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

Badrasawi, Manal; Shahar, Suzana; Zahara, A. M.; Fadilah, Ratnawaty; Singh, Devinder Kaur Ajit

doi:10.2147/cia.s113287

Cited by 53 publications

(52 citation statements)

References 51 publications

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“…This result was consistent with the previous literature (Danon-Hersch et al, 2012). However, many studies revealed that being female was also a contributing factor to frailty syndrome (Alvarado et al, 2008;Ávila-Funes et al, 2011;Collard et al, 2012, Mitsionis et al, 2009, Badrasawi et al, 2016.…”

Section: Ijphcssupporting

confidence: 93%

Association of Socio-Demographic, Psychosocial and Functional Factors with Frailty Syndrome among Community-Dwelling Elderly in Kuala Nerus, Terengganu

2018

IJPHCS

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Background: Frailty syndrome among the elderly is associated with an increased risk of disability, morbidity, and mortality as they aged. There were limited studies on frailty syndrome among the Malaysian elderlies, which were not widely discussed in various settings and factors. Therefore, the association of the factors with the frailty syndrome was still limited and not clearly revealed. This article reports the prevalence of frailty syndrome and its associations with the socio-demographic characteristics, psychosocial and functional status among the community-dwelling elderly in Kuala Nerus, Terengganu. Materials and Methods: Out of the 279 (90% response-rate) elderly respondents, 118 male and 161 female were randomly selected and interviewed. Using the validated Fried's phenotype, respondents were categorized as frail (≥3 criteria) or non-frail (≤2 criteria). Result: The mean age of the respondents was 73.3 ± 6.1 years old. The prevalence of frailty syndrome was 18.3%. From the binary logistic regression, lower participation of the respondents in leisure activities [OR: 2.63; 95% CI: 1.015-6.804] and attending feast [OR: 3.99; 95% CI: 1.015-6.804]; have depressive symptoms [OR: 4.17; 95% CI: 1.367-12.740] and dependent to mobile [OR: 3.42; CI: 1.310-8.925] were significantly associated with frailty syndrome. Conclusion: The understanding of the interactions between frailty syndrome and contributing factors might be significant in identifying the modifiable risk factors and gave an overview that can be used as the baseline data on frailty syndrome for the intervention program.

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Section: Ijphcssupporting

confidence: 93%

Association of Socio-Demographic, Psychosocial and Functional Factors with Frailty Syndrome among Community-Dwelling Elderly in Kuala Nerus, Terengganu

2018

IJPHCS

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“…Exercise may also have positive effects in frailer populations, but the most effective components of this are unclear. 171 Two further RCTs that have been published since our systematic review searches, of l-carnitnine supplementation 172 and an exercise and nutrition intervention, 173 found similarly mixed effects on frailty symptoms and physical functioning.…”

Section: Evidence Reviews: Discussionmentioning

confidence: 90%

Home-based health promotion for older people with mild frailty: the HomeHealth intervention development and feasibility RCT

Walters

Frost

Kharicha

et al. 2017

Health Technol Assess

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Background Mild frailty or pre-frailty is common and yet is potentially reversible. Preventing progression to worsening frailty may benefit individuals and lower health/social care costs. However, we know little about effective approaches to preventing frailty progression. Objectives (1) To develop an evidence- and theory-based home-based health promotion intervention for older people with mild frailty. (2) To assess feasibility, costs and acceptability of (i) the intervention and (ii) a full-scale clinical effectiveness and cost-effectiveness randomised controlled trial (RCT). Design Evidence reviews, qualitative studies, intervention development and a feasibility RCT with process evaluation. Intervention development Two systematic reviews (including systematic searches of 14 databases and registries, 1990–2016 and 1980–2014), a state-of-the-art review (from inception to 2015) and policy review identified effective components for our intervention. We collected data on health priorities and potential intervention components from semistructured interviews and focus groups with older people (aged 65–94 years) (n = 44), carers (n = 12) and health/social care professionals (n = 27). These data, and our evidence reviews, fed into development of the ‘HomeHealth’ intervention in collaboration with older people and multidisciplinary stakeholders. ‘HomeHealth’ comprised 3–6 sessions with a support worker trained in behaviour change techniques, communication skills, exercise, nutrition and mood. Participants addressed self-directed independence and well-being goals, supported through education, skills training, enabling individuals to overcome barriers, providing feedback, maximising motivation and promoting habit formation. Feasibility RCT Single-blind RCT, individually randomised to ‘HomeHealth’ or treatment as usual (TAU). Setting Community settings in London and Hertfordshire, UK. Participants A total of 51 community-dwelling adults aged ≥ 65 years with mild frailty. Main outcome measures Feasibility – recruitment, retention, acceptability and intervention costs. Clinical and health economic outcome data at 6 months included functioning, frailty status, well-being, psychological distress, quality of life, capability and NHS and societal service utilisation/costs. Results We successfully recruited to target, with good 6-month retention (94%). Trial procedures were acceptable with minimal missing data. Individual randomisation was feasible. The intervention was acceptable, with good fidelity and modest delivery costs (£307 per patient). A total of 96% of participants identified at least one goal, which were mostly exercise related (73%). We found significantly better functioning (Barthel Index +1.68; p = 0.004), better grip strength (+6.48 kg; p = 0.02), reduced psychological distress (12-item General Health Questionnaire –3.92; p = 0.01) and increased capability-adjusted life-years [+0.017; 95% confidence interval (CI) 0.001 to 0.031] at 6 months in the intervention arm than the TAU arm, with no differences in other outcomes. NHS and carer support costs were variable but, overall, were lower in the intervention arm than the TAU arm. The main limitation was difficulty maintaining outcome assessor blinding. Conclusions Evidence is lacking to inform frailty prevention service design, with no large-scale trials of multidomain interventions. From stakeholder/public perspectives, new frailty prevention services should be personalised and encompass multiple domains, particularly socialising and mobility, and can be delivered by trained non-specialists. Our multicomponent health promotion intervention was acceptable and delivered at modest cost. Our small study shows promise for improving clinical outcomes, including functioning and independence. A full-scale individually RCT is feasible. Future work A large, definitive RCT of the HomeHealth service is warranted. Study registration This study is registered as PROSPERO CRD42014010370 and Current Controlled Trials ISRCTN11986672. Funding This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 21, No. 73. See the NIHR Journals Library website for further project information.

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“…Furthermore, L‐carnitine decreased adipocyte size and did not negatively impact inflammatory markers. L‐carnitine supplementation has previously been shown to improve markers of mitochondrial and metabolic function in aged rodents (Hagen et al ., ; Noland et al ., ) and has also been shown to improve some biochemical and functional parameters in the elderly (Malaguarnera et al ., ; Badrasawi et al ., ). In the heart, L‐carnitine appeared to have stronger activity than pioglitazone, as it altered the expression of three transcriptional markers of CR in a manner consistent with CR mimicry.…”

Section: Discussionmentioning

confidence: 97%

Identification of tissue‐specific transcriptional markers of caloric restriction in the mouse and their use to evaluate caloric restriction mimetics

Barger¹,

Vann²,

Cray³

et al. 2017

Aging Cell

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SummaryCaloric restriction (CR) without malnutrition has been shown to retard several aspects of the aging process and to extend lifespan in different species. There is strong interest in the identification of CR mimetics (CRMs), compounds that mimic the beneficial effects of CR on lifespan and healthspan without restriction of energy intake. Identification of CRMs in mammals is currently inefficient due to the lack of screening tools. We have performed whole‐genome transcriptional profiling of CR in seven mouse strains (C3H/HeJ, CBA/J, DBA/2J, B6C3F1/J, 129S1/SvImJ, C57BL/6J, and BALB/cJ) in white adipose tissue (WAT), gastrocnemius muscle, heart, and brain neocortex. This analysis has identified tissue‐specific panels of genes that change in expression in multiple mouse strains with CR. We validated a subset of genes with qPCR and used these to evaluate the potential CRMs bezafibrate, pioglitazone, metformin, resveratrol, quercetin, 2,4‐dinitrophenol, and L‐carnitine when fed to C57BL/6J 2‐month‐old mice for 3 months. Compounds were also evaluated for their ability to modulate previously characterized biomarkers of CR, including mitochondrial enzymes citrate synthase and SIRT3, plasma inflammatory cytokines TNF‐α and IFN‐γ, glycated hemoglobin (HbA1c) levels and adipocyte size. Pioglitazone, a PPAR‐γ agonist, and L‐carnitine, an amino acid involved in lipid metabolism, displayed the strongest effects on both the novel transcriptional markers of CR and the additional CR biomarkers tested. Our findings provide panels of tissue‐specific transcriptional markers of CR that can be used to identify novel CRMs, and also represent the first comparative molecular analysis of several potential CRMs in multiple tissues in mammals.

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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

Cited by 53 publications

References 51 publications

Association of Socio-Demographic, Psychosocial and Functional Factors with Frailty Syndrome among Community-Dwelling Elderly in Kuala Nerus, Terengganu

Association of Socio-Demographic, Psychosocial and Functional Factors with Frailty Syndrome among Community-Dwelling Elderly in Kuala Nerus, Terengganu

Home-based health promotion for older people with mild frailty: the HomeHealth intervention development and feasibility RCT

Identification of tissue‐specific transcriptional markers of caloric restriction in the mouse and their use to evaluate caloric restriction mimetics

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