The effects of creatine supplementation on cognitive function in adults: a systematic review and meta-analysis.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of randomized controlled trials
PubMed 39070254 · doi:10.3389/fnut.2024.1424972
What was done
Following PRISMA guidelines, this systematic review and meta-analysis evaluated 16 randomized controlled trials published between 1993 and 2024 examining creatine monohydrate supplementation on cognitive function in 492 adults aged 20.8 to 76.4 years, including both healthy individuals and patients with specific diseases. Effects on overall cognitive function, memory, executive function, attention, and information processing speed were evaluated using standardized mean differences (SMD) and Hedges's g with 95% confidence intervals, alongside GRADE certainty assessments.
What was found
Creatine supplementation showed significant positive effects on memory (SMD = 0.31, 95% CI: 0.18 to 0.44; Hedges's g = 0.3003, 95% CI: 0.1778 to 0.4228), attention time (SMD = -0.31, 95% CI: -0.58 to -0.03; Hedges's g = -0.3004, 95% CI: -0.5719 to -0.0289), and 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). No significant improvements were found for overall cognitive function or executive function. Subgroup analyses indicated greater benefit in females, individuals aged 18 to 60 years, and those with diseases. No significant differences appeared between interventions lasting less than 4 weeks versus 4 weeks or longer.
Why it matters
This meta-analysis demonstrates that creatine monohydrate produces modest, domain-specific improvements in memory, attention, and processing speed rather than generalized cognitive enhancement.
Limits
The total sample across 16 trials is modest at 492 participants, limiting precision across sub-analyses. The pooled population was heterogeneous, combining healthy adults with diverse clinical patient cohorts across an age range of 20.8 to 76.4 years. Included trials demonstrated low-to-moderate risk of bias. According to GRADE assessment, evidence certainty was moderate for memory and low for processing speed, attention, executive function, and overall cognitive function.