Study
Creatine supplementation for older adults: Focus on sarcopenia, osteoporosis, frailty and Cachexia
This narrative review concludes that creatine monohydrate benefits ageing muscle and bone mainly when combined with resistance training, and reports no adverse kidney or liver effects.
Darren Candow and five co-authors reviewed creatine supplementation in older adults across four conditions: sarcopenia, osteoporosis, frailty and cachexia. It is a narrative review. No search protocol, study count, participant total, pooled dose or pooled duration is reported, and no effect sizes, confidence intervals or p-values are given.
The stated findings are qualitative. Creatine combined with resistance exercise increases lean body mass and muscle strength in older adults. Creatine reduces markers of bone breakdown, including urinary excretion of specific collagen markers, which the authors offer as a partial explanation for early improvements in bone density and strength. Creatine increases bone area and strength and slows bone mineral loss. No negative effects on kidney or liver health are associated with supplementation.
The authors are explicit on one point: these bone and muscle advantages do not persist without exercise. They frame creatine as a candidate treatment for frailty and cachexia, populations that include people with cancer, chronic kidney disease and heart failure, while stating that research in those specific clinical areas remains limited. Context given: sarcopenia affects roughly 5 to 17% of community-dwelling older adults and 14 to 85% of those in long-term care, and by 2050 there will be 1.5 billion people aged 65 and over.
There is evidence that creatine monohydrate supplementation, primarily when combined with resistance training, has favorable effects on indices of aging muscle and bone.
Narrative review, not a systematic review or meta-analysis, so it sits below the pooled analyses in evidence weight despite tier 1 placement for scope. No numbers: no N, no dose, no duration, no effect sizes, no confidence intervals. Selection of cited studies is not reproducible. Conflicts of interest are substantial. Darren Candow, Bruno Gualano and Hamilton Roschel have run industry-sponsored creatine research and received creatine and travel support for conference presentations. Candow has also served as an expert witness or consultant in creatine matters. Candow and Gualano sit on the Scientific Advisory Board of Alzchem, a creatine manufacturer. The frailty and cachexia recommendations are explicitly labelled as rationale rather than demonstrated outcomes, since the authors state research in those areas remains limited. Benefits are conditional on resistance training.
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