Creatine monohydrate pilot in Alzheimer's: Feasibility, brain creatine, and cognition.
Level 4 - case-series / case-control
Single-arm uncontrolled intervention study (case series / before-and-after pilot study)
PubMed 40395689 · doi:10.1002/trc2.70101
What was done
In an 8-week, single-arm pilot trial (NCT05383833), 20 patients with Alzheimer's disease received 20 g/day of oral creatine monohydrate. Feasibility was evaluated via compliance monitoring. Investigators measured serum creatine at baseline, 4 weeks, and 8 weeks, as well as brain total creatine (tCr) and cognitive function (NIH Toolbox, MMSE) at baseline and 8 weeks.
What was found
Nineteen participants reached >=80% compliance. Serum creatine was elevated at 4 and 8 weeks (p < .001) and brain tCr increased by 11% (p < .001). Cognitive scores improved on global (p = .02) and fluid (p = .004) composites, List Sorting (p = .001), Oral Reading (p < .001), and Flanker (p = .05) tests. Absolute cognitive baseline and follow-up values were not reported in the abstract.
Why it matters
This study provides initial clinical evidence that high-dose oral creatine monohydrate is feasible and can elevate brain total creatine levels in patients with Alzheimer's disease.
Limits
The study was single-arm with no control or placebo group, meaning cognitive improvements may reflect practice effects. The sample size was small (n = 20), duration was short (8 weeks), and adverse events or raw cognitive scores were not detailed in the abstract.