Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Jul 12:11:1424972.
doi: 10.3389/fnut.2024.1424972. eCollection 2024.

The effects of creatine supplementation on cognitive function in adults: a systematic review and meta-analysis

Chen Xu  1 , Siyuan Bi  1 , Wenxin Zhang  1 , Lin Luo  1
Affiliations

The effects of creatine supplementation on cognitive function in adults: a systematic review and meta-analysis

Chen Xu et al. Front Nutr. .

Erratum in

Abstract

Background: This study aimed to evaluate the effects of creatine monohydrate supplementation on cognitive function in adults and explore its potential role in preventing and delaying cognitive impairment-related diseases.

Methods: Following the PRISMA 2020 guidelines, a systematic review with meta-analysis was conducted. Randomized controlled trials (RCTs) published between 1993 and 2024 were retrieved from PubMed, Scopus, and Web of Science databases. The study protocol was registered with PROSPERO (registration number: CRD42024533557). The impact of creatine supplementation on overall cognitive function, memory, executive function, attention, and information processing speed was assessed using standardized mean differences (SMD) and Hedge's g with 95% confidence intervals (CI).

Results: Sixteen RCTs involving 492 participants aged 20.8-76.4 years, including healthy individuals and patients with specific diseases, were selected. Creatine monohydrate was the form used in all included studies. Creatine supplementation showed significant positive effects on memory (SMD = 0.31, 95% CI: 0.18-0.44, Hedges's g = 0.3003, 95% CI: 0.1778-0.4228) and attention time (SMD = -0.31, 95% CI: -0.58 to -0.03, Hedges's g = -0.3004, 95% CI: -0.5719 to -0.0289), as well as significantly improving processing speed time (SMD = -0.51, 95% CI: -1.01 to -0.01, Hedges's g = -0.4916, 95% CI: -0.7852 to -0.1980). However, no significant improvements were found on overall cognitive function or executive function. Subgroup analyses revealed that creatine supplementation was more beneficial in individuals with diseases, those aged 18-60 years, and females. No significant differences were found between short- (<4 weeks) and long-term (≥4 weeks) interventions for improving cognitive function. Low-to-moderate risk of bias was found, and no significant publication bias was detected. The GRADE assessment indicates that the certainty of evidence for memory function is moderate, suggesting a reasonable level of confidence in the positive effects of creatine on memory. However, the evidence for processing speed, overall cognitive function, executive function, and attention is of low certainty, indicating that further research is needed to confirm these potential benefits.

Conclusion: Current evidence suggests that creatine monohydrate supplementation may confer beneficial effects on cognitive function in adults, particularly in the domains of memory, attention time, and information processing speed. Larger robust clinical trials are warranted to further validate these findings. Furthermore, future research should investigate the influence of different populations and intervention durations on the effects of creatine monohydrate supplementation, as well as elucidate the precise mechanisms underlying its potential cognitive-enhancing properties.

Keywords: brain health; cognitive function; creatine; neuropsychological tests; randomized controlled trials.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
PRISMA diagram of searching and screening process.
Figure 2
Figure 2
Risk of bias assessment for included studies.
Figure 3
Figure 3
Meta-analysis forest plot of the effect of creatine supplementation on overall cognitive function.
Figure 4
Figure 4
Meta-analysis forest plot of the effect of creatine supplementation on executive function scores.
Figure 5
Figure 5
Meta-analysis forest plot of the effect of creatine supplementation on executive function time.
Figure 6
Figure 6
Meta-analysis forest plot of the effect of creatine supplementation on attention scores.
Figure 7
Figure 7
Meta-analysis forest plot of the effect of creatine supplementation on attention time.
Figure 8
Figure 8
Meta-analysis forest plot of the effect of creatine supplementation on memory function.
Figure 9
Figure 9
Meta-analysis forest plot of the effect of creatine supplementation on processing speed scores.
Figure 10
Figure 10
Meta-analysis forest plot of the effect of creatine supplementation on processing speed time.
Figure 11
Figure 11
Sensitivity analysis chart of global cognitive function.
Figure 12
Figure 12
Sensitivity analysis chart of memory.
Figure 13
Figure 13
Sensitivity analysis chart of executive function.
Figure 14
Figure 14
Sensitivity analysis chart of executive function time.
Figure 15
Figure 15
Sensitivity analysis chart of attention.
Figure 16
Figure 16
Sensitivity analysis chart of attention time.
Figure 17
Figure 17
Sensitivity analysis chart of processing speed.
Figure 18
Figure 18
Sensitivity analysis chart of processing speed time.
See this image and copyright information in PMC

References

    1. Bonilla DA, Kreider RB, Stout JR, Forero DA, Kerksick CM, Roberts MD, et al. . Metabolic basis of creatine in health and disease: a bioinformatics-assisted review. Nutrients. (2021) 13:1238. doi: 10.3390/nu13041238, PMID: - DOI - PMC - PubMed
    1. Brosnan JT, da Silva RP, Brosnan ME. The metabolic burden of creatine synthesis. Amino Acids. (2011) 40:1325–31. doi: 10.1007/s00726-011-0853-y - DOI - PubMed
    1. Hespel P, op ‘t Eijnde B, Derave W, Richter EA. Creatine supplementation: exploring the role of the creatine kinase/phosphocreatine system in human muscle. Can J Appl Physiol. (2001) 26:S79–S102. doi: 10.1139/h2001-045, PMID: - DOI - PubMed
    1. Kreider RB, Stout JR. Creatine in health and disease. Nutrients. (2021) 13:2. doi: 10.3390/nu13020447, PMID: - DOI - PMC - PubMed
    1. Rackayova V, Cudalbu C, Pouwels PJW, Braissant O. Creatine in the central nervous system: from magnetic resonance spectroscopy to creatine deficiencies. Anal Biochem. (2017) 529:144–57. doi: 10.1016/j.ab.2016.11.007, PMID: - DOI - PubMed

Publication types

LinkOut - more resources