Creatine Boosts Memory and Attention in Older Adults, Systematic Review Finds

Cognitive decline is a near-universal feature of aging, affecting an estimated two-thirds of Americans by age 70. Simultaneously, older adults tend to have lower creatine levels due to reduced dietary intake, decreased organ synthesis, physical inactivity, and sarcopenia. Creatine is known to support energy metabolism in high-demand tissues like skeletal muscle and brain, and creatine deficiency syndromes are associated with marked cognitive impairment—suggesting a plausible biological rationale for creatine's role in brain health.

This systematic review, registered on PROSPERO (CRD42025643617) and conducted per PRISMA guidelines, searched eight electronic databases (Medline, CINAHL, PsychINFO, EMBASE, PubMed, Scopus, Cochrane Library, Web of Science) through mid-2024. From 2,897 initial articles, six met inclusion criteria: original peer-reviewed studies in adults aged 55+ with cognition as an outcome and creatine (supplementation or dietary) as the primary exposure—without co-interventions like resistance training that would confound isolated creatine effects. A total of 1,542 participants were included (55.7% female), mostly healthy community-dwelling older adults.

Two studies were double-blind randomized controlled trials (RCTs) using creatine monohydrate supplementation (doses ranged from 5 g/day maintenance up to 20 g/day loading phases). Four studies were cross-sectional, estimating creatine consumption via dietary recall. Cognitive domains assessed included memory, selective attention, executive function, short-term memory, processing speed, and general cognitive status. Five of six studies (83.3%) reported positive associations between creatine and cognition, with the strongest and most consistent effects observed in memory and attention tasks. The one RCT that found no significant benefit used a population of overweight older women and may have had insufficient power or an inappropriate dose.

Methodological quality was assessed with a modified Downs and Black checklist. Only one study achieved a 'good' rating; two were rated 'fair' and three 'poor.' Major quality limitations included lack of objective creatine biomarker measurement, reliance on dietary recall (subject to recall bias), small sample sizes, and limited demographic diversity. Critically, none of the studies measured brain creatine levels directly, making it difficult to establish whether cognitive effects were mediated by increases in brain creatine specifically.

The authors note important mechanistic context: only approximately 5% of body creatine is stored in the brain, and higher supplementation doses may be necessary to meaningfully elevate brain creatine concentrations. Future research should include clinical populations with diagnosed cognitive impairment, use neuroimaging or spectroscopy to quantify brain creatine, and account for confounders such as body composition, dietary patterns, and physical activity levels. Despite current evidence limitations, the consistency of positive findings across study types makes creatine a compelling candidate for further investigation as a safe, accessible cognitive intervention in aging.