Creatine and Resistance Training in Older Adults With Mild Cognitive Impairment

Summary

The goal of this 26-week trial is to learn if creatine supplementation and resistance training (i.e., weightlifting; exercise that increases muscle mass), alone and together, impact cognition, brain health, and physical function in older adults with mild cognitive impairment. Previous studies have shown that resistance training improves cognition and brain health in older adults. Creatine is naturally occurring in the human body and is known to decline with age. Studies have shown that creatine increases muscle mass and bone density in older adults when supplemented. Some research has suggested that creatine may also improve cognition and brain health. However, little is known about how creatine supplementation affects the aging brain and body alone and when combined with resistance training, especially in those with known cognitive impairment. In this study, participants will be randomly assigned to one of four groups: 1) creatine and resistance training, 2) placebo and resistance training, 3) creatine and active control (balance and tone classes), or 4) placebo and active control. Participants in the creatine groups will take creatine every day during the study. Participants in the placebo groups will take a look-alike substance that contains no drug every day during the study. Participants in the resistance training groups will attend three 60-minute classes per week that target each major muscle group and will increase in difficulty during the study. Participants in the active control group will attend three 60-minute classes per week that will consist of balance, stretching, and range of motion exercises. This group accounts for variables such as physical training received by traveling to the training centres, social interaction, and changes in lifestyle secondary to study participation. Researchers will collect information before and after the 26 weeks to see if creatine supplementation and/or resistance training have any effects on cognition, brain health, and/or physical function. The investigators suspect that both creatine supplementation and resistance training will improve cognition, brain health, and physical function alone. However, it is thought that the combination of creatine supplementation and resistance training will improve cognition, brain health, and physical function more.

Interventions

• Creatine monohydrate · DIETARY_SUPPLEMENT

  Participants will consume one serving of creatine daily (0.10g of creatine/kg of body weight). This relative dosing approach ensures that smaller participants do not receive excessive doses, while larger participants receive an adequate amount. There is currently limited evidence to conclude the effectiveness of timing daily creatine intake, but it is recommended that creatine be consumed at mealtime for optimal absorption. Participants will choose what meal they will take the supplement and will be asked to keep timing consistent throughout the study. This daily low dose method was chosen because other methods (high-dose loading) may have negative side effects (e.g., water retention, cramping). The trial duration is also enough time to entire creatine saturation with supplementation.

• Resistance training · BEHAVIORAL

  Participants will use the programmable weight machines along with free weights to target primary muscle groups. In addition, they will complete mini-squats, mini-lunges, and lunge walks. Participants will complete two sets of 6-8 reps. Training stimulus will be increased using the 7RM method - when 2 sets of 6-8 reps are completed with proper form and without discomfort. The investigators will record the number of sets completed and the load lifted for each exercise for each participant at every class.

Published eligibility criteria

Verbatim from the registry. Only the site can decide how these apply to a specific patient.

We will include participants who: 1) are aged \>60; 2) are living independently in the community; 3) have normal or corrected-to-normal vision and hearing; 4) read, write, and speak English fluently; 5) are right-handed (if participating in the MRI component); 6) have subjective feelings of memory decline in the past five years; 7) have telephone Montreal Cognitive Assessment (T-MoCA) scores \<19/22; 8) have high independence, as indicated by Instrumental Activities of Daily Living (IADL) scale \>6/8; 9) have a Geriatric Depression Scale (GDS) score \<6/15; 10) are able to exercise at a moderate pace using resistance training for 60 minutes 3x/week; and 11) receive clearance from a physician to participate in an exercise program at baseline.

We will exclude participants who: 1) cannot partake or commit to exercise training 3x/week for 26 weeks or have engaged in resistance training \>1x/week over the past three months; 2) cannot partake or commit to consuming a daily supplement for 26 weeks or have consumed nutritional supplements containing creatine monohydrate over the past three months; 3) have a known allergy to creatine monohydrate or dextrose; 4) have been diagnosed with a neurological disorder (e.g., Alzheimer's disease, Parkinson's disease); 5) have pre-existing kidney disease, heart disease, or liver abnormalities; 6) have one or more uncontrolled chronic or psychiatric conditions (e.g., hypertension, diabetes, depression, anxiety); 7) are taking medication that may impact kidney function (e.g., non-steroidal anti-inflammatory drugs, such as ibuprofen and naproxen); or 8) are ineligible or uncomfortable with blood sampling.

Sites (1)

• Western University, London, Ontario · Recruiting