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Epub 2024 Feb 28. Creatine supplementation for optimization of physical function in the patient at risk of functional disability: A systematic review and meta-analysis Thomas W Davies^ 1 2 , Naomi Watson^ 1 2 , James J Pilkington^ 3 , Thomas J McClelland^ 1 2 , Giada Azzopardi^ 1 2 , Rupert M Pearse^ 1 2 , John Prowle^ 1 2 , Zudin Puthucheary^ 1 2 Affiliations Expand Affiliations * ^1 William Harvey Research Institute, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, London, UK. * ^2 Adult Critical Care Unit, Royal London Hospital, London, UK. * ^3 Centre for Bioscience, Manchester Metropolitan University, John Dalton Building, Manchester, UK. * PMID: 38417175 * DOI: 10.1002/jpen.2607 Item in Clipboard Review Creatine supplementation for optimization of physical function in the patient at risk of functional disability: A systematic review and meta-analysis Thomas W Davies et al. JPEN J Parenter Enteral Nutr. 2024 May. Show details Display options Display options Format [Abstract] JPEN J Parenter Enteral Nutr Actions * Search in PubMed * Search in NLM Catalog * Add to Search . 2024 May;48(4):389-405. doi: 10.1002/jpen.2607. Epub 2024 Feb 28. Authors Thomas W Davies^ 1 2 , Naomi Watson^ 1 2 , James J Pilkington^ 3 , Thomas J McClelland^ 1 2 , Giada Azzopardi^ 1 2 , Rupert M Pearse^ 1 2 , John Prowle^ 1 2 , Zudin Puthucheary^ 1 2 Affiliations * ^1 William Harvey Research Institute, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, London, UK. * ^2 Adult Critical Care Unit, Royal London Hospital, London, UK. * ^3 Centre for Bioscience, Manchester Metropolitan University, John Dalton Building, Manchester, UK. * PMID: 38417175 * DOI: 10.1002/jpen.2607 Item in Clipboard Full text links Cite Display options Display options Format [Abstract] Abstract Background: The efficacy of creatine replacement through supplementation for the optimization of physical function in the population at risk of functional disability is unclear. Methods: We conducted a systematic literature search of MEDLINE, EMBASE, the Cochrane Library, and CINAHL from inception to November 2022. Studies included were randomized controlled trials (RCTs) comparing creatine supplementation with placebos in older adults and adults with chronic disease. The primary outcome was physical function measured by the sit-to-stand test after pooling data using random-effects modeling. We also performed a Bayesian meta-analysis to describe the treatment effect in probability terms. Secondary outcomes included other measures of physical function, muscle function, and body composition. The risk of bias was assessed using the Cochrane risk-of-bias tool. Results: We identified 33 RCTs, comprising 1076 participants. From six trials reporting the primary outcome, the pooled standardized mean difference (SMD) was 0.51 (95% confidence interval [CI]: 0.01-1.00; I^2 = 62%; P = 0.04); using weakly informative priors, the posterior probability that creatine supplementation improves physical function was 66.7%. Upper-body muscle strength (SMD: 0.25; 95% CI: 0.06-0.44; I^2 = 0%; P = 0.01), handgrip strength (SMD 0.23; 95% CI: 0.01-0.45; I^2 = 0%; P = 0.04), and lean tissue mass (MD 1.08 kg; 95% CI: 0.77-1.38; I^2 = 26%; P < 0.01) improved with creatine supplementation. The quality of evidence for all outcomes was low or very low because of a high risk of bias. Conclusion: Creatine supplementation improves sit-to-stand performance, muscle function, and lean tissue mass. It is crucial to conduct high-quality prospective RCTs to confirm these hypotheses (PROSPERO number, CRD42023354929). Keywords: creatine; functional disability; muscle; physical function; sarcopenia. (c) 2024 The Authors. Journal of Parenteral and Enteral Nutrition published by Wiley Periodicals LLC on behalf of American Society for Parenteral and Enteral Nutrition. 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Stares A, Bains M. Stares A, et al. J Geriatr Phys Ther. 2020 Apr /Jun;43(2):99-112. doi: 10.1519/JPT.0000000000000222. J Geriatr Phys Ther. 2020. PMID: 30762623 * Effects of protein supplementation on lean body mass, muscle strength, and physical performance in nonfrail community-dwelling older adults: a systematic review and meta-analysis. Ten Haaf DSM, Nuijten MAH, Maessen MFH, Horstman AMH, Eijsvogels TMH, Hopman MTE. Ten Haaf DSM, et al. Am J Clin Nutr. 2018 Nov 1; 108(5):1043-1059. doi: 10.1093/ajcn/nqy192. Am J Clin Nutr. 2018. PMID: 30475963 * Nutritional supplementation for stable chronic obstructive pulmonary disease. Ferreira IM, Brooks D, White J, Goldstein R. Ferreira IM, et al. Cochrane Database Syst Rev. 2012 Dec 12;12:CD000998. doi: 10.1002 /14651858.CD000998.pub3. Cochrane Database Syst Rev. 2012. PMID: 23235577 Review. See all similar articles References REFERENCES 1. 1. Office for National Statistics. Health state life expectancies, UK, 2018 to 2020. Accessed May 18, 2023. https: //www.ons.gov.uk/peoplepopulationandcommunity/ healthandsocialcare/... 2. 1. Rodrigues MAP, Facchini LA, Thume E, Maia F. Gender and incidence of functional disability in the elderly: a systematic review. Cad Saude Publica. 2009;25(suppl 3):S464-S476. 3. 1. Wittenberg R, Hu B, Hancock R. Projections of demand and expenditure on adult social care 2015 to 2040. Accessed May 18, 2023. http://eprints.lse.ac.uk/88376/ 4. 1. Garin N, Koyanagi A, Chatterji S, et al. Global Multimorbidity Patterns: A Cross-Sectional, Population-Based, Multi-Country Study. J Gerontol A Biol Sci Med Sci. 2016;71 (2):205-214. 5. 1. Stafford M, Steventon A, Thorlby R, Fisher R, Turton C, Deeny S. Briefing: Understanding the Health Care Needs of People with Multiple Health Conditions. The Health Foundation; 2018. 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