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Sarcopenia refers to the age-related reduction in strength, muscle mass and functionality which increases the risk for falls, injuries and fractures. Sarcopenia is associated with other age-related conditions such as osteoporosis, frailty and cachexia. Identifying treatments to overcome sarcopenia and associated conditions is important from a global health perspective. There is evidence that creatine monohydrate supplementation, primarily when combined with resistance training, has favorable effects on indices of aging muscle and bone. These musculoskeletal benefits provide some rationale for creatine being a potential intervention for treating frailty and cachexia. The purposes of this narrative review are to update the collective body of research pertaining to the effects of creatine supplementation on indices of aging muscle and bone (including bone turnover markers) and present possible justification and rationale for its utilization in the treatment of frailty and cachexia in older adults. • The combination of creatine supplementation and resistance training increases lean mass and muscle strength in aging adults. • Creatine supplementation decreases measures of bone catabolism which may help explain some of the preliminary increases in bone area and strength. • Creatine supplementation poses no adverse effect on kidney or liver function. • Creatine supplementation as the potential to be an effective intervention for treating frailty and cachexia. [ABSTRACT FROM AUTHOR]