The article made up the claim it’s not from the paper itself.
There was some improvement in cognitive scores, but no placebo group. Without a placebo group, there are a lot of explanations for the data.
There was some improvement in cognitive scores, but no placebo group. Without a placebo group, there are a lot of explanations for the data.
Yeah 20 patients is not a lot. I'm inferring this is a pre-post test. However some of those p-values are pretty good (.001 on reading and and sorting). Very promising pilot study but not conclusive imo.
And List Sorting, Oral reading, and Flanker only? The first and last are part of global and fluid composites, so those have to be excluded from comparison. That leaves us with 3 improved scores out of 12 tests. So 9 did not improve, or got worse. Figure 3 (of the original article) shows that the changes aren't big. Just "significant". Since the participants were in the early stages of dementia, this seems well within expectations.
So I can't see those numbers as impressive.
> Sounds like something we should study more rather than dismiss.
Ignoring the implication of your use of "dismiss", why? How is this pilot promising?
When I go through the process of reading the entire paper, analyzing the data myself, and the experimental design. That is the opposite of dismissing the claim. That is me, positing that the claim as stated is 'true,' and then asking the questions if the claim is supported by the provided evidence. If it isn't, then doing the work to express what evidence would be needed to support the claim is the feedback needed to help prove the science.
Thank you for taking the time for that wonderful explanation, may it teach some of us/me to think before we shoot. I found it very enlightening and am sure many other drive by casuals do as well.
I apparently produce much less than I can use. Effect is in the, how is this even legal? range.
What I worry about more is that it has more to do with fixing a deficiency. That being deficient in creatine causes a cognitive loss more than supplementing causes a boost.
Also IMO, the Balmer peak is a stronger effect than creatine.
I'll add to this: the referenced trial occurred over 8 weeks, so even if we stipulate that the improvements in cognition (which are dubious, as tgv points out in this comment: https://news.ycombinator.com/item?id=48347906) are due to treatment rather than some other effect, we don't know that the effect is disease-modifying as opposed to symptomatic. As with acetylcholinesterase inhibitors, it may just be having a cognition-enhancing effect which, nevertheless, does not alter the underlying disease trajectory (i.e. just shifting the declining trajectory up vertically by a constant amount), and might revert shortly after discontinuing use of the drug.
A controlled trial, over a much longer duration, and ideally with a wash-out period, would be necessary to identify a disease-modifying effect.
But at the same time "creatine’s brain benefits aren’t as exciting as social media makes them out to be. The research at this point just doesn’t support the hype".
Source: https://physiqonomics.com/creatine-cognitive-performance/
It would actually make sense that as you age and eat less you might get creatine deficient so sure. I don't think it's bullshit, but it's not going to be a huge noticeable effect either.
All of this reminds me of people who don't weight lift "because they don't want to get built." They somehow think you lift some weights and boom you're looking like Arnold. No, it doesn't work that way.
You just needed to read the next paragraph:
"The 2026 multicenter placebo-controlled trial extending this work..."
Confusingly they reference a 2026 article (which isn't included in their citation list) that allegedly includes "placebo-controlled trial", but I think it might just be [0], which is based on the same single-arm trial. If they do have a paper using a placebo-controlled trial, they should definitely include that citation.
Let's be real: I take a lot of edibles. I smoke sometimes on a hike. Every once in a while I get a Guiness and a gyro. My health is by no means perfect, and if I'm willing to take in literal poison (yes, alchohol is that dangerous that I say such things even about my precious Guiness).
Anyways, for years I've been mostly skeptical of vitamins. I've heard a megadose of Vitamin C can shorten the symptoms of a cold, but a "megadose" is relatively small enough that just some OJ can do that, no need for pills.
But if I'm not giving up my Guiness and gyros, I probably should be willing to be more flexible about my "no vitamins or weird supplements rule".
So TL;DR: Let's flip this around: What are the risks of creatine, presuming a safe supply chain? (It's legal where I am as far as I know, which I'm a fan of for most things since then you can get a receipt and there will be some authority that investigates if you're unlucky to get a "bad batch".)
Then again supplements mostly create expensive pee.
Haha, that’s a great quote. Definitely going to borrow that one. Thanks!
The joke has been around forever. Big bang probably did the best “popular” showing off it.
This happens with a lot of popular supplements. I don’t know how common it is, but it’s a thing that happens. There are proponents of every supplement who will tell you it’s perfectly safe and any negative effect is due to impurities or your imagination, but there are a lot of reports from people who believe it’s helping until they stop, and are surprised that they feel better without.
(That's not technically Alzheimer's, but it's believable someone worrying about one might worry about the other)
They also state "cognitive functioning among midlife recreational cannabis users was similar to representative cohort norms". It's clearly shown in Figure 1 - midlife recreational cannabis users actually got smarter than people who quit cannabis according to their data.
There may well be some confounding factor in there. The study was done in New Zealand where cannabis was illegal for the majority of participants, and usage was self-reported so there's a basic issue there as well. One of the meta-analysis citing this (Crisafulli, 2026) and finding no effect criticizes the study design.
The only side effects I've encountered have been mild GI discomfort, and that only rarely (mostly when restarting after a vacation etc-- I drop the routine when I travel). Roughly similar to having a morning coffee at its worst.
I've found I get much thirstier when on this high of a dose. If you're not already a big water drinker I'd definitely invest in a nice insulated bottle to drag around.
Did you build up incrementally and find that to be the best?
Adverse effects, as mentioned, are mostly GI-related, some people experience bloating especially with monohydrate. Another effect is an increase in water retention, which, in turn, means you need to drink more water. It’s generally regarded as safe for the kidneys unless you already have reduced kidney function.
So, overall, not really a big deal to take well over the studied 5g dose. Not to mention the recommended loading dose is 5g 4x daily.
> The 2026 multicenter placebo-controlled trial extending this work enrolled 240 participants with early Alzheimer’s... The intervention group showed slower decline on standard cognitive scales by about 30% versus placebo.
But there's no such study in the references section. Not sure what's going on there but I want to see the data before I believe this.
Give them sugar pills and call them smart pills and their test scores will also improve.
That said, I work out daily and only just discovered the well researched and proven benefits of creatine on that front, so now I'm going to try it.
Worth looking at the range of studies as well.