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.

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zug_zug 2 hours ago | parent | next [-]

>> Recently, a pilot study (single-arm) by Smith et al., recruited 20 patients (73 years of age) with AD and provided them with 20 grams/day of CrM for 8 weeks [20]. Serum creatine levels were increased at weeks 4 and 8 (p < 0.001), and total brain creatine levels (as measured by H-MRS) increased by 11% (p < 0.001). Clinically, there were demonstrated improvements in cognition on global (p = 0.02) and fluid composites (p = 0.004), as well as List Sorting (p = 0.001), Oral Reading (p < 0.001) and Flanker tests (p = 0.05).

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.

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tgv an hour ago | parent | next [-]

19 patients completed, according to the article.

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.

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rzz3 an hour ago | parent [-]

Sounds like something we should study more rather than dismiss.

	▲	tgv an hour ago \| parent \| next [-]
		This study holds little promise at first sight. Remember that there is a lot to study, and only limited research capability. > Sounds like something we should study more rather than dismiss. Ignoring the implication of your use of "dismiss", why? How is this pilot promising?
	▲	jstummbillig 33 minutes ago \| parent \| prev [-]
		Sounds like something that should fly under a different headline until then.

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trehalose 9 minutes ago | parent | prev | next [-]

I wouldn't even call it "promising but inconclusive" so much as "not conclusively a dead-end for further research". In a single-arm open-label study, with no blinding, both the participants and the researchers know who's getting what. You need a placebo and double-blinding for comparison against the active group and to adjust for any ways in which the researchers may have unwittingly influenced the results. (Or perhaps even wittingly, when there are conflicts of interest. I spent half a minute looking up this study and didn't see any statement attesting that there were none.)

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fer an hour ago | parent | prev [-]

.001 for creatine levels isn't surprising; that's a lot of creatine. I'd explain the cognitive tests with the practice effect, because it is unlikely that creatine had such a massive effect and we only discover it now.

	▲	pitched 4 minutes ago \| parent [-]
		I hear about tech bros taking creatine these days with the tone of voice that they use to talk about microdosing. So I can’t imagine it having zero effect. 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.

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DavidSJ 21 minutes ago | parent | prev | next [-]

Yes, I can't find a 30%-slowdown number either.

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.

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baxtr 37 minutes ago | parent | prev [-]

FWIW creatine is "one of the most studied supplements for muscle and strength".

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/