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Studies included were randomized controlled trials (RCTs) comparing creatine supplementation with placebos in older adults and adults with chronic disease. The primary outcome was physical function measured by the sit\u2010to\u2010stand test after pooling data using random\u2010effects modeling. We also performed a Bayesian meta\u2010analysis to describe the treatment effect in probability terms. Secondary outcomes included other measures of physical function, muscle function, and body composition. The risk of bias was assessed using the Cochrane risk\u2010of\u2010bias tool.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We identified 33 RCTs, comprising 1076 participants. From six trials reporting the primary outcome, the pooled standardized mean difference (SMD) was 0.51 (95% confidence interval [CI]: 0.01\u20131.00;\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200962%;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.04); using weakly informative priors, the posterior probability that creatine supplementation improves physical function was 66.7%. Upper\u2010body muscle strength (SMD: 0.25; 95% CI: 0.06\u20130.44;\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090%;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.01), handgrip strength (SMD 0.23; 95% CI: 0.01\u20130.45;\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090%;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.04), and lean tissue mass (MD 1.08\u2009kg; 95% CI: 0.77\u20131.38;\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200926%;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.01) improved with creatine supplementation. The quality of evidence for all outcomes was low or very low because of a high risk of bias.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Creatine supplementation improves sit\u2010to\u2010stand performance, muscle function, and lean tissue mass. It is crucial to conduct high\u2010quality prospective RCTs to confirm these hypotheses (PROSPERO number, CRD42023354929).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jpen.2607","type":"journal-article","created":{"date-parts":[[2024,2,28]],"date-time":"2024-02-28T17:39:55Z","timestamp":1709141995000},"page":"389-405","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Creatine supplementation for optimization of physical function in the patient at risk of functional disability: A systematic review and meta\u2010analysis"],"prefix":"10.1002","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1934-9443","authenticated-orcid":false,"given":"Thomas W.","family":"Davies","sequence":"first","affiliation":[{"name":"William Harvey Research Institute, Barts and The London School of Medicine &amp; Dentistry Queen Mary University of London London UK"},{"name":"Adult Critical Care Unit Royal London Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naomi","family":"Watson","sequence":"additional","affiliation":[{"name":"William Harvey Research Institute, Barts and The London School of Medicine &amp; Dentistry Queen Mary University of London London UK"},{"name":"Adult Critical Care Unit Royal London Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James J.","family":"Pilkington","sequence":"additional","affiliation":[{"name":"Centre for Bioscience Manchester Metropolitan University John Dalton Building Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6662-9176","authenticated-orcid":false,"given":"Thomas J.","family":"McClelland","sequence":"additional","affiliation":[{"name":"William Harvey Research Institute, Barts and The London School of Medicine &amp; Dentistry Queen Mary University of London London UK"},{"name":"Adult Critical Care Unit Royal London Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4598-6526","authenticated-orcid":false,"given":"Giada","family":"Azzopardi","sequence":"additional","affiliation":[{"name":"William Harvey Research Institute, Barts and The London School of Medicine &amp; Dentistry Queen Mary University of London London UK"},{"name":"Adult Critical Care Unit Royal London Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rupert M.","family":"Pearse","sequence":"additional","affiliation":[{"name":"William Harvey Research Institute, Barts and The London School of Medicine &amp; Dentistry Queen Mary University of London London UK"},{"name":"Adult Critical Care Unit Royal London Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Prowle","sequence":"additional","affiliation":[{"name":"William Harvey Research Institute, Barts and The London School of Medicine &amp; Dentistry Queen Mary University of London London UK"},{"name":"Adult Critical Care Unit Royal London Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zudin","family":"Puthucheary","sequence":"additional","affiliation":[{"name":"William Harvey Research Institute, Barts and The London School of Medicine &amp; Dentistry Queen Mary University of London London UK"},{"name":"Adult Critical Care Unit Royal London Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,2,28]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"Office for National Statistics. 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