Sex Differences in Fitness-Cognition

Body fat percentage is the dominant cognitive predictor in females, while hand grip strength is the more sensitive marker in males. Declining estradiol levels during the menopausal transition reduce synaptic plasticity and interact with acetylcholine, dopamine, and mitochondrial pathways, adversely affecting mood, sleep, and memory. Testosterone in males reduces abdominal and visceral fat and improves the metabolic risk profile, with no male equivalent to oestrogen's protective effect against adiposity. Inflammatory processes play a more significant mediating role in the female fitness-cognition relationship, whereas muscle quality predicts cognition more directly in males. Post-menopausal women accumulate central adiposity, which is associated with declining cognitive processes across multiple domains.