Creatine for Healthy Aging: More Than Muscle

Written by: Diego A. Bonilla and Jeffrey R. Stout

IN THIS ARTICLE

1. Why the conversation now goes beyond muscle
2. Where the evidence is strongest
3. Brain health and fatigue resistance
4. Female health, male fertility, and cardiovascular health
5. Safety, dosage, and context
6. The take-home message

The literature on creatine and aging now spans strength, recovery, cognition, safety, and sex-specific health, but the evidence is stronger for some outcomes than others.

Why the conversation now goes beyond muscle

Healthy aging is not only about living longer. It is about maintaining the strength, recovery capacity, physical energy, and cognitive function that support independence. Creatine monohydrate is often discussed as a sport supplement, but in older adults, the conversation is broader. As Figure 1 suggests, interest now extends from muscle and exercise capacity to cognition, fatigue, sex-specific health, cardiovascular function, and long-term safety.

Figure 1. Conceptual overview of the domains commonly linked to creatine monohydrate in the healthy-aging conversation, including female health, energy, recovery, clinical safety, male fertility, anti-fatigue symptoms, cognitive function, and cardiovascular health. In older adults, the strongest evidence remains in muscle strength, lean mass, exercise capacity, recovery, and safety, particularly when creatine is paired with resistance training. Taken from: https://doi.org/10.3389/fphys.2024.1496544

Where the evidence is strongest

Among older adults, the most consistent evidence remains in the musculoskeletal domain. When creatine is combined with resistance training, studies generally show greater improvements in muscle strength, lean mass, and physical function than resistance training alone [1,2]. European Food Safety Authority (EFSA) has likewise concluded that daily creatine can enhance the effect of resistance training on muscle strength in adults over 55 [3].

That is also the clearest way to interpret the figure’s references to energy, recovery, and anti-fatigue symptoms. Creatine helps buffer rapid ATP turnover during repeated muscular work, which may help older adults tolerate training, recover between sessions, and sustain the exercise stimulus needed to preserve function over time [2,6]. In practice, its value is less about “anti-aging” and more about helping people keep doing the work that protects mobility and independence.

Brain health and fatigue resistance

The brain also depends heavily on the creatine-phosphocreatine system for cellular energy, which has led to growing interest in cognitive outcomes [5,6,7]. Emerging data suggest supplementation may support aspects of memory, attention, or processing speed, particularly in older adults or under conditions of metabolic stress [5,7]. At the same time, this literature is still more heterogeneous than the work on strength and lean mass. A careful public-facing message is that cognitive function is promising, but not yet as established as the musculoskeletal evidence. The good news is that there is ongoing clinical research from the laboratories of scientific advisory board members at Creatine For Health that will further contribute to this area of study.

A similar nuance applies to fatigue-related outcomes. Reduced perceived fatigue and better exercise tolerance are plausible and sometimes observed, but they are best interpreted as extensions of improved training capacity rather than as stand-alone universal effects [6].

Female health, male fertility, and cardiovascular health

Figure 1 also highlights female health, male fertility, and cardiovascular health. These are part of a broader and expanding creatine literature, but they do not all carry the same level of direct evidence in older-adult trials. In women, especially during midlife and menopause, creatine has attracted attention as a possible adjunct to exercise for preserving lean mass and strength, with additional interest in bone, fatigue, mood, and cognitive outcomes [4]. This is a scientifically important area, but still a developing one.

Cardiovascular health and male reproductive outcomes are better understood as emerging or population-specific lines of inquiry than as established healthy-aging endpoints for every older adult [6,8]. Including them in the figure is reasonable if readers understand that they reflect the breadth of creatine research, not equal certainty across all outcomes.

The take-home message

Figure 1 is best read as a map of the healthy-aging conversation around creatine. The strongest support is for strength, lean mass, exercise capacity, recovery, and safety, especially when supplementation is paired with resistance training. Other domains, including cognition, fatigue, female health, cardiovascular health, and male fertility, are biologically plausible and increasingly studied, but some remain earlier in the evidence pipeline. Creatine is not a stand-alone solution. Used alongside resistance exercise, adequate protein, and appropriate clinical care, it can be a useful tool for aging well.

Selected references

1. Sharifian, G., Aseminia, P., Heidary, D., & Esformes, J. I. (2025). Impact of creatine supplementation and exercise training in older adults: a systematic review and meta-analysis. European Review of Aging and Physical Activity, 22(1), 1-14. https://doi.org/10.1186/s11556-025-00384-9.

2. Bonilla, D. A., Stout, J. R., Candow, D. G., Jiménez-García, J. D., Gómez-Miranda, L. M., Ortiz-Ortiz, M., … & Kreider, R. B. (2024). The power of creatine plus resistance training for healthy aging: enhancing physical vitality and cognitive function. Frontiers in Physiology, 15, 1496544. https://doi.org/10.3389/fphys.2024.1496544.

3. EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA). (2016). Creatine in combination with resistance training and improvement in muscle strength: evaluation of a health claim pursuant to Article 13 (5) of Regulation (EC) No 1924/2006. EFSA Journal, 14(2), 4400. https://doi.org/10.2903/j.efsa.2016.4400.

4. Smith-Ryan, A. E., DelBiondo, G. M., Brown, A. F., Kleiner, S. M., Tran, N. T., & Ellery, S. J. (2025). Creatine in women’s health: bridging the gap from menstruation through pregnancy to menopause. Journal of the International Society of Sports Nutrition, 22(1), 2502094. https://doi.org/10.1080/15502783.2025.2502094.

5. Dolan, E., Gualano, B., & Rawson, E. S. (2019). Beyond muscle: the effects of creatine supplementation on brain creatine, cognitive processing, and traumatic brain injury. European journal of sport science, 19(1), 1-14. https://doi.org/10.1080/17461391.2018.1500644.

6. Marshall, S., Kitzan, A., Wright, J., Bocicariu, L., & Nagamatsu, L. S. (2025). Creatine and Cognition in Aging: A Systematic Review of Evidence in Older Adults. Nutrition Reviews, nuaf135. https://doi.org/10.1093/nutrit/nuaf135

7. Xu, C., Bi, S., Zhang, W., & Luo, L. (2024). The effects of creatine supplementation on cognitive function in adults: a systematic review and meta-analysis. Frontiers in Nutrition, 11, 1424972. https://doi.org/10.3389/fnut.2024.1424972.

8. Kreider, R. B., Gonzalez, D. E., Hines, K., Gil, A., & Bonilla, D. A. (2025). Safety of creatine supplementation: analysis of the prevalence of reported side effects in clinical trials and adverse event reports. Journal of the International Society of Sports Nutrition, 22(sup1), 2488937. https://doi.org/10.1080/15502783.2025.2488937.

9. de Souza E Silva, A., Pertille, A., Reis Barbosa, C. G., Aparecida de Oliveira Silva, J., de Jesus, D. V., Ribeiro, A. G. S. V., Baganha, R. J., & de Oliveira, J. J. (2019). Effects of Creatine Supplementation on Renal Function: A Systematic Review and Meta-Analysis. Journal of renal nutrition, 29(6), 480–489. https://doi.org/10.1053/j.jrn.2019.05.004.

10. Naeini, E. K., Eskandari, M., Mortazavi, M., Gholaminejad, A., & Karevan, N. (2025). Effect of creatine supplementation on kidney function: a systematic review and meta-analysis. BMC nephrology, 26(1), 622. https://doi.org/10.1186/s12882-025-04558-6.

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