Summary
Interest in creatine as a potential cognitive enhancer has grown due to its key role in brain energy metabolism, so researchers conducted a PRISMA-guided systematic review and meta-analysis of randomized controlled trials published from 1993 to 2024. Sixteen trials involving 492 adults—ranging from young adults to older individuals and including both healthy participants and those with medical conditions—were included, all using creatine monohydrate. The pooled results show that creatine supplementation significantly improved memory, attention time, and information processing speed, with effect sizes in the small-to-moderate range. However, creatine did not produce significant benefits for overall cognitive performance or executive function. Subgroup analyses suggested that adults aged 18–60, women, and individuals with certain diseases may experience stronger cognitive benefits. Short-term and longer-term supplementation appeared similarly effective. Overall, the risk of bias was low to moderate, and evidence quality ranged from moderate (for memory) to low (for other domains), indicating that while creatine shows promise—especially for memory—more large, well-designed trials are needed to confirm its broader cognitive effects and clarify underlying mechanisms.
PMID: 39070254
PMCID: PMC11275561
DOI: 10.3389/fnut.2024.1424972
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.
Xu C, Bi S, Zhang W, Luo L. The effects of creatine supplementation on cognitive function in adults: a systematic review and meta-analysis. Front Nutr. 2024 Jul 12;11:1424972. doi: 10.3389/fnut.2024.1424972. Erratum in: Front Nutr. 2025 Feb 17;12:1570800. doi: 10.3389/fnut.2025.1570800. PMID: 39070254; PMCID: PMC11275561.