Can Creatine Decrease the Risk of Alzheimer’s?

 by Mark Terry

Health influencers, body builders and CrossFitters really like creatine as a safe and reliable supplement — I mean, they really, really like it. Made up of three amino acids, it’s generally found in the muscles, although also found in the brain. People usually get it by eating seafood and red meat, and your liver, pancreas and kidneys can generate about one gram a day.

The idea is that it helps increase strength, helping in exercise recovery, and maybe even in injury prevention. It probably also gives you strong bones and a glossy coat (results may vary).

There is also the suggestion that it might improve cognition, especially in older adults.

A new, very small study out of the University of Kansas suggested it might improve cognition and Alzheimer’s disease biomarkers. The study was published in Alzheimer’s & Dementia Translational Research & Clinical Interventions.

So this study took 20 patients with Alzheimer’s disease between the ages of 60 and 90. All of the patients were already taking a stable dose of Alzheimer’s drug, such as donepezil (Aricept) or memantine (Namenda), for at least 30 days. A bunch of cognitive tests and some biomarker tests were conducted, such as the Mini-Mental State Examination (MMSE), a leg strength test, and although it wasn’t part of eligibility, measured plasma phosphorylated tau-217 (p-tau217).

The study excluded patients with insulin-requiring diabetes, chemotherapy or radiation in the last five years, a cardiac event in the last year, other neurodegenerative disease, inability to receive an MRI, or having participated in a clinical study or investigation drug or therapy in the last 30 days.

The patients were then given 20 grams of creatine monohydrate for eight weeks, split into two 10-gram doses. The participants or their caregivers stirred the creatine powder into whatever beverages they chose. Nineteen of the 20 participants had 80% or better compliance.

The findings: Serum creatine was increased at four and eight weeks and brain total creatine (tCr) increased by 11%. More importantly, in terms of what this study was all about, cognition improved on global and fluid composites, List Sorting, Oral Reading, and Flanker tests, although the authors caution, “Because this was a single-arm trial, we cannot rule out the possibility that improvements may be the results of artifact (test-retest, placebo, and so on). These results merely provide preliminary support for our hypothesis that CRM may be beneficial for cognitive function in AD….”

Conclusions? Well, one, creatine monohydrate supplementation was possible, the patients were generally compliant. Two, it was linked to increased brain total creatine. Three, it was associated with improvements in cognition although there were limitations. And four, they think its efficacy in Alzheimer’s should be studied more.

Part of the rationale for the study was that Alzheimer’s is associated with broken (impaired) brain energy metabolism, which includes the creatine system (although that’s only part of it). Other studies, especially studies in mice, have found that creatine supplements improve cognition and brain energy metabolism while decreasing biomarkers like beta-amyloid and p-tau.

No real clinical trials have been run on using creatine as an adjuvant (additional) therapy for Alzheimer’s patients. This is one of several studies suggesting it helps, and the overall body of studies supporting creatine as being safe is very large.

So it’s safe. It’s found in food, but you’d have to eat about two pounds of red meat or seafood a day to hit 5 grams. Might it help your brain? Seems like it might. Will it help you build muscle and recover from workouts (assuming you’re doing any)? The evidence seems pretty good.

Does this study indicate it will help Alzheimer’s patients? Well, it doesn’t seem to hurt them anyway. You almost always have to question any real improved cognition in a study that only looked at 20 people for two months. The placebo effect could be very real.

So it seems to fall into the category of “won’t hurt, might help.”

But, as Angel Planells, spokesperson for the Academy of Nutrition and Dietetics and a Seattle-based dietitian, told Axios, “A supplement isn’t a cure-all, fix-all.”

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