Creatine supplementation in the aging population: effects on skeletal muscle, bone and brain

Abstract

This narrative review aims to summarize the recent findings on the adjuvant application of creatine supplementation in the management of age-related deficits in skeletal muscle, bone and brain metabolism in older individuals. Most studies suggest that creatine supplementation can improve lean mass and muscle function in older populations. Importantly, creatine in conjunction with resistance training can result in greater adaptations in skeletal muscle than training alone. The beneficial effect of creatine upon lean mass and muscle function appears to be applicable to older individuals regardless of sex, fitness or health status, although studies with very old (>90 years old) and severely frail individuals remain scarce. Furthermore, there is evidence that creatine may affect the bone remodeling process; however, the effects of creatine on bone accretion are inconsistent. Additional human clinical trials are needed using larger sample sizes, longer durations of resistance training (>52 weeks), and further evaluation of bone mineral, bone geometry and microarchitecture properties. Finally, a number of studies suggest that creatine supplementation improves cognitive processing under resting and various stressed conditions. However, few data are available on older adults, and the findings are discordant. Future studies should focus on older adults and possibly frail elders or those who have already experienced an age-associated cognitive decline.

International Society of Sports Nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine

“…A growing collection of evidence supports that creatine supplementation may improve health status as individuals age [41, 43–45, 195]. In this regard, creatine supplementation has been reported to help lower cholesterol and triglyceride levels [67, 196]; reduce fat accumulation in the liver [197]; reduce homocysteine levels [198]; serve as an antioxidant [199–202]; enhance glycemic control [132, 203–205]; slow tumor growth in some types of cancers [32, 198, 206, 207]; increase strength and/or muscle mass [37, 41, 44, 45, 82, 208–212]; minimize bone loss [211, 212]; improve functional capacity in patients with knee osteoarthritis [213] and fibromyalgia [214]; positively influence cognitive function [43, 83, 195]; and in some instances, serve as an anti-depressant [215–217].…”

Creatine: a miserable life without it

“…In a comprehensive review, Gualano et al (2016) discuss the potential benefits of creatine supplementation for the aging population and highlight the positive effects of creatine on skeletal muscle, especially if combined with training, as well as on bone and brain function. Future studies with older individuals, frail elderly and those with cognitive decline were proposed.…”

Beyond sports: Efficacy and safety of creatine supplementation in pathological or paraphysiological conditions of brain and muscle

“…They moreover emphasize that the anabolic effect of creatine can be explained not only by its well‐known energy enhancement but also by various actions on anabolic mediators. In fact, they emphasize that, according to evidence they review, creatine increases the expression of different substances at muscle level, including insulin‐like growth factor‐1 and ‐2 (IGF‐1 and IGF‐2), eukaryotic translation initiation factor eIF4E‐binding protein 1, myogenin, muscle regulatory factor 4 …”

“…Baker et al showed that creatine administration of at least 12 to 14 weeks was effective in improving muscle performance in healthy aging men, while a single 20 g creatine dose 3 hours before the muscular exertion did not improve strength. This finding may theoretically be explained by the facts that (1) creatine uptake by the skeletal muscle increases during the first 5 days of supplementation, thus one single dose may not be sufficient to build in the muscle an adequate intracellular amount of creatine; and (2) the effects by creatine in the muscle may be at least partially mediated by the increase in the expression of the above‐listed regulatory factors as well as proliferation and differentiation of muscle satellite cells, all events which require time to occur …”