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

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. 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.

A key gap in sarcopenia management: many interventions and service models have limited capacity to sustain lifestyle behavioural changes over time.

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). In parallel, VELO-S incorporates goal-oriented empowerment and volunteer-enhanced interactive lifestyle empowerment workshops, 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.