title: Efficacy of L-carnitine supplementation on frailty status and its biomarkers, nutritional status, and physical and cognitive function among prefrail older adults: a double-blind, randomized, placebo-controlled clinical trial.
abstract: BACKGROUND
  Frailty is a biological syndrome of decreased reserve and resistance to stressors due to decline in multiple physiological systems. Amino acid deficiency, including L-carnitine, has been proposed to be associated with its pathophysiology. Nevertheless, the efficacy of L-carnitine supplementation on frailty status has not been documented. Thus, this study aimed to determine the effect of 10-week L-carnitine supplement (1.5 g/day) on frailty status and its biomarkers and also physical function, cognition, and nutritional status among prefrail older adults in Klang Valley, Malaysia.
  
  
  METHODS
  This study is a randomized, double-blind, placebo-controlled clinical trial conducted among 50 prefrail subjects randomized into two groups (26 in L-carnitine group and 24 in placebo group). Outcome measures include frailty status using Fried criteria and Frailty Index accumulation of deficit, selected frailty biomarkers (interleukin-6, tumor necrosis factor-alpha, and insulin-like growth factor-1), physical function, cognitive function, nutritional status and biochemical profile.
  
  
  RESULTS
  The results indicated that the mean scores of Frailty Index score and hand grip test were significantly improved in subjects supplemented with L-carnitine (P<0.05 for both parameters) as compared to no change in the placebo group. Based on Fried criteria, four subjects (three from the L-carnitine group and one from the control group) transited from prefrail status to robust after the intervention.
  
  
  CONCLUSIONS
  L-carnitine supplementation has a favorable effect on the functional status and fatigue in prefrail older adults.
authors.affiliation: Dietetic Programme, School of Healthcare Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia; Nutrition Program, Faulty of Applied Sciences, Palestine Polytechnic University, Hebron, Palestine.
authors.forename: M
authors.initials: M
authors.lastname: Badrasawi
authors.affiliation: Dietetic Programme, School of Healthcare Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
authors.forename: Suzana
authors.initials: S
authors.lastname: Shahar
authors.affiliation: Dietetic Programme, School of Healthcare Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
authors.forename: A M
authors.initials: AM
authors.lastname: Zahara
authors.affiliation: Biomedical Programme, School of Healthcare Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
authors.forename: R
authors.initials: R
authors.lastname: Nor Fadilah
authors.affiliation: Physiotherapy Programme, School of Rehabilitation Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
authors.forename: Devinder Kaur Ajit
authors.initials: DK
authors.lastname: Singh
mesh_terms: D000368:Aged; D015415:Biomarkers; D002331:Carnitine / Q000008:administration & dosage*; D003071:Cognition; D019587:Dietary Supplements; D004311:Double-Blind Method; D005260:Female; D000073496:Frailty / Q000188:drug therapy*; D018737:Hand Strength; D006304:Health Status; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000032:analysis; D015850:Interleukin-6 / Q000097:blood; D008296:Malaysia; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
chemical_list: D015415:Biomarkers; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D007334:Insulin-Like Growth Factor I; D002331:Carnitine
keywords: Frailty Index accumulation of deficit; Fried criteria; L-carnitine supplementation; frailty; frailty biomarkers; physical function; prefrail elderly; randomized controlled clinical trial