Frailty is a geriatric syndrome characterized by muscle weakness, sarcopenia, 
and fatigue, and is associated with several adverse health outcomes, including 
disability. Design of therapeutic interventions for geriatric frailty has been 
challenging and may be because of inadequate understanding of its biological 
underpinnings. Carnitine is important for energy production in skeletal muscles 
and there seems to be a negative correlation between advancing age and muscle 
carnitine levels. Carnitine deficiency may therefore contribute to geriatric 
frailty. Age-associated carnitine deficiency from a variety of etiologies, 
including organic cation transporter (OCTN2) mutation and carnitine 
palmitoyltransferase II (CPT) deficiency, may potentially explain the 
relationship between carnitine-associated mitochondrial dysfunction and 
geriatric frailty. Development of therapeutic agents capable of prevention or 
reversal of carnitine deficiency in older adults may minimize the occurrence of 
frailty in geriatric populations.