Check out the summary of the trial study which investigated the feasibility and efficacy of creatine monohydrate (CrM) in patients diagnosed with Alzheimer's disease (AD). As usual you can listen to a more detailed audio version or study the text summary below. Check out a free brain test in our app BreathNow which can estimate your cognitive decline and risk of dementia in just few minutes.
The study found that CrM supplementation was feasible and well-tolerated, with high participant compliance. Crucially, the intervention was associated with a significant increase in brain total creatine (tCr) levels (11%) and improvements in several cognitive domains, including global cognition, fluid cognition, list sorting working memory, and oral reading recognition. These findings suggest that CrM may offer bioenergetic and cognitive benefits in AD.
Main Themes and Key Findings
The study demonstrated that 20g/day of CrM for 8 weeks is feasible and well-tolerated in patients with AD. All 20 participants completed the study, with high self-reported compliance (mean 90.0%).
Adverse events were mild and included "cramping/muscle pain, diarrhoea, constipation, nausea, facial flushing, and sleep disturbance," aligning with the known good safety profile of CrM.
Serum creatine levels were significantly elevated at 4 and 8 weeks, serving as an objective biomarker of compliance. No significant adverse changes were observed in comprehensive metabolic panel safety labs, except for a "slight increase in serum creatinine," which is expected with CrM supplementation.
Increase in Brain Total Creatine (tCr):
CrM supplementation was associated with a significant increase in brain tCr concentrations from baseline to 8 weeks. Brain tCr increased by an average of "11%
Improvements in Cognitive Function:
The CrM intervention was associated with improvements across several cognitive measures:
- Total Cognition: Improved from 75.3 to 78.6
- Fluid Cognition: Improved from 59.1 to 63.5
- List Sorting Working Memory: Improved from 66.2 to 74.2.
- Oral Reading Recognition: Improved from 98.0 to 103.
Brain tCr change was positively correlated with improvements in "oral reading recognition and crystalized cognition." The authors highlight these improvements are "promising, as AD is a progressive disease with expected decline over time."
Biological Rationale:
The study underscores the importance of the creatine system in brain energy metabolism, noting that "Impaired brain energy metabolism, including dysfunction in the creatine (Cr) system, may contribute to the development and progression of Alzheimer's disease."
These human trial results are "aligned with the results of previous preclinical studies in AD mouse models," which suggested that CrM supplementation improves "brain mitochondrial function and cognition," and reduces "pathological biomarkers"
Future Directions:
This was a "small, single-arm pilot trial of short duration," meaning the "preliminary secondary outcome results should be interpreted with caution."
The authors strongly recommend "Larger efficacy trials are needed to investigate CrM supplementation as a potential therapy in AD and to determine the optimal dose."
Conclusion
This study provides significant preliminary evidence that creatine monohydrate supplementation is a feasible and safe intervention for patients with Alzheimer's disease.
If proven effective in larger trials, creatine could represent a cost-effective and well-tolerated treatment option given the anticipated rise in AD cases. Check out a free brain test in our app BreathNow which can estimate your cognitive decline and risk of dementia in just few minutes.
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