Alzheimer’s disease continues to confound researchers and devastate families, a neurodegenerative puzzle with few effective treatments. Against this backdrop, a recent pilot study led by Smith and colleagues (2025) has stirred renewed interest in an unexpected contender: creatine monohydrate. Best known as a gym supplement for boosting muscle strength, creatine is now being investigated as a potential ally in preserving brain function in Alzheimer’s patients.
Creatine is central to cellular energy metabolism. In muscles, it transports high-energy phosphates to replenish ATP, the molecular currency of energy. Extending this mechanism to the brain, however, has been contentious. Skeptics have long questioned whether creatine taken orally could meaningfully cross the blood-brain barrier or produce cognitive benefits beyond the placebo effect. Past studies have sometimes overpromised, and claims of brain-boosting powers often failed to replicate, feeding a reputation for hype within both scientific and popular circles.
Yet the CABA trial, conducted at the University of Kansas Medical Center, appears to have confronted these doubts head-on. Twenty participants with clinically diagnosed Alzheimer’s disease were instructed to consume 20 grams of creatine daily for eight weeks. Compliance was carefully monitored, not only through self-reports but also by measuring serum creatine levels. The study used magnetic resonance spectroscopy to quantify brain creatine and assessed cognition with validated tools including the NIH Toolbox and the Mini-Mental State Examination.
The results, while preliminary, are hard to ignore. Brain creatine levels rose by roughly 11 percent, indicating that oral supplementation can indeed alter brain chemistry in adults with Alzheimer’s. Cognitive assessments showed improvements in total cognition, fluid intelligence, working memory, attention control, and even the seemingly mundane task of oral reading recognition. The increase in brain creatine correlated with gains in reading and crystallized cognition, hinting that the energy boost at a cellular level might translate into subtle cognitive advantages.
Still, caution is warranted. The trial was small, brief, and lacked a control group, so placebo effects or practice effects on the cognitive tests cannot be dismissed. Yet these findings are notable precisely because they confront the long-standing skepticism surrounding creatine. For decades, researchers debated whether creatine’s benefits in the brain were more myth than reality, especially given the supplement industry’s tendency to overstate its claims. The CABA study adds carefully gathered human data to a body of preclinical work suggesting that creatine can improve mitochondrial function, reduce pathological proteins like amyloid beta and phosphorylated tau, and enhance memory in animal models.
The implications are intriguing. If these results are confirmed in larger, controlled trials, creatine could emerge as a low-cost, well-tolerated adjunct in the fight against Alzheimer’s, targeting energy metabolism rather than only symptoms. Beyond potential efficacy, the study also challenges the dismissive narrative that creatine is solely a “bodybuilding supplement,” suggesting its role in neurodegeneration deserves a second look.
Creatine has a history of being hyped, misrepresented, and occasionally misapplied in human studies. It reminds the scientific community that even substances with decades of research behind them can remain controversial when translated from muscle to mind. The CABA trial does not claim to cure Alzheimer’s, but it opens a window onto a provocative possibility: that the same molecule athletes use to lift weights might also help the brain resist decline.
Ultimately, creatine’s journey from gym bags to neurodegenerative research exemplifies the complicated path of translational science. The CABA trial may not settle the debate, but it provides a careful, methodical step into territory long dismissed as implausible. In the struggle against Alzheimer’s, small sparks of evidence like this are rare, and they deserve attention—so long as we remain critical, measured, and grounded in the data.
References
Smith AN, Choi IY, Lee P, Sullivan DK, Burns JM, Swerdlow RH, Kelly E, Taylor MK. Creatine monohydrate pilot in Alzheimer’s: Feasibility, brain creatine, and cognition. Alzheimer’s & Dementia: Translational Research & Clinical Interventions. 2025;11:e70101. https://doi.org/10.1002/trc2.70101
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