Article Text

Download PDFPDF
Personalising exercise recommendations for healthy cognition and mobility in aging: time to address sex and gender (Part 1)
  1. Cindy K Barha1,
  2. Ryan S Falck1,
  3. Søren T Skou2,3,
  4. Teresa Liu-Ambrose1
  1. 1 Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada
  2. 2 Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
  3. 3 Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Slagelse, Denmark
  1. Correspondence to Dr Teresa Liu-Ambrose, Physical Therapy, The University of British Columbia Faculty of Medicine, Vancouver, BC V6T 1Z3, Canada; teresa.ambrose{at}

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


Impaired cognition and mobility are common in older adults and they often coexist due to shared pathophysiology.1 Worldwide, one new case of dementia is detected every 3 s.2 Exercise improves cognitive function and reduces the risk of mobility disability and falls.3–5

Leaders in physical activity and exercise research are aiming to delineate what (e.g., type, duration, frequency and intensity) exercise should be recommended and when (e.g., midlife versus late life) it is best done for promoting cognitive and mobility outcomes in healthy individuals and in those at risk for cognitive impairment. Two other key questions are how (e.g., neurotrophic factors, cardiovascular fitness) and for whom (e.g., biological sex, gender) does exercise benefit cognition and mobility. Understanding mediators (i.e., how) could help maximise gains by enhancing intervention elements that impact key mechanisms at lower cost and/or risk. Identifying moderators (e.g., who, when)—factors that either attenuate or amplify the effects of exercise—will enable precise recommendations for individuals with similar characteristics (i.e., subgroups).

In this two-part editorial series, we focus on for whom factors that may moderate the effect of exercise on cognitive function and mobility outcomes. In Part 1, we focus on biological sex and gender. Biological sex is defined as the genetics, gonadal hormones and phenotype resulting from XX versus XY chromosomes. Gender refers to the social, environmental, cultural and behavioural factors that influence individual actions and experiences. In Part 2, …

View Full Text


  • Twitter @dr_cindy_b, @STSkou, @UBC_CogMobLab

  • Contributors All authors contributed to the conception and design on this paper. TLA, CKB and RSF drafted the work and STS provided substantial feedback on content and edits. All authors approve the final version.

  • Funding Canadian Institutes of Health Research (MOP-142206 and PJT-148902) to TLA. STS is currently funded by a grant from Region Zealand (Exercise First) and a grant from the European Research Council (ERC) under the European Union's Horizon 2020 research and innovation program (grant agreement no. 801790). TLA is a Canada Research Chair in Physical Activity, Mobility and Cognitive Neuroscience. CKB is an Alzheimer Association of USA and Brain Canada Postdoctoral Fellow. Content for this commentary was in part generated from a workshop (May 2019) hosted by the Physical Activity for Precision Health (PA4PH) Research Cluster (, University of British Columbia, Vancouver, BC, Canada. STS is associate editor of Journal of Orthopaedic & Sports Physical Therapy, he has received grants from The Lundbeck Foundation, personal fees from Munksgaard, all outside the submitted work. He is cofounder of Good Life with Osteoarthritis in Denmark (GLA:D), a not-for profit initiative hosted by the University of Southern Denmark aimed at implementing clinical guidelines for osteoarthritis in clinical practice.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

Linked Articles