Creatine, traditionally associated with young athletes and bodybuilders, has recently gained attention for its potential health benefits in middle-aged and older adults. Age-related muscle loss, also known as sarcopenia, begins around age 30 and accelerates with advancing age, affecting strength, balance, and overall quality of life. Emerging research shows that creatine supplementation can support protein synthesis, mitigate muscle loss, enhance bone density, improve cognitive function, and reduce inflammation. This article reviews the mechanisms, efficacy, and safety of creatine supplementation in older populations, highlighting its potential to promote healthy aging and improve life quality.
Introduction: Age-Related Muscle Loss and the Role of Creatine
Previously, creatine supplements were considered primarily for young athletes and bodybuilders, but now they are increasingly recognized for their health benefits in older adults.
Starting around age 30, the human body begins to experience gradual muscle loss. Depending on overall health and activity level, muscle mass decreases by 3%–8% per decade. After age 40, muscle mass can decline by 16%–40%. This age-related muscle loss, also called sarcopenia, affects an individual’s strength in daily activities.
Most people have lost about 10% of their muscle mass by age 50. The rate of muscle decline accelerates with age, reaching up to a 15% decrease per decade after age 70.
Although everyone loses muscle mass with age, the rate of decline is significantly faster in individuals with sarcopenia. Severe muscle loss can lead to physical weakness, reduced balance, and an increased risk of falls and injuries. Maintaining muscle mass is therefore crucial for healthy aging and preserving quality of life.
To support protein synthesis—the process of building and maintaining muscle—women aged 50 and older should consume at least 25 grams of protein per meal, while men require 30 grams. Recent studies suggest that creatine may improve age-related muscle loss, bone density decline, and even cognitive decline.
What is Creatine?
Creatine (C₄H₉N₃O₂) is a naturally occurring compound in the human body and an important biochemical component stored in muscles and the brain. Its primary function is to provide energy to muscle cells, and it is also a key energy source for brain cells.
The body can synthesize some creatine from amino acids, mainly in the liver, pancreas, and kidneys. However, the amount produced endogenously is usually insufficient, and most people require an additional 1–2 grams daily from dietary sources such as meat, seafood, eggs, and dairy products. Creatine is also available as a dietary supplement in forms such as powder, capsules, and gummies.
In 2024, the global creatine supplement market reached USD 1.11 billion, and it is projected to grow to USD 4.28 billion by 2030.
Creatine functions as the body’s energy generator, helping produce adenosine triphosphate (ATP), the primary source of cellular energy. As a naturally occurring molecule similar to amino acids, creatine plays a crucial role in the human energy system, which becomes increasingly important with age. Beyond its well-known effects on athletic performance, creatine supplementation offers scientifically supported health benefits for older adults.
Creatine: Cognitive Improvement and Anti-Aging Benefits
Recent studies primarily focus on creatine’s potential in anti-aging and cognitive health for middle-aged and older adults.
1. Creatine Improves Age-Related Cognitive Decline
Higher brain creatine levels are associated with improved neuropsychological function. Recent research demonstrates that creatine supplementation increases brain creatine and phosphocreatine levels. Further studies indicate that creatine supplementation can mitigate cognitive deficits caused by experimental conditions (e.g., sleep deprivation) or natural aging.
In January 2025, researchers at Nanjing University of Chinese Medicine investigated the effects of creatine supplementation on learning, memory, and synaptic structural plasticity by modulating CK-BB (brain-type creatine kinase). CK-BB is one of three creatine kinase isoenzymes (CK-MB and CK-MM are the others) predominantly present in brain tissue and clinically associated with brain injury or specific disease states.
Researchers first established an aging mouse model using different concentrations of D-galactose. Then, 3% creatine was added to the diet of D-galactose-induced aging mice. The results showed that creatine supplementation increased CK-BB activity by 36% and CK-BB expression by 14.3%. Additionally, creatine reduced cognitive impairment, oxidative stress, and hippocampal structural plasticity damage induced by chronic D-galactose injection. This indicates that creatine can act as a neuroprotective agent, preventing or delaying age-related cognitive decline.
In May 2025, a study assessed the feasibility of daily creatine monohydrate (CrM) supplementation at 20 grams for eight weeks in 20 patients with Alzheimer’s disease. Results showed a positive correlation between CrM supplementation and total brain creatine levels, along with improvements in working memory and overall cognitive function.
2. Creatine Mitigates Age-Related Muscle Loss
Beyond cognition and anti-aging, creatine has been studied for its effects on sarcopenia in older adults. With aging, regardless of clinical sarcopenia diagnosis, individuals often experience declines in strength, muscle mass, bone mass, and balance, accompanied by increased body fat. Nutritional and exercise interventions, including creatine supplementation during resistance training, have been proposed to counteract sarcopenia in older adults.
A recent meta-analysis indicates that creatine supplementation combined with resistance training significantly improves upper body strength, as measured by chest press and/or bench press, compared with resistance training alone.
This approach has practical value for performing daily activities such as lifting, pushing, or pulling. Another meta-analysis found that creatine supplementation improves grip strength in older adults—a critical predictor of health outcomes, including hospitalization and physical disability, and positively correlated with total body strength. Notably, creatine’s effect on lower body strength is less pronounced than on upper body strength.
3. Creatine Supports Bone Health
Creatine supplementation combined with resistance training is more effective than training alone in increasing bone density and maintaining skeletal health. Research suggests that creatine may help prevent age-related bone loss by reducing bone resorption.
A preliminary small-scale study found that in a one-year resistance training program, creatine supplementation (0.1 g/kg/day) reduced femoral neck bone mineral density loss in postmenopausal women to 1.2%, compared with a 3.9% decline in the placebo group. This preservation approaches clinical significance, as a 5% bone mineral density loss increases fracture risk by 25%.
Another study reported that older men taking creatine during strength training experienced a 27% reduction in osteoporosis, whereas osteoporosis increased by 13% in the placebo group. These findings suggest that creatine may support osteoblast activity and slow osteoporosis progression.
4. Creatine Reduces Inflammation in Aging
Creatine may have antioxidant effects on mitochondria. In myocytes exposed to oxidative damage, creatine supplementation mitigated differentiation decline and reduced mitochondrial damage observed under electron microscopy. Therefore, creatine may reduce inflammation and muscle injury during aging by protecting mitochondria from oxidative stress. Recent human studies indicate that creatine supplementation (2.5 g/day) during 12 weeks of resistance and high-intensity interval training can lower inflammatory markers.
Safety of Creatine
The most common reaction to creatine supplementation is transient intracellular water retention in muscle cells, which is a normal physiological response rather than visible subcutaneous edema. To minimize this effect, it is recommended to start with small doses, take it with meals, and increase daily water intake; most individuals adapt quickly.
Regarding drug interactions, clinical evidence shows no significant interactions between creatine and common antihypertensive medications, and concurrent use is generally considered safe.
However, creatine may not be suitable for everyone. Since creatine is metabolized by the liver and kidneys, individuals with liver or kidney disease may experience adverse effects.
Overall, creatine is an affordable and safe dietary supplement. Its benefits for older adults are significant, potentially improving quality of life and reducing the disease burden associated with sarcopenia and cognitive decline.
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