Science

Aaron N. Smith, In-Young Choi, Phil Lee, Debra K. Sullivan, Jeffrey M. Burns, Russell H. Swerdlow, Emma Kelly, Matthew K. Taylor

BACKGROUND:
Preclinical studies suggest that creatine monohydrate (CrM) improves cognition and Alzheimer’s disease (AD) biomarkers. However, there is currently no clinical evidence demonstrating the effects of CrM in patients with AD.

METHODS:
In this single-arm pilot trial, we investigated the feasibility of 20 g/day CrM for 8 weeks in 20 patients with AD. We measured compliance throughout; serum creatine at baseline, 4 weeks, and 8 weeks; and brain total creatine (tCr) and cognition (National Institutes of Health [NIH] Toolbox, Mini Mental State Examination [MMSE]) at baseline and 8 weeks.

RESULTS:
Nineteen participants achieved the target of ≥80% compliance with the
CrM intervention. Serum Cr was elevated at 4 and 8 weeks (p less than .001) and brain tCr increased by 11% (p less than .001). Cognition improved on global (p= .02) and fluid (p= .004) composites, List Sorting (p= .001), Oral Reading (p less than .001), and Flanker (p= .05) tests.

DISCUSSION:
Our data suggest that CrM supplementation is feasible in AD and
provides preliminary evidence for future efficacy and mechanism studies.