Acetyl-L-carnitine Slows the Progression from Prefrailty to Frailty in Older Subjects: A Randomized Interventional Clinical Trial

Abstract

Background: The elderly is characterized by a gradual decline in body function, which represents the clinical situation called "frailty". Prefrailty is the intermediate stage between frailty and the robust condition. L-carnitine (LC) plays an important role in energy production from long-chain fatty acids in mitochondria and its serum level is lower in prefrail and frail subjects. Objective: This study aims to evaluate the effect of Acetyl-L-carnitine (ALCAR) in pre frail older patients. Methods: We scheduled 3 months of treatment and then 3 months of follow-up. 92 subjects were selected from May 2009 to July 2017 in a randomized, observational, double-blind, placebo-controlled study. We scheduled 3 months of treatment and then 3 months of follow-up. ALCAR (oral 1.5 g/bis in die - BID) or placebo group. Results: After the treatment, only the treated group displayed a decrease in C reactive protein (CRP) p<0.001, an increase in serum free carnitine and acetyl carnitine (p<0.05), in Mini Mental state (MMSE) p<0.0001 and 6-walking distance (p<0.0001); ALCAR group vs. placebo group showed a decrease in HDL cholesterol and in CRP (p<0.01), an increase in MMSE score (p< 0.001) and in 6-walking distance (p<0.001) Conclusions: ALCAR treatment delays the incidence and severity of onset in prefrail subjects of degenerative disorders of the elderly, with improvement in memory and cognitive processes.