Does Creatine Enhance the Effects of Cognitive Training in Older Adults with Mild Cognitive Impairment?

The intervention comprises daily oral creatine supplementation as an adjunctive treatment to a 12-week, twice-weekly cognitive training program. In this trial, all participants will complete the same cognitive training program; however the experimental condition refers to whether the adjunctive dietary supplement is active (i.e. creatine) or inactive (i.e. placebo). This will be randomly allocated. In terms of the dietary supplements, participants will self-administer one daily oral dose, administered in 5g sachets. Participants will be instructed to dissolve the supplement in warm water and take one-hour before or after meals in order to maximise absorption. In both the active and inactive arms, an initial dose of 10g (5g twice daily) will be administered for 3 days to assess for tolerance. If the supplements are well tolerated, then a loading dose of 20g (10g twice daily) will be administered for the following 4 days. Subsequently, a maintenance dose of 10g (5g twice daily) will continue for a further 11 weeks, i.e. over the duration of the cognitive training period. Participants will be given written instructions for administration of all supplements. Participants will be asked to return any unused medication for adherence checks and safety on a fortnightly basis, in line with the dispensing schedule. At each dispensation, the trial clinician will do a compliance check as well as check for side effects or any adverse events the participants might have experienced. Participants will also receive a medication tracking calendar to aid compliance and recording of any side effects. The cognitive training program used in this trial is the computer-based Captains Log MindPower Builder software package, which targets multiple cognitive domains using an array of both auditory and visual exercises requiring responses via keyboard and mouse clicks. All participants will complete the same program of tasks; however graded difficulty is automatically adapted for each individual by the software program, with difficulty increasing as the participant improves their performance on each task. Each training session will last for 1 hour. The training will take place in a purpose-built cognitive training computer laboratory at the Brain and Mind Centre, Camperdown, Sydney. Each participant will work at their own computer and at their own pace; however multiple participants may attend the same training session simultaneously (based on availability). The training sessions will be run by trained facilitators comprising both Clinical Neuropsychologists, postdoctoral researchers and PhD students all of whom have received specialised training in these techniques and whom are experienced in facilitating cognitive training in over 400 older adults.