Effect of 16 Weeks of Strength Training and Creatine
Supplementation on Strength and Cognition in Older
Adults: A Pilot Study
André C. Smolarek1,2, Steven R. McAnulty3, Luis H. Ferreira1,
Gabriel R. Cordeiro2, Alana Alessi2, Denise B. Rebesco2, Ilma C.
Honorato2, Erivelton F. Laat2, Luis P. Mascarenhas2, Tácito P.
1GPMENUTF / UFPR / Curitiba, PR, Brazil, 2LABE / UNICENTRO /
Irati, PR, Brazil, 3Appalachian State University, Boone, NC, USA
Smolarek AC, McAnulty SR, Ferreira LH, Cordeiro GR, Alessi A,
Rebesco DB, Honorato IC, Laat EF, Mascarenhas LP, Souza-
Junior TP. Effect of 16 Weeks of Strength Training and Creatine
Supplementation on Strength and Cognition in Older Adults: A Pilot
Study. JEPonline 2020;23(4):88-94. The purpose of this study was
to determine the effect of 16 wks of resistance training and creatine
supplementation on strength and cognition in 26 older adults (5 male
and 21 female) who were randomly assigned to the Control Group
(CG, n=13) or the Intervention Group (IG, n=13). Weight and height
were measured. The JAMAR™ hand dynamometer was used for the
dominant and nondominant handgrip. Cognitive performance was
measured with the MoCa questionnaire. Resistance training plus 5
g∙d-1 of creatine supplementation were applied as the intervention
protocol for 16 consecutive wks. After the 16 wks of intervention, the
IG improved in both the handgrip strength (P<0.05) and cognitive
performance (P<0.05). The findings indicate that 16 wks of
resistance training and creatine monohydrate supplementation
improved older adults’ handgrip strength and cognitive performance.
Key Words: Cognition, Creatine Supplementation, Handgrip,
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The loss of neuromuscular function and brain aging are prevalent in older adults, leading to a
progressive reduction of functional independence (2). This study involved adults over 60 yrs
of age who underwent strength training after demonstrated loss of strength, functionality in
physical tests, daily activities, and cognitive ability (18,19). Recently, studies show that
physical exercise has a positive effect on cognition through certain mechanisms, such as a
change in brain volume, connectivity, cerebral perfusion, synaptic plasticity, neurogenesis,
and regulation of trophic factors (1).
A growing collection of evidence supports that creatine supplementation may improve health
status as individuals age (7,12,15). In this regard, creatine supplementation has been
reported to positively influence cognitive function (12,15) and in some instances serve as an
Some studies have shown that creatine supplementation can increase brain creatine content
by 5 to 15% (5,14). Moreover, creatine supplementation can reduce mental fatigue. McMorris
and co-workers (11) found that creatine supplementation (20 g∙d-1 for 7 days) after sleep
deprivation provided significantly less decrement in performance in random movement
generation, choice reaction time, balance and mood state in elderly subjects. This suggests
that creatine improves cognitive function in response to sleep deprivation. McMorris et al.
(11) also examined the effects of creatine supplementation on cognitive function in elderly
participants and found that creatine supplementation significantly improved performance on
random number generation, forward spatial recall, and long-term memory tasks.
The effects of creatine supplementation on the cognitive performance of the elderly are also
not thoroughly clear since creatine deficiency is recognized for decreasing cognitive capacity
in humans (4). The amount and time of supplementation, and the responsible brain areas still
need attention. Comparing the effects of resistance training with creatine supplementation on
handgrip and cognitive aspects in the elderly is essential because these indicators have a
strong relationship with diseases such as dinapenia, dementia, and Alzheimer's, which are
rather common in aging. Thus, the purpose of this study was to verify the effect of 16 wks of
resistance training with creatine supplementation on strength and cognitive performance in
The study included 26 adults over 60 yrs of age (mean ± SD, 68.9 ± 6.8) residing in a long-
term care center for the elderly. Only older people with full physical and mental capacities
were part of the study, allowing the choice to be a member of the sample or not. All subjects
signed an informed consent form.
This study was a cross-sectional study of 16 wks. The subjects were randomly distributed
into either a Control Group or an Intervention Group who performed resistance training and
received 5 g∙d-1 of creatine monohydrate supplementation (Dymatize™). The subjects
engaged in resistance training sessions 2 times∙wk-1 with the intensity being progressive from
65 to 75% of the test of 10 maximum repetitions (16). The exercises consisted of a biceps
curl, shoulder abduction, squat, and leg extension. Each series of exercises consisted of 10
repetitions with a total volume of 30 repetitions. The intervals utilized were 1 min within sets
of exercises and 2 min between exercises. The velocity of execution of the movements
remained 2 sec in the eccentric phase and 2 sec in the concentric phase.
To evaluate body mass, a Beurer™ scale with a 0.1 kg resolution was used. The accuracy
was 100 g. Height was determined using a Sanny™ stadiometer with a scale of 0.1 cm
following the Frankfurt plane (6). A handgrip dynamometer JAMAR™ with a capacity of 100
N/kgf and resolution of 1 N/kgf was applied. The subject chose the best position of the arm
that could remain abducted with the forearm remaining in a neutral position to produce hand
tension for both the dominant hand and the nondominant hand (9). Each analysis of cognitive
capacity was estimated by using the Montreal Cognitive Assessment (MoCA) questionnaire
that included cross-cultural validation for the Brazilian Portuguese language (13).
Descriptive techniques were used to describe the sample. A Kolmogorov Smirnov normality
test was applied to check the data distribution. A one-way ANOVA analysis of variance with a
Tukey post hoc was used with a 95% confidence interval and an alpha level of P<0.05 for
statistical significance. All data collected were analyzed utilizing SPSS™ software version
22.0, (Chicago,IL, USA). All analyses were performed pre and post-intervention.
Descriptive, handgrip, and MoCA data, as well as, the pre- and post-intervention with
resistance training and 5 g∙d-1 of creatine supplementation results are depicted in Table 1.
Table 1. Description, Handgrip, and MoCA Data Pre and Post 16 wks of Intervention.
Dominant Hand (N/Kgf)
Nondominant Hand (N/Kgf)
a = Significant Difference between Control Group and G1. *P<0.05. MoCA = Montreal Cognitive
No significant results were observed after intervention in weight and height variables.
However, for the dominant hand, non-dominant hand, and MoCA differences were identified
(P<0.05) when the Control Group was compared with the Intervention Group.
The purpose of the study was to determine the effect of 16 wks of resistance training and
creatine supplementation on the handgrip strength and cognitive capacity in elderly men and
women. The main findings of the present study were a significant increase in the handgrip
strength and cognitive capacity of the elderly. In a recent review, it was suggested that
resistance training promotes improvements in several geriatric diseases and physical
exercise programs specific to strength with satisfactory outcomes in physical performance,
functional activity, and in avoiding falls (8).
In addition to aging, the lack and/or reduction of physical activity can result in less muscle
stimulus, which can reflect neuromuscular system dysfunction, decreasing strength capacity,
and a dinapenia phenomenon (3). In support, our results suggest that 16 wks of a resistance
training program and 5 g∙d-1 of creatine monohydrate supplementation will have a positive
effect on the handgrip strength (correlating with strength capacity and cognition), and
associated with functional autonomy.
In the human body, Twycross-Lewis et al. (21) indicates that 95% of creatine is located in the
sarcoplasm, either in the phosphorylated form (PCr) or free creatine (Cr) form. As an
increase in Cr consumption occurs, this can increase the content of PCr and Cr in the brain,
resulting in the maintenance of brain function and providing for conditions of higher cognitive
activity in the elderly. In fact, the results of the present study indicate improvement in the
MoCa questionnaire, which reflects an improvement in the subjects’ cognition performance
after resistance training combined with 5 g∙d-1 of creatine supplementation in older adults.
When older people develop strength such as with the handgrip exercise, there is a
relationship with cognitive capacity that is reflected by more powerful older people having
higher scores and performance on cognitive examinations (10). Even though we did not
examine a relationship between handgrip strength to MoCA, we noticed progress in both the
older adults’ strength and MoCA score after 16 wks of intervention with the combine
treatment of resistance training and 5 g∙d-1 creatine supplementation.
Limitations in this Study
One of the limitations of the present study is the number of subjects, which is small even for a
pilot study. Another limitation is in regards to the design of the study that did not permit
comparison between the outcome of the intervention with a group that only trained for
strength and/or only utilized creatine supplementation with a nutritional strategy. It is
important that the future studies consider these limitations and examine the role of each in
Our results indicate improvements in the handgrip strength and cognitive performance
through increases in MoCA score after 16 wks of resistance training and 5 g∙d-1 creatine
supplementation in older adults.
This study was financed in part by the “Coordenação de Aperfeiçoamento de Pessoal de
Nível Superior – Brasil” (CAPES) - Finance Code 001.
Address for correspondence: Andre C Smolarek, 1220, Coronel Pires, Irati, Parana, Brazil,
84500-059, Email: firstname.lastname@example.org
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