Fall Prevention in Healthy Aging, Frailty, Frailty Syndrome, Malnutrition Elderly, Sarcopenia, Sarcopenia in Elderly
Conditions
Keywords
sarcopenia, elderly, frailty, fall prevention, malnutrition, health-related quality of life, digital intervention
Brief summary
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.
Detailed description
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.
Interventions
BEHAVIORALVolunteer-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. One brief orientation and strategic planning and individualised care planning session, five volunteer-enhanced interactive workshops led by nurses will be delivered to equip older adults with knowledge and practical skills to manage sarcopenia. Participants will be assisted by a corresponding health coach throughout the 12-week intervention workshop.
BEHAVIORALAttention 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
Sponsors
The University of Hong Kong
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
SINGLE (Outcomes Assessor)
Masking description
Outcome assessors will be blinded to the intervention assignment results.
Intervention model description
This RCT randomised 200 older adults at risk of, or diagnosed with, sarcopenia to receive the digital pathway intervention or to an attention control group
Eligibility
Sex/Gender
ALL
Age
60 Years to No maximum
Healthy volunteers
No
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
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Appendicular skeletal muscle mass index (ASMI) | Baseline (T0), 3 months (T1), and 6 months (T2) | Appendicular skeletal muscle mass index (ASMI) measured by Bioelectrical impedance analysis (BIA) |
| Handgrip Strength | 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. |
| Short Physical Performance Battery (SPPB) | 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. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Sarcopenia and calf circumference scale (SARC-CalF) | 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. |
| 11-item Edmonton Frail Scale | 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. |
| The EuroQoL-5D-5L instruments | 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. |
| The EuroQoL-5D-5L Visual Analog Scale | 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. |
| Lipid Biomarkers | 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 |
| Timed Up and Go (TUG) test | 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. |
| Metabolic Biomarkers | Baseline (T0) | Assess the fasting glucose through capillary blood samples collected via fingertip puncture |
| The Mini Nutritional Assessment (MNA) | 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. |
| International Physical Activity Questionnaire (IPAQ-Short) | 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. |
Countries
Hong Kong
Contacts
CONTACTDoris Sau Fung YU, PhD
PRINCIPAL_INVESTIGATORDoris Sau Fung YU, PhD
The University of Hong Kong
Outcome results
None listed