Clinical Sciences/Health Conditions
Makoto Ueno, MD, PhD
Assistant Professor
Department of Rehabilitation and Physical Medicine, Kagoshima University Graduate School of Medical and Dental Sciences
Kagoshima, Kagoshima, Japan
Yoshihiro Matsumoto, MD
Rehabilitation Physician
Kohshinkai Ogura Hospital
Kanoya, Kagoshima, Japan
Kentaro Kawamura, MD, PhD
Assistant Professor
Department of Rehabilitation and Physical Medicine, Kagoshima University Graduate School of Medical and Dental Sciences
Kagoshima, Kagoshima, Japan
Rintaro ohama, MD, PhD
Assistant Professor
Department of Rehabilitation and Physical Medicine, Kagoshima University Graduate School of Medical and Dental Sciences
Kagoshima, Kagoshima, Japan
Keizo Shigenobu, MD
Deputy Hospital Director
Department of Rehabilitation, Kohshinkai Ogura Hospital
Kanoya, Kagoshima, Japan
Tadashi Ogura, MD
President of the Medical Corporation Kohshinkai
Department of Orthopedics, Kohshinkai Ogura Hospital
Kanoya, Kagoshima, Japan
Megumi Shimodozono, MD, PhD
Professor
Department of Rehabilitation and Physical Medicine, Kagoshima University Graduate School of Medical and Dental Sciences
Kagoshima, Kagoshima, Japan
Our previous cross-sectional study was among the first to identify carnitine deficiency as a prevalent and clinically relevant issue in rehabilitation inpatients, and it was associated with poorer functional status at admission. However, whether carnitine status at admission predicts longitudinal recovery remains unknown. This study aimed to determine whether free carnitine at admission could independently predict motor and cognitive outcomes at discharge in older adults with musculoskeletal diseases (MSD).
Design:
A single-center retrospective longitudinal observational study was conducted. We analyzed data from 103 consecutive patients aged ≥65 years with MSD admitted to a rehabilitation ward. Patients who died during hospitalization were excluded. The primary outcome was the Functional Independence Measure (FIM) motor score at discharge. Secondary outcomes included the FIM cognitive score at discharge and FIM motor gain. Multivariate linear regression analysis with stepwise variable selection was used to identify potential independent predictors.
Results:
In multivariate models, free carnitine at admission was a significant independent predictor of the primary outcome, the FIM motor score at discharge (β = 0.25, p = 0.027), after adjusting for covariates, including FIM scores at admission and the Body Mass Index. Furthermore, free carnitine at admission also independently predicted the secondary outcomes: the FIM cognitive score at discharge (β = 0.10, p = 0.043) and FIM motor gain (β = 0.25, p = 0.027).
Conclusion:
In this single-center retrospective study, higher free carnitine at admission was associated with better motor and cognitive outcomes and greater motor recovery. These findings suggest that carnitine status may be an independent predictor in rehabilitation for older adults. Given the study's limitations, the results should be considered hypothesis-generating. Prospective, multicenter studies are warranted to confirm these associations and to investigate carnitine as a potential therapeutic target.
