline (T0), 3 months (T1), and 6 months (T2)
International Physical Activity Questionnaire (IPAQ-Short)
Time Frame: Baseline (T0), 3 months (T1), and 6 months (T2)
Measured by International Physical Activity Questionnaire is a self-report measure of physical activity. Frenquency and time spent on walking, moderate and vigorous physical activity will be reported. More time spent on physical actiivty indicating a higher physical activity level.
Baseline (T0), 3 months (T1), and 6 months (T2)
The EuroQoL-5D-5L instruments
Time Frame: Baseline (T0), 3 months (T1), and 6 months (T2)
Assess the health-related quality of life to generate the utility score for cost-effective analysis. Including the status on mobility, self-care, usual activities, pain/discomfort, and anxiety/depression using a 5-level response set, with "unable to" levels mean a worse situation.
Baseline (T0), 3 months (T1), and 6 months (T2)
The EuroQoL-5D-5L Visual Analog Scale
Time Frame: Baseline (T0), 3 months (T1), and 6 months (T2)
Assess the health-related quality of lifeby a 0-100 scores Visual Analog Scale to measure perceived health, higher scores mean a better outcome.
Baseline (T0), 3 months (T1), and 6 months (T2)
Lipid Biomarkers
Time Frame: Baseline (T0)
Assess the comprehensive lipid panel including triglyceride, total cholesterol, high-density lipoprotein and low density lipoprotein through capillary blood samples collected via fingertip puncture
Baseline (T0)
Metabolic Biomarkers
Time Frame: Baseline (T0)
Assess the fasting glucose through capillary blood samples collected via fingertip puncture
Baseline (T0)

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

The University of Hong Kong

Investigators

  • Principal Investigator: Doris Sau Fung YU, PhD, The University of Hong Kong

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

June 1, 2026

Primary Completion (Estimated)

March 30, 2027

Study Completion (Estimated)

September 30, 2027

Study Registration Dates

First Submitted

January 7, 2026

First Submitted That Met QC Criteria

January 7, 2026

First Posted (Actual)

January 16, 2026

Study Record Updates

Last Update Posted (Actual)

May 7, 2026

Last Update Submitted That Met QC Criteria

April 30, 2026

Last Verified

March 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • VELO-S

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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