Creatine raises brain energy levels and slows cognitive decline: study

肌酸能提升大脑能量水平并减缓认知衰退：一项研究发现

Scientists found that the creatine supplement millions take for muscle gains is quietly raising brain energy levels and slowing early Alzheimer’s cognitive decline by 30%. 科学家发现，数以百万计的人用于增肌的肌酸补充剂，正在悄然提升大脑能量水平，并将早期阿尔茨海默病的认知衰退速度减缓了 30%。

Tens of millions of people take creatine every day. They bought it for their muscles. They measure their doses by how much weight they can add to a bench press or how quickly they recover between sets. Almost none of them know that the same supplement is crossing the blood-brain barrier, raising phosphocreatine levels in their neurons, and doing something to their cognitive function that the fitness industry has never advertised and most users have never been told. 数以千万计的人每天都在服用肌酸。他们购买它是为了肌肉。他们通过卧推重量的增加幅度或组间恢复速度来衡量剂量。几乎没有人知道，这种补充剂同样能穿过血脑屏障，提高神经元中的磷酸肌酸水平，并对他们的认知功能产生影响——而这一点从未被健身行业宣传过，大多数使用者也从未被告知。

A comprehensive review published in the Journal of Psychiatry and Brain Science in 2025, alongside a landmark pilot trial published in Alzheimer’s and Dementia: Translational Research and Clinical Interventions, has assembled the most complete picture yet of what creatine is quietly doing inside the brain. The findings span cognitive performance in healthy adults, depression treatment outcomes, sleep deprivation resilience, and most strikingly, a 30% slowing of cognitive decline in early Alzheimer’s patients in controlled trials. None of this is in the marketing on the tub sitting in most gym bags. 2025 年发表在《精神病学与脑科学杂志》（Journal of Psychiatry and Brain Science）上的一篇综述，以及发表在《阿尔茨海默病与痴呆症：转化研究与临床干预》（Alzheimer’s and Dementia: Translational Research and Clinical Interventions）上的一项里程碑式试点试验，共同勾勒出了肌酸在大脑内部悄然发挥作用的最完整图景。研究结果涵盖了健康成年人的认知表现、抑郁症治疗效果、睡眠剥夺恢复能力，最引人注目的是，在对照试验中，早期阿尔茨海默病患者的认知衰退速度减缓了 30%。而这些信息在大多数健身包里的肌酸罐包装营销文案中只字未提。

Why the Brain Needs Creatine

大脑为何需要肌酸

The brain is the most energy-demanding organ in the human body, consuming approximately 20% of the body’s total energy output despite representing only 2% of its mass. Neurons do not store meaningful energy reserves. They rely on a continuous supply of ATP, adenosine triphosphate, the molecule that powers virtually every cellular process from maintaining ion gradients across membranes to releasing neurotransmitters at synapses. 大脑是人体能量需求最高的器官，尽管其质量仅占体重的 2%，却消耗了人体约 20% 的总能量输出。神经元无法储存大量的能量储备。它们依赖于 ATP（三磷酸腺苷）的持续供应，这种分子为几乎所有的细胞过程提供动力，从维持跨膜离子梯度到在突触处释放神经递质。

Creatine plays a critical role in the energy metabolism of brain cells. After cellular uptake, creatine is converted into phosphocreatine, which is rapidly broken down via catalysis by creatine kinase to facilitate ATP regeneration, thereby serving as a crucial element in energy transfer. In muscles, this phosphocreatine system provides the rapid energy burst needed for explosive physical effort. In neurons, it serves a different but equally important function: providing an emergency energy buffer during periods of high metabolic demand. 肌酸在脑细胞的能量代谢中起着至关重要的作用。细胞摄取肌酸后，它会被转化为磷酸肌酸，随后通过肌酸激酶的催化迅速分解，以促进 ATP 的再生，从而成为能量转移的关键要素。在肌肉中，这种磷酸肌酸系统提供爆发性体力活动所需的快速能量爆发。在神经元中，它发挥着不同但同样重要的功能：在高代谢需求期间提供紧急能量缓冲。

When a neuron fires rapidly, when the prefrontal cortex is working through a complex problem, when the hippocampus is encoding a new memory, ATP consumption spikes in ways that oxidative phosphorylation alone cannot immediately meet. The phosphocreatine system fills that gap in milliseconds, regenerating ATP faster than any other available mechanism. When brain creatine levels are insufficient, neurons working at high intensity hit an energy ceiling. Processing slows. Working memory capacity shrinks. The brain can still function, but it is operating below its energy capacity in exactly the situations that demand the most from it. 当神经元快速放电、前额叶皮层处理复杂问题或海马体编码新记忆时，ATP 的消耗量会激增，仅靠氧化磷酸化无法立即满足需求。磷酸肌酸系统能在几毫秒内填补这一缺口，其再生 ATP 的速度比任何其他现有机制都要快。当大脑肌酸水平不足时，高强度工作的神经元就会触及能量上限。处理速度变慢，工作记忆容量缩减。大脑虽然仍能运作，但在最需要能量的情况下，它却处于能量负荷不足的状态。

What Happens to Brain Creatine as You Age

随着年龄增长，大脑肌酸会发生什么

The problem that makes this relevant beyond athletic performance is what happens to the brain’s creatine system over time. Impaired brain energy metabolism, including dysfunction in the creatine system, may contribute to the development and progression of Alzheimer’s disease, making it a compelling therapeutic target. The evidence for creatine system dysfunction in Alzheimer’s is specific and measurable. Phosphocreatine levels in the brains of Alzheimer’s patients are significantly lower than in age-matched healthy controls. The enzyme creatine kinase, which catalyzes the conversion of phosphocreatine to ATP, shows reduced activity in Alzheimer’s brain tissue. 使这一问题超越运动表现范畴的原因在于，大脑的肌酸系统会随时间推移发生变化。大脑能量代谢受损（包括肌酸系统功能障碍）可能导致阿尔茨海默病的发生和进展，这使其成为一个极具潜力的治疗靶点。阿尔茨海默病中肌酸系统功能障碍的证据是具体且可测量的。阿尔茨海默病患者大脑中的磷酸肌酸水平显著低于同龄健康对照组。催化磷酸肌酸转化为 ATP 的肌酸激酶，在阿尔茨海默病脑组织中表现出活性降低。

Mitochondrial dysfunction in Alzheimer’s neurons creates what researchers describe as a bioenergetic crisis, a state where the cells most responsible for memory and cognition are chronically energy-deprived and increasingly unable to maintain the ATP levels needed for normal synaptic function. Mitochondrial impairment in Alzheimer’s disease reduces ATP production in brain and blood cells, ultimately creating a bioenergetic crisis as part of its pathophysiology. The creatine system is one of the few mechanisms that can partially compensate for this deficit, providing ATP through a pathway that does not depend on fully functional mitochondria. This is why researchers began asking whether supplementing creatine could meaningfully restore brain energy levels in people whose neurons were already struggling. 阿尔茨海默病神经元中的线粒体功能障碍造成了研究人员所说的“生物能量危机”，即负责记忆和认知的细胞长期处于能量匮乏状态，且越来越难以维持正常突触功能所需的 ATP 水平。阿尔茨海默病中的线粒体损伤减少了脑细胞和血细胞中的 ATP 产生，最终作为其病理生理学的一部分引发了生物能量危机。肌酸系统是少数能够部分补偿这种缺陷的机制之一，它通过一条不依赖于功能完好的线粒体的途径来提供 ATP。这就是为什么研究人员开始探讨，补充肌酸是否能有效恢复那些神经元已经受损的人群的大脑能量水平。

The Clinical Trial That Answered the Question

回答这一问题的临床试验

The University of Kansas Medical Center’s CABA trial, the Creatine to Augment Bioenergetics in Alzheimer’s study, published its results in Alzheimer’s and Dementia: Translational Research and Clinical Interventions in early 2026. Twenty patients with clinically confirmed Alzheimer’s disease took 20 grams of creatine monohydrate daily for eight weeks. They improved on cognitive function, scoring higher in sorting, reading and attention tests after the full eight weeks were over. Brain phosphocreatine levels, measured using magnetic resonance spectroscopy, increased measurably following supplementation, confirming that oral creatine was successfully crossing the blood-brain barrier and raising intracellular creatine concentrations in neural tissue. 堪萨斯大学医学中心的 CABA 试验（即“肌酸增强阿尔茨海默病生物能量研究”）于 2026 年初在《阿尔茨海默病与痴呆症：转化研究与临床干预》上发表了结果。20 名临床确诊的阿尔茨海默病患者每天服用 20 克一水肌酸，持续八周。八周结束后，他们的认知功能有所改善，在分类、阅读和注意力测试中得分更高。通过磁共振波谱法测量发现，补充肌酸后大脑磷酸肌酸水平有可测量的增加，证实口服肌酸成功穿过了血脑屏障，并提高了神经组织内的细胞内肌酸浓度。

The 2026 multicenter placebo-controlled trial extending this work enrolled 240 participants with early Alzheimer’s. After 12 weeks of oral creatine supplementation at 5 grams per day, participants showed a 10 to 15% increase in brain phosphocreatine on MRS scans. Improvements in energy metrics correlated with modest gains in short-term memory tests. The intervention group showed slower decline on standard cognitive scales by about 30% versus placebo. A 30% slowing of cognitive decline in early Alzheimer’s from a supplement that costs pennies per dose and is already sitting in the… 2026 年开展的一项多中心安慰剂对照试验延续了这项工作，招募了 240 名早期阿尔茨海默病参与者。在每天口服 5 克肌酸补充剂 12 周后，参与者的 MRS 扫描显示大脑磷酸肌酸增加了 10% 到 15%。能量指标的改善与短期记忆测试中的适度提升相关。与安慰剂组相比，干预组在标准认知量表上的衰退速度减缓了约 30%。一种每剂仅需几分钱且早已存在于……（原文此处中断）