Creatine supplementation to enhance cognitive functions

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SBU Enquiry Service

Consists of structured literature searches to highlight studies that can address questions received by the SBU Enquiry Service from Swedish healthcare or social service providers. We assess the risk of bias in systematic reviews and when needed also quality and transferability of results in health economic studies. Relevant references are compiled by an SBU staff member, in consultation with an external expert when needed.

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Published: Report no: ut202515 Registration no: SBU 2025/948

Question

What effect does creatine supplementation have on cognitive functions?

PICO

  • Population: People of all ages, with or without medical conditions.
  • Intervention: Creatine supplementation as a standalone or additional intervention.
  • Comparison: Placebo, no intervention, or other active intervention.
  • Outcome: Cognitive functions such as memory, attention, and executive functions.

Method

A systematic literature search was performed using the following databases: Medline via OvidSP, Scopus and CINAHL via EBSCO.

Two authors independently assessed the abstracts of all identified studies.

Risk of bias in relevant systematic reviews was assessed using an assessment tool based on AMSTAR.

Identified literature

In seven relevant systematic reviews, the risk of bias was considered to be high, therefore the results and conclusions are not reported [1-7].

References

  1. Avgerinos KI, Spyrou N, Bougioukas KI, Kapogiannis D. Effects of creatine supplementation on cognitive function of healthy individuals: A systematic review of randomized controlled trials. Exp Gerontol. 2018;108:166-73. Available from: https://doi.org/10.1016/j.exger.2018.04.013
  2. Kaviani M, Shaw K, Chilibeck PD. Benefits of Creatine Supplementation for Vegetarians Compared to Omnivorous Athletes: A Systematic Review. Int J Environ Res Public Health. 2020;17(9). Available from: https://doi.org/10.3390/ijerph17093041
  3. Marshall S, Kitzan A, Wright J, Bocicariu L, Nagamatsu LS. Creatine and Cognition in Aging: A Systematic Review of Evidence in Older Adults. Nutr Rev. 2025:nuaf135. Available from: https://doi.org/10.1093/nutrit/nuaf135
  4. McMorris T, Hale BJ, Pine BS, Williams TB. Creatine supplementation research fails to support the theoretical basis for an effect on cognition: Evidence from a systematic review. Behav Brain Res. 2024;466:114982. Available from: https://doi.org/10.1016/j.bbr.2024.114982
  5. Prokopidis K, Giannos P, Triantafyllidis KK, Kechagias KS, Forbes SC, Candow DG. Effects of creatine supplementation on memory in healthy individuals: a systematic review and meta-analysis of randomized controlled trials. Nutr Rev. 2023;81(4):416-27. Available from: https://doi.org/10.1093/nutrit/nuac064
  6. Stares A, Bains M. The Additive Effects of Creatine Supplementation and Exercise Training in an Aging Population: A Systematic Review of Randomized Controlled Trials. J Geriatr Phys Ther. 2020;43(2):99-112. Available from: https://doi.org/10.1519/JPT.0000000000000222
  7. Xu C, Bi S, Zhang W, Luo L. The effects of creatine supplementation on cognitive function in adults: a systematic review and meta-analysis. Front Nutr. 2024;11:1424972. Available from: https://doi.org/10.3389/fnut.2024.1424972

Literature search

Medline via OvidSP 16 September 25

Title: Creatine and cognition
/ = Term from the MeSH controlled vocabulary; .sh = Term from the MeSH controlled vocabulary; exp = Term from MeSH including terms found below this term in the MeSH hierarchy; .ti,ab = Title or abstract; .tw = Title or abstract; .kf = Keywords; .kw = Keywords, exact; .bt = Book title. NLM Bookshelf; .pt = Publication type; .ja = Journal abbreviation; .af = All fields; adjn = Adjacent. Proximity operator retrieving adjacent words, adj3 retrieves records with search terms within two terms from each other; * or $ = Truncation; “ “ = Citation Marks; searches for an exact phrase
Search terms Items found
Intervention: Creatine
1. Exp Creatine/ 16 897
2. (creatine or Cr or CrM or phosphocreatine or PCr).ti,ab,bt,kf. 856 064
3. 1 OR 2 861 479
Outcome: Cognition
4. Exp mental processes/ 1 305 343
5. Exp fatigue/ 42 034
6. Exp attention/ 91 713
7. (cognit* OR thinking OR memory OR attention OR processing speed* OR executive function* OR perception* OR (brain adj3 (health or function* or fatigue)) OR (mental adj3 (function* or process* or fatigue))).ab,ti,bt,kf. 1 849 445
8. 4 OR 5 OR 6 OR 7 2 782 003
Study types: systematic reviews and meta-analysis
9. ((Systematic Review/ or Meta-Analysis/ or Cochrane Database Syst Rev.ja. or ((systematic adj4 review) or "meta analys*" or metaanalys*).ti,bt,ab.) not (editorial/ or letter/ or case reports/)) 561 244
Combined sets:
10. 3 AND 8 AND 9 380
Final result
11. 3 AND 8 AND 9 380

Scopus via scopus.com 16 September 25

Title: Creatine and cognition
TITLE-ABS-KEY = Title, abstract or keywords (including indexed keywords and author keywords); ALL = All fields; W/n = Within. Proximity operator retrieving terms within n words from each other; PRE/n = Precedes by. Proximity operator, the first term in the search must precede the second by n words; LIMIT-TO (X) = Includes only results of specified type, e.g., publication type or time range; DOCTYPE = Publication type; “re” = review; “le” = letter; “ed” = editorial; “ch” = book chapter; “cp” = conference proceedings; * = Truncation; “ “ = Citation Marks; searches for an exact phrase
Search terms Items found
Intervention: Creatine
1. TITLE-ABS-KEY (creatine OR Cr OR CrM OR phosphocreatine OR PCr) 1 445 186
Outcome: Cognition
2. TITLE-ABS-KEY ( (cognit* OR memory OR thinking OR attention OR “processing speed” OR “executive function” OR perception) OR (brain W/3 (health OR function* OR fatigue)) OR (mental W/3 (function* OR process* OR fatigue)) ) 6 112 951
Study types: systematic reviews and meta-analysis
3. TITLE-ABS-KEY ( ( systematic W/2 review ) OR "meta analy*" OR metaanaly* ) AND (EXCLUDE (DOCTYPE, “le”) OR EXCLUDE (DOCTYPE, “ed”) OR EXCLUDE (DOCTYPE, “ch”) OR EXCLUDE (DOCTYPE, “cp”)) 841 438
Combined sets:
4. 1 AND 2 AND 3 728
Final result
5. 1 AND 2 AND 3 728

CINAHL via EBSCO 16 September 25

Title: Creatine and cognition
TI = Title; AB = Abstract; SU = Keyword, exact or part (including all other fields for indexed and author keywords); XB = Title and abstract MH = Exact subject heading, indexed keywords; TX = All text; PT = Publication type; Nn = Near. Proximity operator retrieving terms within n words from each other; * = Truncation; “ “ = Citation Marks; searches for an exact phrase
Search terms Items found
Intervention: Creatine
1. XB (“creatine” or “cr” or “CrM” or “phosphocreatine” or “PCr”) or SU (“creatine” or “cr” or “CrM” or “phosphocreatine” or “PCr”) 68 235
Outcome: Cognition
2. (MH “mental processes+”) 509 992
3. (MH “cognition+”) 92 160
4. (MH “memory+”) 40 448
5. (MH “perception+”) 98 476
6. XB (“thinking” OR “attention” OR “processing speed” OR “executive function” OR “perception*” OR ”cognit*” OR “memory” OR (mental N3 (function* or process* or fatigue) OR (mental N3 (function* or process* or fatigue)) OR SU (“thinking” OR “attention” OR “processing speed” OR “executive function” OR “perception*” OR ”cognit*” OR “memory” OR (mental N3 (function* or process* or fatigue) OR (mental N3 (function* or process* or fatigue)) 636 079
7. 2 OR 3 OR 4 OR 5 OR 6 923 207
Study types: systematic reviews and meta-analysis
8. ((XB((systematic N3 review) OR "meta analys*" OR metaanalys*) OR SU((systematic N3 review) OR "meta analys*" OR metaanalys*)) OR (PT "Systematic Review" OR PT "meta analysis")) NOT (MH "CaseSStudies" OR PT "Commentary" OR PT "Editorial" OR PT "Letter") 293 541
Combined sets:
9. 1 AND 7 AND 8 135
Final result
10. 1 AND 7 AND 8 135
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