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Creatine and strength training in older adults: an update
Abstract
Aging is associated with numerous physiological, musculoskeletal, and neurological impairments including a loss of muscle, strength, function, bone mineral, and cognition. Strength training is an effective intervention to counter these age-associated declines. In addition, creatine supplementation is purported to enhance strength training gains in lean tissue mass, muscular strength, and function. There is emerging evidence that creatine combined with strength training can alter bone geometry and cognitive performance. The purpose of this review is to update previous meta-analyses examining creatine combined with strength training on lean tissue mass and bone density compared to strength training and placebo. A secondary purpose was to explore the effects of creatine and strength training on cognition. Updated meta-analyses revealed that creatine enhances lean tissue mass (mean difference [MD]: 1.18 kg, 95 % CI: 0.70–1.67; p<0.00001) and upper body muscular strength (standard mean difference [SMD]: 0.24, 95 % CI: 0.05–0.43; p=0.02) compared to strength training and placebo. Creatine combined with strength training had no greater effects compared to strength training and placebo on lower body muscular strength (SMD: 0.17, 95 % CI: −0.03–0.38; p=0.09), whole-body (MD: −0.00 g cm −2 ; 95 % CI: −0.01–0.00, p=0.32), femoral neck (MD: −0.00 g cm −2 ; 95 % CI: −0.01–0.00, p=1.00), or lumbar bone mineral density (MD: 0.00 g cm −2 , 95 % CI: −0.01–0.01; p=045). There is preliminary evidence that combining strength training and creatine is an effective strategy to improve bone geometry in postmenopausal females and cognitive function in older adults. Overall, the combination of creatine and strength training has favorable effects on lean tissue mass and upper body strength. In contrast, creatine combined with strength training does not enhance lower-body strength or bone mineral.
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“CrM consistently improves chest press and/or bench press strength [18,90,91,93–97] compared to resistance training alone”
From Creatine monohydrate supplementation for older adults and clinical populations (2025) · cites this paper as [90]
In the citing paper
“Forbes and Candow [90] failed to find a statistical improvement in lower-body strength from CrM compared to placebo in 663 healthy older adults (SMD: 0.17; 95% CI: −0.03 to 0.38; p = 0.09).”
From Creatine monohydrate supplementation for older adults and clinical populations (2025) · cites this paper as [90]
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“Several meta-analyses have been performed showing that the combination of CrM (≥5 grams/day) and resistance training improves measures of muscle strength [18,90–92], a key factor in the diagnosis of sarcopenia in older adults.”
From Creatine monohydrate supplementation for older adults and clinical populations (2025) · cites this paper as [90]
In the citing paper
“The most recent meta-analysis involving CrM and resistance training in older adults (n = 1063) showed that CrM significantly improved upper-body strength (Standardized mean difference [SMD]: 0.24, 95% CI: 0.05 to −0.43; p = 0.02) compared to resistance training alone [90].”
From Creatine monohydrate supplementation for older adults and clinical populations (2025) · cites this paper as [90]
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“Importantly, creatine in the recommended doses is safe [63] and despite numerous misconceptions [64], creatine in addition to strength training is an e ff ective strategy in older adults.”
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Self-citationEffect of creatine and weight training on muscle creatine and performance in vegetarians
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Cited by
Creatine monohydrate supplementation for older adults and clinical populations
Candow, D. G., Ostojic, S. M., Chilibeck, P. D., Longobardi, I., Gualano, B., Tarnopolsky, M. A., Wallimann, T., Moriarty, T., Kreider, R. B., Forbes, S. C., et al. (2025) · Journal of the International Society of Sports Nutrition · doi:10.1080/15502783.2025.2534130 · Cited by 43
Self-citationAntonio, J., Brown, A. F., Candow, D. G., Chilibeck, P. D., Ellery, S. J., Forbes, S. C., Gualano, B., Jagim, A. R., Kerksick, C., Kreider, R. B., et al. (2025) · Journal of the International Society of Sports Nutrition · doi:10.1080/15502783.2024.2441760 · Cited by 33
Self-citation
Metadata
- Authors
- Forbes, S. C., & Candow, D. G.
- Affiliations
- Department of Physical Education Studies , 1916 Brandon University , Brandon , MB , Canada
- Faculty of Kinesiology and Health Studies , University of Regina , Regina , SK , Canada
- ORCID
- Forbes, Scott C.
- Venue
- Translational Exercise Biomedicine
- Publisher
- Walter de Gruyter GmbH
- Published
- 2024-09-01
- Volume
- 1
- Issue
- 3-4
- Pages
- 212-222
- ISSN
- 2942-6812
- Cited by
- 10
- References
- 21
- Language
- en
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