Creatine and Healthy Aging

Creatine has spent the last year and a half being rediscovered as a healthy-aging supplement. That shift makes sense, but the pitch is often too tidy: take creatine, keep your muscle, stay sharp, age better.

The more interesting question is narrower. If resistance training is already the main tool for preserving strength and muscle as we age, does creatine make that tool work better?

The short answer appears to be yes, especially when paired with resistance training.

A 2025 systematic review and meta-analysis examined eight randomized controlled trials involving 482 older adults performing resistance training two to three times per week. Compared with resistance training alone, adding creatine produced greater improvements in lean tissue mass and lower-body strength. Statistically, the effects were relatively small: standardized mean differences of 0.27 for lean tissue mass and 0.29 for lower-body strength. In absolute terms, creatine increased lean tissue mass by approximately 0.56 kg more than resistance training alone, while the lower-body strength advantage was approximately 2.0 kg. Creatine did not replace the training stimulus; it appeared to provide an additional benefit on top of it.

Which may be exactly why creatine matters. In aging, meaningful benefits do not always appear as dramatic changes in a single workout or a sudden increase in strength. A small improvement in training quality, recovery, or lean tissue gained over months can accumulate into a larger difference in physical capacity over years. That extra reserve may help someone climb stairs, rise from a chair, carry groceries, or recover from illness with less difficulty. Because muscle loss and declining strength are gradual, even modestly slowing that trajectory can preserve independence and reduce the likelihood that a minor setback becomes a major loss of function.

Creatine increases intramuscular phosphocreatine availability, helping regenerate ATP during repeated high-intensity muscular contractions. In practical terms, this may support training performance and, over months of repeated workouts, potentially allow greater adaptation.

Earlier research puts the potential size of that advantage into perspective. A meta-analysis of 22 studies involving 721 adults, with mean ages ranging from 57 to 70, found that creatine combined with resistance training increased lean tissue mass by 1.37 kg more than resistance training alone. The 95% confidence interval ranged from 0.97 to 1.76 kg. It also produced greater gains in both chest-press and leg-press strength.

An additional 1.37 kg roughly three pounds of lean tissue is a substantial difference in an older population, particularly during a stage of life when maintaining muscle mass becomes progressively more difficult. The significance of creatine may therefore be less about producing dramatic short-term performance changes and more about improving the return from resistance training over time.

There is also growing interest in the brain.

Creatine is not stored exclusively in skeletal muscle. The brain also uses the creatine-phosphocreatine energy system. A 2025 systematic review examining adults 55 and older included six studies and 1,542 participants. Five of the six studies reported a positive relationship between creatine and cognition, particularly memory and attention. However, only two were double-blind creatine supplementation trials; the other four estimated dietary creatine intake. The authors therefore characterized the evidence as promising but limited.

That caution is important. A broader 2024 meta-analysis of 16 randomized trials found improvements in memory, attention time, and processing speed, but not overall cognition or executive function, and rated much of the evidence as low certainty.

The takeaway is not that creatine prevents aging. It is that creatine may help preserve something increasingly valuable with age: physiological reserve.

Resistance training provides the stimulus. Adequate nutrition supplies the building materials. Creatine may help increase the return from that process- and over decades, additional muscle and strength may matter considerably more than they do at 25.

- Conrad RN

References:

1. Liu S, Huang N, Wu W, et al. The impact of creatine supplementation associated with resistance training on muscular strength and lean tissue mass in the aged: a systematic review and meta-analysis. European Review of Aging and Physical Activity. 2025;22(1):26. doi:10.1186/s11556-025-00392-9.
   
   
2. Chilibeck PD, Kaviani M, Candow DG, Zello GA. Effect of creatine supplementation during resistance training on lean tissue mass and muscular strength in older adults: a meta-analysis. Open Access Journal of Sports Medicine. 2017;8:213-226. doi:10.2147/OAJSM.S123529.
   
   
3. Forbes SC, et al. Creatine and Cognition in Aging: A Systematic Review of Evidence in Older Adults. Nutrition Reviews. 2025. doi:10.1093/nutrit/nuaf135.
   
   
4. Xu C, Bi S, Zhang W, Luo L. The effects of creatine supplementation on cognitive function in adults: a systematic review and meta-analysis. Frontiers in Nutrition. 2024;11:1424972. doi:10.3389/fnut.2024.1424972.