Does creatine increase muscle strength in older adults?

Yes, a little. In older adults doing resistance training, creatine added a small strength gain beyond training alone. Some trials found no extra gain, and results for those not training are unknown.

Who it's for

Older adults doing regular strength training; not shown to help those who don't train.

What to expect

A small extra strength gain, mainly leg press, plus about 1.4 kg more lean mass.

Watch out for

Gains are inconsistent; no serious side effects were reported in trials.

What guidelines say

The NIH Office of Dietary Supplements says creatine may increase strength, power and work from maximal muscle effort, with individual responses varying2Guideline · 2026Dietary Supplements for Exercise and Athletic Performance: Fact Sheet for Health ProfessionalsCreatine: Numerous clinical trials generally showing a benefit for high-intensity, intermittent activity; potential variation in individual responses. May increase strength, power, and work from maximal effort muscle contractions; over time helps body adapt to athlete-training regimens; of little value for endurance…NIH Office of Dietary Supplements. The International Society of Sports Nutrition found creatine safe and well tolerated, at up to 30 g a day for 5 years, in groups from infants to older adults1Guideline · 2017Position stand: safety and efficacy of creatine supplementationThe position stand concludes that short- and long-term creatine supplementation, up to 30 g a day for 5 years, has been safe and well tolerated in healthy people and in patient groups ranging from infants to older adults.International Society of Sports Nutrition.

What the studies show

• A review that pooled 22 randomized trialsrandomized trials People are assigned by chance to the treatment or a comparison, so a difference in results is likely caused by the treatment itself. (721 men and women, average ages 57 to 70, training 7 to 52 weeks) found creatine plus training gave about 1.4 kg more lean mass and a small extra gain in leg press strength3Meta-analysis · 2017 · 721 peopleEffect of creatine supplementation during resistance training on lean tissue mass and muscular strength in older adults: a meta-analysis.These are included in a narrative review in the discussion section of this article. In summary, creatine supplementation increases lean tissue mass and upper and lower body muscular strength during resistance training of older adults, but potential mechanisms by which creatine exerts these positive effects have yet to…Open Access J Sports Med. Just over half of the individual trials showed a significant benefit3Meta-analysis · 2017 · 721 peopleEffect of creatine supplementation during resistance training on lean tissue mass and muscular strength in older adults: a meta-analysis.These are included in a narrative review in the discussion section of this article. In summary, creatine supplementation increases lean tissue mass and upper and lower body muscular strength during resistance training of older adults, but potential mechanisms by which creatine exerts these positive effects have yet to…Open Access J Sports Med.
• A 2021 review of trials in older adults found a similar gain of about 1.3 kg in lean mass. Strength gains depended on dosing: when trials using a loading phase (20 g or more a day for 5 to 7 days) were excluded, creatine had no added effect on chest or leg press4Meta-analysis · 2021Meta-Analysis Examining the Importance of Creatine Ingestion Strategies on Lean Tissue Mass and Strength in Older Adults.Finally, creatine supplementation only on resistance training days significantly increased measures of lean tissue mass and strength vs. placebo.Nutrients.
• An earlier review of 357 older adults (average age about 64, about 13 weeks of training) found extra gains in chest press, leg press and a 30-second chair stand test. Knee extension and biceps curl strength did not differ6Meta-analysis · 2014 · 357 peopleCreatine supplementation during resistance training in older adults-a meta-analysis.Retention of muscle mass and strength is integral to healthy aging. The results from this meta-analysis are encouraging in supporting a role for Cr supplementation during RT in healthful aging by enhancing muscle mass gain, strength, and functional performance over RT alone; however, the limited number of studies…Med Sci Sports Exerc.
• In older women, a review of 10 trials (211 women) found more upper-body strength, but no change in lower-body strength or muscle mass overall. Trials of 24 weeks or longer showed gains in both5Meta-analysis · 2021 · 211 peopleEfficacy of Creatine Supplementation Combined with Resistance Training on Muscle Strength and Muscle Mass in Older Females: A Systematic Review and Meta-Analysis.In conclusion, older females supplementing with Cr experience significant gains in muscle strength, especially when RT lasts for at least 24 weeks in duration. However, given the level of evidence, future high-quality studies are needed to confirm these findings.Nutrients. These studies were small, so the authors call for better research.
• A trial of 200 pre-frail and frail older adults (154 women in the creatine comparison, 16 weeks) found creatine did not boost the effects of training7Randomized trial · 2021 · 154 peopleSupplement-based nutritional strategies to tackle frailty: A multifactorial, double-blind, randomized placebo-controlled trial.Neither protein (whey and soy), leucine, nor creatine supplementation enhanced resistance training-induced adaptations in pre-frail and frail elderly, regardless of sex. These findings do not support the notion that some widely used supplement-based interventions can add to the already potent effects of resistance…Clin Nutr. A 12-month trial of 38 older men found no extra strength either12Randomized trial · 2021 · 20 peopleEffect of 12 months of creatine supplementation and whole-body resistance training on measures of bone, muscle and strength in older males.Twelve months of creatine supplementation and supervised, whole-body resistance training had no greater effect on measures of bone, muscle, or strength in older males compared with placebo.Nutr Health.
• Small trials point both ways: 28 adults over 65 gained more knee strength over 14 weeks10Randomized trial · 2003 · 14 peopleCreatine supplementation enhances isometric strength and body composition improvements following strength exercise training in older adults.This study confirms that supervised heavy resistance exercise training can safely increase muscle strength and functional capacity in older adults. The addition of CrM supplementation to the exercise stimulus enhanced the increase in total and fat-free mass, and gains in several indices of isometric muscle strength.J Gerontol A Biol Sci Med Sci. A trial of 45 adults claimed more strength over 10 weeks8Randomized trial · 2023The role of resistance training and creatine supplementation on oxidative stress, antioxidant defense, muscle strength, and quality of life in older adults.Regular resistance training can be recommended as a very suitable non-pharmacological approach to strengthen the body's antioxidant system, muscle strength and quality of life in older adults. There are no definite findings on the role of creatine on the antioxidant system and quality of life in older adults, but the…Front Public Health. Because trials this small can be swayed by chance, they count for less than the pooled reviews.

Review figures compare groups, so one person's gain depends on their starting strength and training.

Key studies

Safety

Trials in older adults reported no significant side effects7Randomized trial · 2021 · 154 peopleSupplement-based nutritional strategies to tackle frailty: A multifactorial, double-blind, randomized placebo-controlled trial.Neither protein (whey and soy), leucine, nor creatine supplementation enhanced resistance training-induced adaptations in pre-frail and frail elderly, regardless of sex. These findings do not support the notion that some widely used supplement-based interventions can add to the already potent effects of resistance…Clin Nutr,10Randomized trial · 2003 · 14 peopleCreatine supplementation enhances isometric strength and body composition improvements following strength exercise training in older adults.This study confirms that supervised heavy resistance exercise training can safely increase muscle strength and functional capacity in older adults. The addition of CrM supplementation to the exercise stimulus enhanced the increase in total and fat-free mass, and gains in several indices of isometric muscle strength.J Gerontol A Biol Sci Med Sci and no difference in side effects from placeboplacebo A dummy treatment that looks like the real one, so people can't tell which they got. over 12 months12Randomized trial · 2021 · 20 peopleEffect of 12 months of creatine supplementation and whole-body resistance training on measures of bone, muscle and strength in older males.Twelve months of creatine supplementation and supervised, whole-body resistance training had no greater effect on measures of bone, muscle, or strength in older males compared with placebo.Nutr Health. A position stand found creatine safe in healthy people at up to 30 g a day for 5 years1Guideline · 2017Position stand: safety and efficacy of creatine supplementationThe position stand concludes that short- and long-term creatine supplementation, up to 30 g a day for 5 years, has been safe and well tolerated in healthy people and in patient groups ranging from infants to older adults.International Society of Sports Nutrition.

What we don't know

• Whether creatine helps older adults who don't do resistance training, since trials paired it with training.
• Which dose and schedule work best, and whether a loading phase matters, as trials disagree4Meta-analysis · 2021Meta-Analysis Examining the Importance of Creatine Ingestion Strategies on Lean Tissue Mass and Strength in Older Adults.Finally, creatine supplementation only on resistance training days significantly increased measures of lean tissue mass and strength vs. placebo.Nutrients.