Dementia is one of the most pressing health care issues of this century. As no curative treatment for dementia exists, research efforts are growing to identify effective lifestyle interventions to prevent or delay onset. One such promising strategy that promotes cognitive and brain health is engaging in physical exercise. However, current exercise recommendations are imprecise. To advance the potential of exercise as a preventative and treatment strategy, important questions regarding moderators (ie, biological sex and age) are being addressed in the literature. Biological sex is recognized as an important variable to consider in exercise efficacy on brain health, with females showing greater cognitive gains. This may be related to sex differences in underlying mechanisms. Here, we argue to better understand the sex differences in exercise efficacy, the timing of exercise intervention should also be considered. Specifically, we present the hypothesis that midlife in females is a critical window for the implementation of exercise as an early intervention to promote brain health and prevent dementia. Further, we speculate that exercise interventions targeting midlife will be of critical importance for the female brain, as females exit this period of the lifespan at greater risk for cognitive impairment. Given the potential sex differences in dementia risk and prevalence, it is imperative to assess potential sex differences in exercise efficacy as an early intervention during midlife.

中文翻译：

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运动功效的性别差异：中年是促进健康认知衰老的关键窗口吗？

痴呆症是本世纪最紧迫的医疗保健问题之一。由于痴呆症尚无治愈性治疗方法，因此越来越多的研究努力确定有效的生活方式干预措施以预防或延迟发病。促进认知和大脑健康的一种很有前途的策略是进行体育锻炼。然而，目前的锻炼建议并不准确。为了提高运动作为预防和治疗策略的潜力，文献中正在讨论有关调节因素（即生理性别和年龄）的重要问题。生物性别被认为是锻炼对大脑健康影响的重要变量，女性表现出更大的认知能力。这可能与潜在机制的性别差异有关。这里，我们认为，为了更好地了解运动效果的性别差异，还应考虑运动干预的时机。具体而言，我们提出假设，女性中年是实施运动作为促进大脑健康和预防痴呆症的早期干预的关键窗口。此外，我们推测针对中年的运动干预对女性大脑至关重要，因为女性在度过这一生命周期时面临更大的认知障碍风险。鉴于痴呆风险和患病率的潜在性别差异，必须评估运动效果的潜在性别差异，作为中年早期干预措施。我们提出假设，女性中年是实施运动作为促进大脑健康和预防痴呆症的早期干预的关键窗口。此外，我们推测针对中年的运动干预对女性大脑至关重要，因为女性在度过这一生命周期时面临更大的认知障碍风险。鉴于痴呆风险和患病率的潜在性别差异，必须评估运动效果的潜在性别差异，作为中年早期干预措施。我们提出假设，女性中年是实施运动作为促进大脑健康和预防痴呆症的早期干预的关键窗口。此外，我们推测针对中年的运动干预对女性大脑至关重要，因为女性在度过这一生命周期时面临更大的认知障碍风险。鉴于痴呆风险和患病率的潜在性别差异，必须评估运动效果的潜在性别差异，作为中年早期干预措施。随着女性走出这个生命周期，认知障碍的风险更大。鉴于痴呆风险和患病率的潜在性别差异，必须评估运动效果的潜在性别差异，作为中年早期干预措施。随着女性走出这个生命周期，认知障碍的风险更大。鉴于痴呆风险和患病率的潜在性别差异，必须评估运动效果的潜在性别差异，作为中年早期干预措施。