Eight weeks of creatine monohydrate supplementation is associated with increased muscle strength and size in Alzheimer's disease: data from a single-arm pilot study.
Level 4 - case-series / case-control
Single-arm pilot trial without a control group (pre-post design)
PubMed 40977987 · doi:10.3389/fnut.2025.1670641
What was done
In a single-arm pilot trial, 20 participants with Alzheimer's disease received 8 weeks of creatine monohydrate supplementation (20 g/day). Outcomes assessed at baseline and 8 weeks included dominant handgrip strength (n = 20), lower body strength by leg dynamometry at three velocities (n = 10), muscle cross-sectional area (mCSA) and muscle thickness of the rectus femoris, vastus medialis, and vastus lateralis by ultrasound (n = 18), subcutaneous fat (n = 18), and neuromuscular junction integrity via plasma C-terminal agrin fragment (CAF) levels (n = 19).
What was found
Following 8 weeks, mean handgrip strength increased by 1.9 kg from baseline (p = 0.02). Lower leg strength showed no change across any velocity among the 10 participants tested. Rectus femoris mCSA (p = 0.03) and vastus medialis mCSA (p = 0.01) increased, while muscle thickness did not significantly change in the rectus femoris (p = 0.41), vastus medialis (p = 0.37), or vastus lateralis (p = 0.17). Subcutaneous fat decreased in the rectus femoris (p = 0.006) and vastus lateralis regions (p = 0.003), but not the vastus medialis (p = 0.52). Plasma CAF levels did not change significantly (p = 0.46).
Why it matters
This pilot study provides initial feasibility data suggesting high-dose creatine supplementation may support specific muscular outcomes in individuals with Alzheimer's disease, establishing a preliminary basis for controlled trials.
Limits
The study is limited by a small sample size (n = 20, with only 10 completing leg dynamometry) and the absence of a control or placebo group. Long-term functional performance and cognitive outcomes were not reported in the abstract.