Sex Matters in the Association between Physical Activity and Fitness with Cognition

Abstract

Purpose: The benefits from physical activity (PA) and cardiorespiratory fitness (CRF) on normal age-related cognitive decline might be sex dependent. Our aim was to explore the relationship between different types of PA, CRF, and cognition and to identify the mediating effects of CRF in the association between PA and cognition in women and men. Methods: We recruited 115 healthy adults 50-70 yr of age. We obtained demographic, cognitive, and PA status data based on the Projecte Moviment protocol. We calculated cognitive domains by grouping z-sample scores. We obtained self-reported total energy expenditure during the last month and grouped it into sportive PA (S-PA) and nonsportive PA (NS-PA). CRF was estimated using the Rockport 1-Mile Walk Test. We applied regression models and mediation analyses in a final sample of 104 individuals (65 women and 39 men). Results: In the total sample, CRF was positively associated with executive function, verbal memory, and attention-speed. S-PA was positively related to executive function and attention-speed, whereas NS-PA was unrelated to cognitive domains. Greater amounts of S-PA were associated with executive function and attention-speed for both women and men. Higher CRF was associated with executive function, memory, language, and attention-speed only in men. Mediation analyses showed that CRF was a significant mediator of the positive effects of S-PA on executive function and attention-speed in men but not in women. Conclusions: Both women and men show cognitive benefits from greater S-PA, but not from NS-PA. However, there were sex differences in the mediating effects of CRF in this relationship, showing that CRF was mediating these benefits only in men.

Molecular and Brain Volume Changes Following Aerobic Exercise, Cognitive and Combined Training in Physically Inactive Healthy Late-Middle-Aged Adults: The Projecte Moviment Randomized Controlled Trial

“…However, we found that sex moderated the effects of the intervention on brain volumes on AE (total WM, parietal, temporal, and dorsolateral prefrontal cortex) and COMB groups (ventricles, temporal and dorsolateral prefrontal cortex) suggesting that men may benefit more than women. These results are consistent with our previously published results ( Castells-Sánchez et al, 2019 , 2020 , 2021 ) and the larger adaptations that men might experience after exercise, as suggested in previous research ( Al-Mallah et al, 2016 ). Moreover, these findings add support to the literature highlighting biological sex as a relevant moderator of the relationship between exercise and brain health ( Barha and Liu-Ambrose, 2018 ; Barha et al, 2019 ).…”

“…Cognitive changes in Executive Function and Attention-Speed in the AE group and in Attention-Speed in the COMB group were previously published ( Roig-Coll et al, 2020 ) and led us to address other micro and macroscopic correlates that might be involved in these interventions. We previously found that regular exercise was related to the inflammatory profile, brain volume and cognition in a cross-sectional sample ( Castells-Sánchez et al, 2020 , 2021 ).…”

Exercise and Fitness Neuroprotective Effects: Molecular, Brain Volume and Psychological Correlates and Their Mediating Role in Healthy Late-Middle-Aged Women and Men

“…This is a cross-sectional study based on Projecte Moviment (Castells-Sánchez et al, 2019) and is drawn from our previously published results (Castells-Sánchez et al, 2020). The study was carried out by the University of Barcelona in collaboration with Institut Universitari d'Investigació en Atenció Primària Jordi Gol and Hospital Germans Trias i Pujol.…”

“…Identifying these pathways by which the benefits of exercise are realized is a challenge not only due to the multilevel mechanisms but also because of the role of factors that may moderate the association such as sex (Barha et al, 2019). Previous evidence suggests that both women and men might positively benefit cognition from exercise, although the CRFcognition relationship was only significant in men (Castells-Sánchez et al, 2020). Moreover, there are sex differences in the mediators of this relationship described in the ongoing research.…”

Changes in cardiovascular health and white matter integrity with aerobic exercise, cognitive and combined training in physically inactive healthy late-middle-aged adults: the “Projecte Moviment” randomized controlled trial

“…It also underlines the benefits of a low-cost high-impact lifestyle intervention on healthy aging, which might lead to long-term molecular, structural, and functional long-term neuroprotective benefits (Stillman et al 2016 ). In our previous cross-sectional studies, we reported a positive relationship between physical exercise and an inflammatory profile, brain volume, and cognition (Castells-Sánchez et al 2020 , 2021 ); however, we could not replicate the molecular and brain volume imaging findings after implementing the RCT (Castells-Sánchez et al 2022 ). Similarly, although previous cross-sectional studies (Gow et al 2012 ; Johnson et al 2012 ; Liu et al 2012 ) showed that higher PA levels are related to increased global FA and local FA levels in the corpus callosum, superior longitudinal fasciculus and arcuate fasciculus, several RCT failed to find significant changes on WM microstructure (Clarck et al 2019 ; Sexton et al 2020 ; Voss et al 2013 ).…”