Creatine Supplementation in Addition to Physical Exercise in the Treatment of Sarcopenia: A Metanalysis

Sarcopenia is a progressive condition in older adults characterized by reduced muscle mass, strength, and function, increasing the risk of disability and mortality. Resistance training is the primary intervention, and creatine supplementation may enhance its ef-fects. This meta-analysis assessed the impact of creatine, alone or combined with re-sistance training, on muscle mass and strength in elderly individuals with sarcopenia. A systematic search was conducted in PubMed, Scopus, and Web of Science following PRISMA 2020 guidelines, identifying 14 eligible studies. Two primary outcomes were an-alyzed: lean mass gain and strength improvement measured by leg press. Creatine com-bined with resistance training significantly increased lean mass (p = 0.0034; I² = 0%), in-dicating consistent benefits, while no significant improvement was observed in leg press strength (MD = −0.66; p = 0.83; I² = 21%). Reported adverse effects were minimal and mainly gastrointestinal. These findings suggest creatine supplementation effectively im-proves muscle mass but does not enhance leg press performance, which may not ade-quately reflect functional recovery. Future research should incorporate comprehensive functional assessments, including balance and mobility tests, to better evaluate the clini-cal impact of creatine in sarcopenia.