PURPOSE: To synthesize randomized controlled trial (RCT) evidence on the effects of exercise on cognitive outcomes in peri- and postmenopausal women and to contextualize these findings using mechanistic insights from estrogen-deficit preclinical models.METHODS: PubMed and Web of Science were searched (December 14, 2025). Eligible human studies were RCTs in peri- and postmenopausal women reporting cognitive outcomes following chronic exercise interventions. Preclinical evidence was drawn from ovariectomized (OVX) or aged female animal studies reporting both behavioral and neurobiological outcomes. Findings were synthesized narratively by exercise modality and cognitive domain (global cognition, executive function, and memory) due to heterogeneity in population, prescriptions, and outcome measures.RESULTS: Eight RCTs met inclusion criteria. Global cognition was assessed mainly with screening tools (MMSE, RUDAS) and showed modest, heterogeneous signals, with relatively favorable trends reported in resistance-oriented, Pilates/mind-body, and selected lifestyle/multimodal interventions. Executive function outcomes appeared more consistently responsive when interventions combined feasible physiological loading with sustained cognitive engagement, whereas higher-load dance-based protocols and co-interventions limited exercise-specific attribution. Memory outcomes were reported in only two RCTs using non-uniform assessments, indicating preliminary evidence. Five OVX/aged female animal studies supported mechanistic plausibility, implicating neurotrophin signaling (BDNF-TrkBCREB), oxidative/mitochondrial regulation, and cell-survival/neurogenesis pathways as exercise-responsive mechanisms, while underscoring translational constraints.CONCLUSIONS: Exercise may support cognitive health across the menopausal transition, but effects appear domain-sensitive and contingent on outcome sensitivity and intervention “active ingredients.” Future trials should prioritize domain-sensitive cognitive batteries, mechanism-aligned biomarkers, and designs that strengthen causal attribution.
PURPOSE: Pre-COPD, characterized by mild airflow limitation, represents a critical window for preventing progression to chronic obstructive pulmonary disease (COPD). This pilot randomized controlled trial examined the effects of high-intensity interval training (HIIT) versus high-intensity circuit training (HICT) on pulmonary function in older adults with pre-COPD.METHODS: Twenty older men aged 60-75 years with pre-COPD, defined as normal or near-normal FEV1 with symptoms, risk factors, and mild airflow limitation (FEV1/FVC 0.70-0.95), were screened. Fourteen eligible participants were randomized to HIIT (n=7) or HICT (n=7) for a 9-week supervised intervention. Due to three HIIT dropouts, on-treatment analysis included 4 HIIT and 7 HICT participants. Primary outcomes were pulmonary function, with secondary measures of cardiopulmonary and functional fitness.RESULTS: Despite the limited sample size, significant time×group interactions were observed for FEV1/FVC ratio (p=.004, η²p =0.62) and FEV1 % predicted (p=.018, η²p =0.37). The HIIT group improved FEV1/FVC ratio (0.82±0.08 to 0.91±0.06, +11.0%) and FEV1 (91.4±15.2% to 98.7±14.8%, +8.0%), while the HICT group showed unexpected decrements (FEV1/FVC: 0.88±0.06 to 0.84±0.07, -4.5%; FEV1: 97.3±14.6% to 89.2±15.3%, -8.3%). Functional fitness improvements were observed exclusively in the HIIT group, with significant gains in lower extremity strength and aerobic endurance.CONCLUSIONS: This preliminary investigation indicates that HIIT may be associated with favorable changes in pulmonary function in older adults with pre-COPD, although these findings should be interpreted with caution. Given the limited sample size, the results primarily provide exploratory effect size estimates and feasibility data for future studies. The observed differences between HIIT and HICT underscore the need for further research on exercise prescription in this population.
