Creatine for Alzheimer's? Results of a New Study

A recent study is the first to study the use of creatine in Alzheimer's disease

By Austin Perlmutter, MD

Creatine

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Can Creatine Supplementation improve brain function in Alzheimer’s? Today we’re exploring the results of a just-published clinical trial showing this may be the case.

For background on creatine and this study, several recent publications have discussed creatine’s value for brain health due to its potential to primarily boost brain metabolism and potentially, to improve the immune system. As it relates to Alzheimer’s disease, this is the most common form of dementia, making up roughly 70% of dementia cases worldwide.

Based on the most current research, roughly 40% of Alzheimer’s cases are thought to be preventable. However, we’re now seeing that one of the most potentially powerful pathways we may be able to target relates to brain metabolism. A number of studies have shown that in the brains of people with Alzheimer’s, there are changes in brain glucose use. This has lead some researchers to call the disease “type 3 diabetes,” and undergirds the idea that boosting alternate fuel sources to the brain like ketones may prove therapeutic. So how does this get us to creatine?

We know that supplemental creatine increases levels of creatine in the body and the brain dramatically. But it’s never been tested in an interventional trial for Alzheimer’s disease. In this study, published in Alzheimer’s & Dementia: Translational Research & Clinical Interventions, a team of researchers wanted to look at creatine monohydrate supplementation in individuals with Alzheimer’s disease (AD). This pilot study, published on May 19, 2025, investigates the feasibility and effects of administering 20 grams per day of creatine monohydrate over an eight-week period to patients with a high likelihood of Alzheimer’s based on clinical and laboratory criteria.

One of the main outcomes of interest was to see if supplementation with creatine monohydrate elevated brain creatine. This is important, as many supplements may not be able to reach the brain, and when it comes to creatine, it’s key to show that any cognitive benefits are tethered to actual penetration of the blood-brain barrier. In this study, they showed that using advanced MR imaging, 85 percent of the participants showed increases in brain creatine levels, on average by 11 percent, with variability that the researchers said could be explained in part by changes in transport across the blood-brain barrier. This is the first time that research has demonstrated that supplementing creatine can increase brain creatine in people with Alzheimer’s disease.

When it came to the cognitive effects of creatine supplementation, they found statistically significant improvements in overall cognitive scores, fluid cognition, a working memory and reading recognition test, with a trend towards improvement in an inhibitory control and attention test, and no changes in crystalized cognition, picture memory, crystallized cognition, and other tests. They also didn’t see an improvement in the mini-mental status test, which is a standard test used in the clinic to look for cognitive impairment. Notably, when they compared the cognitive tests against brain creatine to see if changes in cognition correlated with brain creatine levels, they found significance only for oral reading recognition and crystallized cognition.

To summarize, after eight weeks of supplementation with 20 grams of creatine in patients with Alzheimer’s disease, researchers showed increases in brain creatine levels and improvements across several cognitive tests, with a small signal that some of these changes correlated with the brain creatine changes.

What does all this mean? First, the caveats. This was a very small study; it wasn’t placebo-controlled. It wasn’t blinded. Any major conclusions here would need to be further substantiated with, ideally, scaled, randomized, placebo-controlled trials. However, in the context of strong mechanistic support for creatine as a potential brain-enhancing molecule, these findings are promising and certainly worth our attention.