Creatine supplementation in the elderly: is resistance training really needed?

Moon, Anna ORCID: https://orcid.org/0000-0002-6587-4425, Heywood, L., Rutherford, Stephen M. ORCID: https://orcid.org/0000-0002-5572-8854 and Cobbold, C. 2015. Creatine supplementation in the elderly: is resistance training really needed? Journal of Nutrition and Health Sciences 2 (2) , pp. 1-9.

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Abstract

Introduction: Decreases in muscle mass, strength and power are associated with ageing, all of which increase the risk of falls, and cause a loss of independence. Creatine supplementation is often used in younger athletes to improve anaerobic performance, power and strength, however the potential benefits of creatine supplementation in older individuals are less clear. With an ageing population comes age-related losses in skeletal muscle mass, sarcopenia and associated risks of falls, morbidity and mortality. Importantly many older individuals still regularly perform aerobic and resistance training which serves to maintain this muscle mass and reduce these risks however a large proportion do not partake in regular exrecise [1]. There is evidence that creatine supplementation may maintain muscle mass and function in older adults [2], but an important question is whether resistance training and creatine supplementation have an additive effect on muscle structure and function or can older adults receive the same degree of benefit by just partaking in one of these protocols? Creatine Creatine is important for energy metabolism, and is thought to be an effective ergogenic aid in physical performance [3]. Creatine is synthesised within the body and ingested naturally from meat [3] or artificially through supplements. 94% of total body creatine is located in skeletal muscles and is stored as either free (40%) or phosphorylated creatine (PCr; 60%) [4]. Within skeletal muscles, creatine is hypothesised to shuttle high energy phosphogens between the mitochondria and cytosol [5], increasing the efficiency of cross-bridge cycling and thereby enhancing skeletal muscle contraction (Figure 1). Firstly, ATP synthesised in the mitochondrial matrix is transported via creatine kinase (CK) to the mitochondrial intermembrane space where CK catalyses the formation of ADP and PCr; Figure 2 reveals the equation from which ATP is then generated from stores of PCr via creatine kinase during periods of intense exercise. The ADP produced is transported back to the matrix where it is rephosphorylated when required. Liberated PCr migrates to the cytosol to sites of ATP consumption, where local CK enzymes regenerate ATP to allow for increased contraction. The liberated creatine then diffuses back to the mitochondria to allow for subsequent phosphorylation if required. This “transport” process is thought to occur in endurance-type activities [6-8]. Creatine supplementation has been shown to increase PCr regeneration [9], increasing ATP availability, thus facilitating prolonged physical activity [4]. Aim: This review assesses the current literature on whether creatine supplementation in the presence of resistance training enhances physical performance in older adults above and beyond those undertaking resistance training alone or only taking creatine supplements. Results: Whilst reports are conflicting, there is good evidence to suggest that creatine supplementation with resistance training increases muscular endurance, lower body strength and lean body mass; this is above results obtained with creatine supplementation or resistance training alone. The increased muscle mass observed with training has previously been shown to lead to increased bone mineral content and an associated reduced fracture risk; however, the additional benefits of creatine supplementation on this are less clear, and more work is needed to confirm whether exogenously taken creatine will benefit bone mineral density. Conclusion: Creatine supplementation in the elderly may lead to increased muscle mass, endurance and performance, and those who undertake resistance training may show further improvements with creatine supplementation. However, for elderly subjects who do not partake in resistance training, creatine supplementation offers significant improvements in increasing muscular mass and strength, and increasing their quality of life, whilst these benefits are lower on the whole than those who undertake regular resistance training.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Biosciences MRC Centre for Neuropsychiatric Genetics and Genomics (CNGG) Medicine Neuroscience and Mental Health Research Institute (NMHRI)
Subjects:	R Medicine > R Medicine (General)
Publisher:	Annex Publishers
ISSN:	2393-9060
Date of First Compliant Deposit:	8 March 2019
Date of Acceptance:	19 May 2015
Last Modified:	04 May 2023 21:24
URI:	https://orca.cardiff.ac.uk/id/eprint/72842

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