Abstract
CONTEXT: Creatine is a well-studied dietary supplement that is known to benefit aging muscle and bone, especially when combined with resistance training. Some studies suggest that creatine may also be favorable for cognitive function, yet these independent effects have not been thoroughly reviewed in older adults. OBJECTIVE: The objective of this study was to systematically examine the current literature on creatine and cognition in older adults. DATA SOURCES: A comprehensive search was conducted across eight electronic databases. DATA EXTRACTION: Original peer-reviewed studies investigating creatine supplementation and/or estimations of dietary creatine intake in older adults (aged 55+ years) with cognition assessed as an outcome were included. Studies not examining creatine and cognition exclusively, only in combination with another intervention (e.g., resistance training), were excluded. The methodological quality of each study was evaluated using a modified version of the Downs and Black (1998) checklist. DATA ANALYSIS: Six studies were included, with a total of 1542 participants (55.7% female). Most participant samples included healthy community-dwelling older adults, with the exception of one study examining overweight older women. Two studies were double-blind interventions in which participants were supplemented with creatine monohydrate. Four studies were cross-sectional and estimated creatine consumption through dietary recall. Five of the six (83.3%) studies reported a positive relationship between creatine and cognition in older adults, particularly in the domains of memory and attention. One study achieved a methodological quality rating of "good", two "fair", and three "poor". CONCLUSION: The current limited evidence suggests that creatine may be associated with benefits for cognition in generally healthy older adults. However, high-quality clinical trials are warranted to further validate this relationship. Future research should investigate creatine supplementation in older clinical populations with notable cognitive deficits, objectively measure creatine concentrations, and consider additional factors that may influence creatine levels in the body and brain (e.g., body weight, muscle mass, dietary intake, physical activity levels). SYSTEMATIC REVIEW REGISTRATION: PROSPERO No. CRD42025643617.