Title : A multifactorial approach to creatine in fall prevention among the elderly: From Akt/mTOR signaling to cognitive function
Abstract:
Falls in the elderly represent a critical challenge in physical medicine and rehabilitation, resulting from a complex interplay between neuromuscular decline and the impairment of executive functions. This study aims to analyze how creatine both dietary and supplemented can act as an adjuvant strategy to mitigate this risk by addressing both physical integrity and cognitive processing. At the muscular level, creatine supplementation has been shown to potentiate the Akt/mTOR signaling pathway, which is essential for protein synthesis and hypertrophy. By elevating intramuscular phosphocreatine levels, ATP resynthesis is optimized, thereby enhancing muscle power and postural stability determinant factors for balance recovery following trips or stumbles. However, recent literature cautions that creatine as an isolated intervention may be insufficient, underscoring the necessity of concomitant physical exercise protocols to maximize benefits in sarcopenia management.
Simultaneously, habitual dietary creatine intake demonstrates a direct positive association with memory measures in older adults. Evidence indicates that the amount of creatine obtained through daily nutrition is strongly correlated with visuospatial short-term memory, as assessed by forward and backward Corsi block-tapping tests. Older individuals consuming amounts above the daily median of 0.382 g exhibit significantly superior performance in these visuospatial tasks compared to those with lower intake. This cognitive competence is fundamental for maintaining independence and preventing the loss of autonomy, enabling the elderly to process and retain environmental information to navigate safely, avoid obstacles, and, consequently, reduce fall risk. In conclusion, creatine offers a promising therapeutic pathway in rehabilitation by strengthening the musculoskeletal system and enhancing cognitive vigilance. However, the heterogeneity of clinical protocols warrants caution, reinforcing that efficacy in fall prevention depends on an integrated approach combining rigorous nutritional support and specialized physical training.
