The Additive Effects of Creatine Supplementation and Exercise Training in an Aging Population: A Systematic Review of Randomized Controlled Trials.
Level 1 - systematic review of randomized trials
Systematic review of randomized controlled trials
PubMed 30762623 · doi:10.1519/JPT.0000000000000222
What was done
This systematic review searched PubMed, CINAHL, and Web of Science for randomized controlled trials assessing whether creatine supplementation combined with exercise provides additive improvements in muscle, bone, and mental health compared to exercise alone in healthy older adults. Two reviewers independently screened studies and appraised quality using the Physiotherapy Evidence Database (PEDro) scale.
What was found
Seventeen randomized controlled trials were reviewed across categories of strength, endurance, functional capacity, body composition, cognition, and safety. The abstract reports no numerical effect sizes or statistical values. Reported qualitative findings suggest additive gains in upper- and lower-body strength, functional capacity, and lean mass require continuous daily low-dose creatine combined with at least 12 weeks of resistance training. Regional increases in femoral bone mineral density may require at least 1 year of supplementation. Beneficial effects appeared more consistent in older women than men. Creatine showed no additive benefit over exercise alone on mental health indices, and creatine monohydrate was safe.
Why it matters
It indicates that creatine-derived musculoskeletal gains in older populations require sustained daily dosing alongside at least 12 weeks of structured resistance training.
Limits
The abstract provides only qualitative conclusions without quantitative effect sizes, confidence intervals, or total participant sample size. Long-term bone data and evidence for cognitive outcomes were limited.