Supplements · Metabolic & Cardiometabolic
creatine improves physical function in older adults
In plain terms: Can creatine help older adults stay strong and mobile?
Part of: 🧪 creatine
Yes for strength and muscle when combined with resistance training, which everyday tasks rely on. Trials measuring everyday function directly are fewer and less consistent, so the benefit to function itself is less certain.
🧭 Read this score with how it was built in mindWe re-read the papers behind these claims and corrected how each one is counted
Up to strong support on the score, and the summary tells you what carries it: meta-analyses of creatine plus resistance training show more lean mass and more strength than training alone. The trials that measured everyday function directly (chair rises, walking, stair climbing) are mixed. Two supporting analyses come from one research network and are counted once. Until indirect evidence has its own rule, read this as 'strong for strength and muscle, unsettled for function'.
🧭 Read this score with how it was built in mindWe re-read the papers behind these claims and corrected which ones are entitled to count
In August the two supporting analyses from one commercially-linked research network were merged so they vote once. The verdict did not move then; it moved in September for a different reason, described in the note for that wave.
🧭 Read this score with how it was built in mindStudies that measured a neighbour of the claim can no longer carry a strong verdict
Seven of the ten counting studies pooled strength or lean mass rather than a test of everyday function, or tested creatine combined with HMB. The two that measured function directly disagree: one small pooled analysis found a better chair-stand result, a larger one found no added benefit.
📅 Last reviewed: 2026-07-14 ⓘ
Evidence ladder
How far up the ladder this claim has climbed. A high consensus on a low rung means "consistent so far," not "proven in people."
Top evidence so far: All trials, pooled (Meta-analysis)
How the studies fall
What the evidence shows
Creatine with resistance/weight-bearing training improves physical function in older adults. The raw score reads strong, but the headline is capped to leans-support because more than half of the weight is carried by strength and lean-mass surrogates, now marked indirect: meta-analyses of creatine plus training versus training alone find roughly 1.3-2.
The evidence (15)
| Source | Grade | Stance | Quality | Finding |
|---|---|---|---|---|
| Naddafha S, Antonio J, Kreider RB, Stout JR 2026 · J Int Soc Sports Nutr | meta-analysis | contradicts | low | [Clean null on a directional 'improves function' claim = contradicts] Function narrated, NOT pooled (secondary outcome in 2-4 of 7 RCTs, postmenopausal women ~62 y): 'For the timed up-and-go (TUG) test, two studies reported small improvements over time with resistance training, with no additional benefit of creatine versus placebo' - in Lobo's trial 'both groups improved TUG by ~0.5 s, with no between-group difference'; chair-rise 'creatine did not augment training-related gains'; 12-min walk 'increased similarly in both groups'; falls ~25% in each arm (p=0.8). Single exception: Chilibeck 2023 'reported a significantly greater increase in walking speed for the creatine group'. Authors' GRADE: 'Physical function-low certainty ... an effect cannot be distinguished from the absence of evidence.' Lean-mass (+0.37 kg) and leg-press (+7.5 kg) results belong to other endpoints. |
| Devries MC, Phillips SM 2014 · Med Sci Sports Exerc | meta-analysis | supports | low | Meta-analysis of randomized placebo-controlled trials, 357 older adults (~64 yr), 12.6 ± 4.9 wk of resistance training. The functional endpoint was pooled directly: 'Cr + RT had a greater effect than RT alone on the 30-s chair stand test (P = 0.03).' Body composition and compound-lift strength also favoured creatine, but four strength endpoints (knee extension and biceps curl 1RM, isokinetic and isometric knee extension peak torque) were null. Authors caveat: 'the limited number of studies indicates further work is needed.' |
| Sharifian G, Aseminia P, Heidary D, Esformes JI 2025 · Eur Rev Aging Phys Act | meta-analysis | supports | moderate | INDIRECT (strength surrogate; no functional test was pooled). MA of creatine + exercise vs placebo + exercise in older adults (20 articles / 1093 participants; discussion says 18 RCTs). Outcomes 'selected for meta-analysis were one-repetition maximum (1RM), fat percentage, and bone mineral density (BMD)': 1RM 'mean difference = 2.122, Z = 3.255, P = 0.001' (I2 0%; significant for leg press and lat pull-down, not arm curl, bench or chest press). The authors' 'functional performance' conclusion rests on 1RM. Authors: 'the included studies were of moderate quality according to the Cochrane RoB 2 tool, the results of the present study should be interpreted with caution.' |
| Fernandez-Garrido J, Martin EG, Saez-Berlanga A, Gargallo-Bayo P, Gene-Morales J, Alix-Fages C, Jiménez-Martínez P, Caballero O, Salvador-Palmer R, Colado JC 2026 · Experimental Gerontology | RCT | supports | low | 16-wk randomized, double-blind, placebo-controlled trial (NCT06620666), 103 older adults (68.2 +/- 4.6 y) in six arms crossing elastic-band / aquatic / no-training with creatine 3 g/d or placebo (~17 per cell). Physical function was measured by timed up-and-go, 30-s chair-stand and 6-min walk. 'Creatine provided additional benefits, increasing GPx, reducing IL-6/TNF-alpha and improving strength and function when combined with exercise modalities.' Two cautions on the prior wording: the p<0.05 in the abstract attaches to the TRAINING effect ('Both training modalities produced significant improvements ...'), not to the creatine contrast, which is reported narratively without statistics; and the creatine function benefit is stated only in combination with exercise - the creatine-alone arm's reported gains were F2-isoprostanes, TNF-alpha and perceived health, so creatine monotherapy on physical function is the paper does not say from the abstract. Product and publication charges supplied by creatine manufacturer AlzChem Group AG. |
| Ramos-Hernández R, Mielgo-Ayuso J, Fernández-Lázaro D, Abia A, Pérez-López JF, Saiz-Rodríguez M, Busto N 2026 · Biogerontology | RCT | tested-null | low | Secondary analysis of a 30-person (62.7 y) randomized crossover trial of 3 g/day creatine + 3 g/day HMB vs placebo during training. 'Primary endpoints were oxidized glutathione and the Glutathione Redox Index'; functional tests 'were not analyzed as efficacy outcomes. Instead, they were used exclusively to derive percent changes (Δ%) for exploratory associations with redox biomarkers', and 'no absolute values or efficacy interpretations are reported, as these have been previously published for this cohort'. Redox effects did not survive FDR adjustment. Off-scope for function; the cohort's function efficacy votes via s41511610. Combination product (creatine + HMB). |
| Forbes SC, Candow DG, Ostojic SM, Roberts MD, Chilibeck PD 2021 · Nutrients | meta-analysis | supports | moderate | INDIRECT (surrogates only - no physical-function outcome pooled). Candow-network MA updating the group's 2017 MA: creatine + RT vs placebo + RT in adults >50; lean tissue mass '16 RCTs with 18 treatment arms ( n = 509) ... mean difference = 1.32 kg [95% CI: 0.93, 1.72]'; chest press SMD 0.28 [0.09, 0.47] (17 RCTs, n=456); leg press 'standard mean difference = 0.20 [95% CI: 0.00, 0.39] p = 0.05'. Leg/chest press gains lost significance when loading-phase trials were excluded. Fixed-effects model; funnel plots inspected visually only; authors report creatine-industry ties. |
| Li N 2025 · Frontiers in nutrition | observational | supports | low | Narrative review: creatine + resistance training significantly improves muscle strength, lean mass, and functional capacity in older adults; cognitive effects modest and secondary. |
| Dos Santos EEP, de Araújo RC, Candow DG, Forbes SC, Guijo JA, de Almeida Santana CC, Prado WLD, Botero JP 2021 · Nutrients | meta-analysis | mixed | low | Meta-analysis of 8 RCTs, n = 176 older females, creatine + RT vs placebo + RT, 12-52 weeks. NO functional endpoint was pooled - the outcomes were 1RM chest/leg press strength and muscle mass; the link to daily function is the authors' discussion-level inference from an external citation, not a measured result. Mixed on what it did measure: 'Overall, Cr significantly increased measures of upper-body strength (7 studies, n = 142, p = 0.04), with no effect on lower-body strength or measures of muscle mass.' The muscle-mass result is explicitly null - 'Cr, independent of study duration, had no effect on measures of muscle mass ( Figure 4 )' - correcting the previous extract, which claimed creatine improved muscle mass. Authors' conclusion: 'Cr + RT in a small cohort of older females enhanced muscle strength when the duration was at least 24 weeks; however, there was no effect on muscle mass. Overall, the certainty of the evidence is low.' Quality set to low to match that GRADE rating. |
| Ramos-Hernández R, Busto N, Miguel-Ortega Á, Martínez-Ferrán M, Santamaría-Peláez M, Saiz-Rodríguez M, Mielgo-Ayuso J 2026 · Aging clinical and experimental research | RCT | supports | moderate | 30 physically active older adults (≥60y), randomized double-blind placebo-controlled crossover, 6wk creatine+HMB vs placebo during supervised multicomponent exercise: significant improvements in gait speed, sit-to-stand, TUG, and 400m walk |
| Chilibeck PD, Kaviani M, Candow DG, Zello GA 2017 · Open Access J Sports Med | meta-analysis | supports | moderate | INDIRECT (surrogates only - no physical-function outcome pooled). Candow-network MA of 22 RCTs, 721 older adults (mean 57-70 y), creatine vs placebo during RT for 7-52 weeks: 'lean tissue mass (mean difference =1.37 kg [95% CI =0.97–1.76]; p <0.00001), chest press strength (standardized mean difference [SMD] =0.35 [0.16–0.53]; p =0.0002), and leg press strength (SMD =0.24 [0.05–0.43]; p =0.01)'. Five of 22 trials combined creatine with protein or CLA. Largely re-pooled in the group's 2021 update (s34199420). |
| Chen KH, Yeh TP, Lin SC, Liu PJ, Bai D, Chen IH 2026 · Int J Med Sci | meta-analysis | mixed | low | SR/MA pooling protein, amino acids and creatine plus exercise in women 33-67 y. Bench press g=0.279 (0.008 to 0.550), handgrip g=0.412 (0.039 to 0.786), leg press g=0.201 (-0.081 to 0.483), all pooled across supplement types; creatine attribution for bench press is narrative (3 of 4 studies). |
| Gielen E, Beckwée D, Delaere A, De Breucker S, Vandewoude M, Bautmans I, Sarcopenia Guidelines Development Group of the Belgian Society of Gerontology and Geriatrics (BSGG) 2021 · Nutr Rev | meta-analysis | supports | low | Umbrella review whose units are systematic reviews: 'A total of 15 systematic reviews were included. The following supplements were examined: proteins, essential amino acids, leucine, β-hydroxy-β-methylbutyrate, creatine, and multinutrient supplementation'. Abstract's best-supported recommendation is leucine; creatine direction not stated in abstract. Review — zero weight. |
| Davies TW, Watson N, Pilkington JJ, McClelland TJ, Azzopardi G, Pearse RM, Prowle J, Puthucheary Z 2024 · JPEN J Parenter Enteral Nutr | meta-analysis | supports | low | SR/MA of 33 RCTs (1076 participants; older adults AND adults with chronic disease - partly a proxy population; training not required). Primary outcome sit-to-stand: 'From six trials reporting the primary outcome, the pooled standardized mean difference (SMD) was 0.51 (95% confidence interval [CI]: 0.01-1.00; I 2 = 62%; P = 0.04); using weakly informative priors, the posterior probability that creatine supplementation improves physical function was 66.7%.' Small, imprecise, but the interval excludes zero - supports. Authors: 'The quality of evidence for all outcomes was low or very low because of a high risk of bias.' (Abstract-grade record.) |
| Choi M, Kim H, Bae J 2021 · BMC Geriatr | meta-analysis | supports | moderate | SR/MA of 22 RCTs in older adults: resistance training + a nutritional intervention vs training alone. Creatine subgroup: lean body mass MD +2.61 kg (95% CI 0.51 to 4.72; 4 trials, I2 9%) and knee-extension strength SMD 0.74 (0.09 to 1.38; 2 trials); no creatine-specific chair-stand or timed-up-and-go estimate reported. The overall null (e.g. chair stand MD -0.13, -0.43 to 0.17; 7 trials) pools protein, multi-nutrient, omega-3, vitamin and other supplements - off-object for creatine. Authors: 'Only creatine showed synergistic effects with resistance training on muscle mass.' Creatine-specific findings all favour the claim, but on surrogates (lean mass, strength) rather than physical function itself: supports, indirect. |
| Al-Humadi S, Kohut K, Denard PJ 2026 · Cureus | observational | supports | low | Narrative review: in older adults, creatine supplementation with resistance training has been shown to increase muscle mass and strength in some studies; no adverse renal effects noted. |
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