Rethinking Creatine: A Powerful Tool Against Alzheimer’s?

Creatine monohydrate is best known for fueling muscle strength — but a groundbreaking pilot trial, Creatine to Augment Bioenergetics in Alzheimer’s (CABA), shows this humble supplement may hold transformative benefits for the brain too. Until now, creatine’s marketing focused on gym-goers and bodybuilders — but these findings demand a full repositioning.

In this pilot study, researchers recruited 20 patients diagnosed with Alzheimer’s disease, aged approximately 60 to 90 years. Participants received a daily dose of 20 grams of creatine monohydrate for eight weeks. The intervention was well-tolerated, with 19 out of 20 participants maintaining over 80% adherence and reporting no serious adverse effects. Significant increases in serum creatine levels were observed after 4 and 8 weeks, and magnetic resonance spectroscopy (MRS) revealed approximately an 11% rise in total brain creatine levels — indicating successful uptake and metabolic integration.

What Did It Measure?

Test	Purpose (1-sentence)
NIH Toolbox Fluid Cognition Composite	Measures reasoning, processing speed, and memory flexibility.
List Sorting (Working Memory)	Tests ability to hold and reorder items mentally.
Oral Reading Recognition	Gauges reading-aloud accuracy and fluency.
Flanker (Executive Function/Attention)	Assesses ability to focus and resist distractions.

In Alzheimer’s, where decline is expected, merely stabilizing function is a breakthrough — but this study went further, showing real gains in several key areas of memory performance after only eight weeks: fluid cognition improved, indicating better reasoning and mental flexibility; working memory was enhanced, allowing participants to hold and manipulate information more effectively; oral reading ability increased, reflecting stronger language and verbal processing; executive function was strengthened, supporting better decision-making and self-control; and attention improved, with participants showing greater focus and reduced distractibility.

Why It Matters

1. Energy metabolism reset: Alzheimer’s brains show impaired energy systems — creatine restores phosphocreatine/ATP reserves, boosting neuron function

2. Expands creatine’s value: From gym supplement to potential adjunct therapy for dementia — a market shift is overdue.

3. Affordable & safe: At common doses, creatine is inexpensive and well-tolerated; only high dosing warrants occasional kidney monitoring 

Rewriting the Marketing Playbook

This isn’t just bodybuilding hype anymore. Creatine’s benefits extend into neurology —:

• Manufacturers should highlight brain and aging benefits in packaging & campaigns.

• Distributors & marketers must pivot from “muscle-only” imagery to age-diverse cognitive support themes.

• Healthcare professionals could consider prescribing creatine alongside established Alzheimer’s treatments like donepezil or memantine.

• Regulators should encourage (or require) cognitive wellness labeling if supported by further trials.

Conclusion: A Supplement at a Crossroads

The CABA trial is small, open-label, and exploratory — but profoundly promising. Eight weeks of daily creatine not only fed the brain but measurably improved cognition in Alzheimer’s patients. If these results hold in larger, controlled studies, creatine will cross a threshold — from gym staple to a recognized therapeutic agent for neurodegeneration.

It’s time for the industry — manufacturers, marketers, healthcare, and regulators — to wake up. Creatine's purpose is bigger than building muscle; it's rewriting how we approach brain health.

Reference: Smith, A. N., Choi, I. Y., Lee, P., Sullivan, D. K., Burns, J. M., Swerdlow, R. H., ... & Taylor, M. K. (2025). Creatine monohydrate pilot in Alzheimer's: Feasibility, brain creatine, and cognition. Alzheimer's & Dementia: Translational Research & Clinical Interventions, 11(2), e70101.