Creatine for Older Adults: Sarcopenia, Falls and Bone - What Trials Found
What trials and meta-analyses found for creatine in older adults: strength and lean mass with training, falls and fractures, bone density, and why kidney questions come first.
Content last updated . This page has not been medically reviewed.
Quick answer
In older adults who do resistance training, reviews of randomized trials report small extra gains in strength and lean mass with creatine, but the certainty is mixed and the review that looked at this described its participants as generally healthy older adults. [1] Trials of bone density mostly found no effect on density itself. We did not find a trial designed to test whether creatine prevents falls. This page describes studies. It is not advice, and a clinician or pharmacist is the right person to ask about your own situation.
Ask first. Creatine can raise the blood creatinine test that doctors use to judge kidney function. Anyone with kidney disease, on dialysis, or on kidney-affecting medicines must ask a clinician before using it. See Creatine and kidney disease.
Evidence labels used: promising but limited, mixed, insufficient evidence, no good evidence of benefit and Proper evidence not found. The main guide is Creatine.
Terms
- Sarcopenia is described in a position paper as a progressive and generalized skeletal muscle condition with a decrease in muscle mass, strength and functionality. [2] For the condition itself, see Sarcopenia and muscle loss.
- Osteosarcopenia is described as an age-related condition with reductions in bone mineral, muscle or lean mass, strength and function. [3]
- Resistance training means supervised or structured weight or strength exercise. Almost all the trials below added creatine or placebo to a training program.
Muscle strength and lean mass
| Source | Who and what | What it found | Label |
|---|---|---|---|
| 2014 meta-analysis | 357 older adults (average age about 64) | Creatine plus training increased fat-free mass and chest and leg press strength more than training alone; the review also found a greater effect on a 30-second chair-stand test. [4] | Promising but limited |
| 2017 meta-analysis | 22 studies, 721 people, mean ages 57 to 70, training 2 to 3 days a week for 7 to 52 weeks | Lean tissue mass gain was 1.37 kg larger, with greater chest press and leg press strength. [5] | Promising but limited |
| 2025 meta-analysis | 8 trials, 482 people | Lower-limb strength and lean tissue mass improved; upper-limb strength did not improve significantly overall. [6] | Mixed |
| 2026 meta-analysis | 11 trials, adults 60 and over | Strength improved modestly (moderate certainty); muscle mass and physical function were not significantly different (low and very low certainty). [1] | Promising but limited |
| 2021 meta-analysis | 10 trials, 211 older females | Upper-body strength increased; no effect on lower-body strength or muscle mass overall. [7] | Mixed |
Two points on reading the table. First, results differ across reviews, partly because each pooled a different set of trials. Second, the 2026 review said its findings should not be extended to frail, sarcopenic or functionally limited older adults. [1] A 2024 review that included older adults and adults with chronic disease (33 trials) rated the quality of evidence for all outcomes as low or very low because of a high risk of bias. [8]
Physical function and daily tasks
The 2024 review pooled six trials (the primary outcome was physical function on the sit-to-stand test) and found a standardized mean difference of 0.51 with a confidence interval that just excluded zero (0.01 to 1.00). [8] That is a small and uncertain signal on a simple test. The 2014 review also reported a greater effect on a 30-second chair-stand test. [4] These are test results, not measures of independence, hospital stays or quality of life.Without exercise
A position paper concluded that creatine alone, without a resistance training program, is unlikely to give substantial gains in strength and function, and that most studies of chronic use alone (30 days or more) failed to show a benefit on lean mass. [2] A 2-year trial of postmenopausal women with osteopenia supports this: lean mass rose in both groups with no additive effect of creatine. [9]Falls and fractures
In the 2-year trial of 200 postmenopausal women with osteopenia (study amount 3 g a day), the number of falls and fractures did not change with creatine. [9] Falls and fractures were secondary outcomes there, not the main target. Proper evidence not found for a trial whose main outcome was falls or fractures. We searched PubMed for creatine plus falls in older adults and found bone, muscle and review papers but no falls-prevention trial. For fall prevention in general, see Falls and balance problems.Bone
| Trial | Who and how long | What it found |
|---|---|---|
| 12-month trial | 47 postmenopausal women, 33 analyzed; study amount 0.1 g per kg of body weight per day with resistance training [10] | Femoral neck bone density was preserved with creatine compared with placebo, and femoral shaft width was larger; 14 of the 47 women randomized were not analyzed at 12 months. [10] |
| 2-year trial | 237 postmenopausal women; study amount 0.14 g per kg per day with training and walking [11] | No effect on bone density; some hip bone geometry measures improved; no effect on strength. [11] |
| 2-year trial | 200 postmenopausal women with osteopenia; study amount 3 g a day [9] | No improvement in bone health, no change in bone markers or in falls and fractures. [9] |
| 1-year trial | 70 adults, mean age 58; study amount 0.1 g per kg per day with training [12] | Some favorable effects on bone area and muscle density. [12] |
The 2026 meta-analysis in postmenopausal women found bone density unchanged overall and risk of bias mostly rated "some concerns". [13] Bone density is a measure, not a fracture count. Label: mixed, leaning to no good evidence of benefit for bone density. A 2025 review said no study had tested creatine, with and without exercise, in older adults who already have osteosarcopenia, and that trials are needed to confirm safety and efficacy. [3] For bone health in general, see Osteoporosis and bone health.
Limits
Many trials were small, short and in generally healthy volunteers. Authors of the position paper we read declare ties to companies that sell creatine. [2] Older adults may begin with lower muscle creatine than younger adults, according to some evidence described in a 2025 review. [17] Strength training and protein come first in most guidance; see Strength training and protein for older adults.Frequently asked questions
Does creatine help sarcopenia?
Reviews report small extra gains in strength with training in generally healthy older adults. The 2026 review warned against applying this to people who are sarcopenic or frail. [1]
Does creatine prevent falls?
We did not find a trial built to test that. In one 2-year trial the number of falls and fractures did not change. [9]
Does creatine strengthen bones?
Mostly not in terms of bone density. One 12-month trial found less femoral neck loss, while two 2-year trials found no density benefit. [10] [11] [9]
Does creatine work without exercise?
A position paper said it is unlikely to give substantial strength or function gains on its own. [2]
Is creatine safe for older adults with kidney problems?
Ask a clinician first. Creatine can raise creatinine on blood tests, which can make kidney tests harder to read. [14] [16]
More details: evidence, limits and cautions
The details behind this page: cautions, limits of the evidence and where sources disagree. Open any note to read it.
Safety
- Kidney tests. A 2026 meta-analysis found creatine raised serum creatinine and lowered estimated filtration based on creatinine, with no change when measured by a different method, and the authors said this likely reflects altered creatinine metabolism rather than kidney injury. [14] Another 2026 meta-analysis also found a creatinine rise without significant changes in urea or eGFR and called for trials longer than 1 year. [15] A position paper found no compelling evidence of kidney harm but noted that some suggest people with kidney disease consult a physician first. [16] See also Creatinine, eGFR and cystatin C.
- Medicines. Many older adults take several medicines. Ask a pharmacist: How interactions work.
- Side effects, surgery and bleeding. Adverse events in the postmenopausal meta-analysis were mild and similar to placebo. [13] Surgery and bleeding risk are not described in the sources we read; tell your surgical team about every supplement.
- Quality. See Quality testing and certifications.
References
- Yao L, et al. Effects of resistance training combined with creatine supplementation on muscle strength, physical function, and muscle mass in older adults: a systematic review and three-level meta-analysis. Front Nutr 2026 (abstract read). Read 2026-10-23.
- Antonio J, et al. Common questions and misconceptions about creatine supplementation: what does the scientific evidence really show?. J Int Soc Sports Nutr 2021 (full text read via PMC7871530; position paper by creatine researchers, several authors declare ties to companies that sell creatine). Read 2026-10-23.
- Candow DG, et al. The potential of creatine monohydrate supplementation in the management of osteosarcopenia. Curr Opin Clin Nutr Metab Care 2025 (abstract read). Read 2026-10-23.
- Devries MC, et al. Creatine supplementation during resistance training in older adults-a meta-analysis. Med Sci Sports Exerc 2014 (abstract read). Read 2026-10-23.
- Chilibeck PD, et al. Effect of creatine supplementation during resistance training on lean tissue mass and muscular strength in older adults: a meta-analysis. Open Access J Sports Med 2017 (abstract read). Read 2026-10-23.
- Liu S, et al. The impact of creatine supplementation associated with resistance training on muscular strength and lean tissue mass in the aged: a systematic review and meta-analysis. Eur Rev Aging Phys Act 2025 (abstract read). Read 2026-10-23.
- Dos Santos EEP, et al. Efficacy of Creatine Supplementation Combined with Resistance Training on Muscle Strength and Muscle Mass in Older Females: A Systematic Review and Meta-Analysis. Nutrients 2021 (abstract read). Read 2026-10-23.
- Davies TW, et al. Creatine supplementation for optimization of physical function in the patient at risk of functional disability: A systematic review and meta-analysis. JPEN J Parenter Enteral Nutr 2024 (abstract read). Read 2026-10-23.
- Sales LP, et al. Creatine Supplementation (3 g/d) and Bone Health in Older Women: A 2-Year, Randomized, Placebo-Controlled Trial. J Gerontol A Biol Sci Med Sci 2020 (abstract read). Read 2026-10-23.
- Chilibeck PD, et al. Effects of Creatine and Resistance Training on Bone Health in Postmenopausal Women. Med Sci Sports Exerc 2015 (abstract read). Read 2026-10-23.
- Chilibeck PD, et al. A 2-yr Randomized Controlled Trial on Creatine Supplementation during Exercise for Postmenopausal Bone Health. Med Sci Sports Exerc 2023 (abstract read). Read 2026-10-23.
- Candow DG, et al. Efficacy of Creatine Supplementation and Resistance Training on Area and Density of Bone and Muscle in Older Adults. Med Sci Sports Exerc 2021 (abstract read). Read 2026-10-23.
- Naddafha S, et al. Creatine monohydrate for lean mass, strength, and bone density in postmenopausal women: a systematic review and meta-analysis. J Int Soc Sports Nutr 2026 (abstract read). Read 2026-10-23.
- de Souza Almeida A, et al. Impact of creatine supplementation on kidney health: a systematic review and meta-analysis. Int Urol Nephrol 2026 (abstract read). Read 2026-10-23.
- Tsiaras A, et al. The Effect of Creatine Supplementation on Kidney Function: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. J Ren Nutr 2026 (abstract read). Read 2026-10-23.
- Kreider RB, et al. International Society of Sports Nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine. J Int Soc Sports Nutr 2017 (full text read via PMC5469049; prepared at the request of the Council for Responsible Nutrition and the ISSN; several authors declare industry ties). Read 2026-10-23.
- Antonio J, et al. Part II. Common questions and misconceptions about creatine supplementation: what does the scientific evidence really show?. J Int Soc Sports Nutr 2025 (full text read via PMC11703406; narrative review by creatine researchers, authors declare ties to creatine-related companies). Read 2026-10-23.
Education, not medical advice. This page is for general information. It does not diagnose or treat any condition and is not a substitute for care from a qualified health professional. Natural does not automatically mean safe. Ask a clinician or pharmacist before changing your care, especially if you take medication, are pregnant or breastfeeding, or have a health condition.