A supplement traditionally associated with enhancement of athletic performance, creatine monohydrate, is now attracting scientific interest for a distinct clinical application: preservation of muscle strength in patients with Alzheimer’s disease (AD). A recent study published in Frontiers in Nutrition reports that eight weeks of daily creatine monohydrate supplementation resulted in modest yet clinically meaningful improvements in muscle strength among individuals with AD, suggesting a potential adjunctive, low-cost strategy that warrants further investigation.
While AD is classically characterized by progressive cognitive decline, there is increasing recognition that physical deterioration, including sarcopenia and reduced muscle strength, is a critical but underappreciated component of the disease trajectory. Loss of muscle mass and strength contributes substantially to frailty, impaired mobility, reduced independence, and increased mortality in this population. Emerging evidence indicates that neuromuscular dysfunction may precede overt cognitive symptoms, highlighting the interconnected nature of neural and musculoskeletal health in neurodegenerative disorders.
Previous studies in older adults with mild cognitive impairment have demonstrated that resistance training can improve muscle strength and functional outcomes, and preclinical studies suggest that enhancement of skeletal muscle metabolism may exert beneficial effects on brain function. Against this scientific background, creatine monohydrate, an extensively studied and widely available supplement known to improve cellular energy buffering through phosphocreatine pathways, has emerged as a biologically plausible candidate in AD care.
Supporting this concept, Smith et al. previously demonstrated the feasibility and tolerability of creatine monohydrate supplementation in patients with AD, with findings showing increased total brain creatine levels and preliminary signals of cognitive improvement. Although not definitive, these observations suggest potential central as well as peripheral effects, reinforcing the need for further mechanistic and clinical evaluation.
In the current study, patients with AD received 20 g of creatine monohydrate daily for eight weeks. Adherence to supplementation was high, and no significant safety or withdrawal-related concerns were reported. Over the intervention period, mean handgrip strength increased from 33.5 kg to 35.5 kg, representing an approximate 6% improvement. This change is considered clinically relevant, as handgrip strength is a well-established surrogate marker for overall muscle function, mobility, disability risk, and mortality in older adults. Additionally, localized increase in muscle size were observed, suggesting that creatine supplementation may help attenuate the accelerated muscle loss associated with AD.
However, the authors appropriately acknowledge several limitations, including the absence of a control group, short study duration, and limited demographic diversity, which restrict the generalizability and causal interpretation of the findings. As such, these results should be viewed as preliminary and hypothesis-generating rather than practice-changing.
Despite these constraints, the study provides encouraging early evidence that creatine monohydrate may help preserve physical strength and functional capacity in patients with AD, which may be associated with a reduced rate of functional decline alongside cognitive deterioration. Larger, randomized, placebo-controlled trials with longer follow-up and diverse patient populations are essential to validate these findings and to clarify the optimal dosing, safety profile, and potential cognitive benefits.
If confirmed, creatine monohydrate could represent a simple, accessible, and adjunctive intervention in AD management, addressing not only cognitive aspects but also the musculoskeletal health that underpins independence, quality of life, and overall outcomes in this vulnerable population.
Reference
- Smith AN, Sullivan DK, Morris JK, Carbuhn AF, Herda TJ, Taylor MK. Eight weeks of creatine monohydrate supplementation is associated with increased muscle strength and size in Alzheimer’s disease: data from a single-arm pilot study. Front Nutr [Internet]. 2025 Sept 4 [cited 2025 Nov 29];12. Available from: https://www.frontiersin.org/journals/nutrition/articles/10.3389/fnut.2025.1670641/full
- Smith AN, Choi IY, Lee P, Sullivan DK, Burns JM, Swerdlow RH et al. Creatine monohydrate pilot in Alzheimer’s: Feasibility, brain creatine, and cognition. Alzheimers Dement (N Y). 2025 May 19;11(2):e70101.