In 1849, mathematician Ada Lovelace presented a vision in which machines could not only compute but also recognize patterns and compose. She spoke about thought processes, not about genders. However, a century later, popular myths shaped the idea that female and male brains were “fundamentally different” – a narrative that revealed more about culture than biology. Today, research is correcting this picture: sex differences in the brain exist, but they are context-dependent, shaped by biology and experience – and, above all, changeable through lifestyle and prevention.

The brain is a plastic organ – it adapts to experiences, environmental stimuli, and training. Sex differences often manifest as differences in distribution, not as rigid categories: overlaps are the rule, not the exception. It is crucial to avoid deterministic interpretations. Biology provides possibilities, not destinies. The term sexual dimorphismbiological differences between the sexes describes average differences but says little about the individual. More relevant for high performers is neuroplasticitythe brain's ability to change its structure and function through experience and the question of how we build cognitive reserves. Equally important is the risk factor networkinterconnected biological, lifestyle, and genetic influences that together shape disease risk – because prevention becomes more effective when it considers these connections.

For longevity and cognitive performance, precision counts instead of cliché. Studies show that men and women have different focal points in their risk factor networks for cognitive decline: In women, blood pressure and genetic factors like APOE ε4 come to the forefront, while in men, cognitive outcomes dominate the network flow ^[1]. This means that blood pressure control can secure cognitive reserve particularly well in women; for men, close cognitive monitoring and early training are worthwhile. Physical activity enhances cognitive function in both sexes, with nuances: women benefit more in executive functions and visuospatial abilities, while men excel in memory – a lever to intentionally strengthen skills that ensure performance and independence in daily life ^[2]. At the same time, research warns against biological determinism: those who view sex as an unchangeable fate overlook the malleability of the brain through learning, hormones, and experience – thus missing growth potential ^[3].

A network analysis with 896 participants compared modifiable, non-modifiable, and cognitive risk factors for dementia, separated by sex and cognitive status. The result: In women, both the structure and connectivity of risk factor networks changed significantly along the spectrum from healthy to cognitively impaired; systolic blood pressure and APOE ε4 were central nodes. In men, the connectivities remained more stable; cognitive measures shaped the network more strongly ^[1]. Practical relevance: Prevention should prioritize blood pressure and genetically informed strategies for women while addressing functional cognition early in men. Additionally, the FemBER-Africa Initiative addresses a critical research gap: it builds a deeply phenotyped African cohort across the entire dementia spectrum to capture sex-, gender-, and origin-specific risk factors – including endocrine transitions such as menopause – with biomarkers, imaging, and culture-sensitive tests ^[4]. This is crucial because existing risk models are Western-focused, and the group most affected globally – women in low- and middle-income countries – has been underrepresented until now. Finally, a study on physical activity in older adults shows: those who meet the WHO movement targets achieve higher cognitive scores; the nature of the gains differs by sex – an example of how behavioral interventions should be planned differently without falling into stereotypes ^[2]. Together, these works provide a picture of precision prevention: gender-specific where data suggest, individualized and behavior-oriented where leverage exists.

- Meet the WHO movement targets with a profile: Plan for at least 150 minutes of moderate-intensity training each week. For women: interval-oriented cardio plus coordination- and planning-intensive exercises (e.g., dance, agility drills) to strengthen executive functions and visuospatial skills. For men: combine endurance with memory emphasis – e.g., running intervals where you mentally recall word lists or sequences of routes. Studies show sex-specific cognitive gains from exercise ^[2]. - Blood pressure is brain protection – especially for women: Measure it 2–3 times a week at home, set a target range after consulting with a doctor, and pair training days with salt-conscious nutrition. Network research identifies systolic blood pressure as a central risk node for women ^[1]. - Track cognitive markers – especially for men: Conduct standardized self-tests (e.g., word lists, task switching, reaction time apps) every 3–6 months and link anomalies to training adjustments. Male networks are more strongly influenced by cognitive outcomes ^[1]. - Personalize prevention according to origin and life reality: If you come from underserved settings or have other cultural stressors, prioritize accessible levers: regular walking programs, group-based activities, blood pressure screenings in the community. Large projects like FemBER-Africa emphasize that prevention must be sensitive to sex, gender, and origin ^[4]. - Consider hormonal transitions: Women around menopause should closely monitor cardiometabolic factors (blood pressure, waist circumference, HbA1c) and use exercise as foundational therapy; research underscores the relevance of endocrine factors for dementia risk and the necessity for individualized strategies ^[4]. - Combine mental work with movement: Integrate “dual-task” sessions (e.g., brisk walking plus mental math). This way, you utilize the differentiated cognitive effects of physical activity and increase everyday resilience ^[2]. - Think anti-deterministically: Rely on neuroplasticity through learning challenges (new language, instrument), rather than invoking supposed “gender limits.” An interactionist perspective – biology plus experience – fosters growth and prevents self-limiting beliefs ^[3].

Sex shapes risks – but your daily life shapes the outcome. Start this week with 150 minutes of targeted movement, regularly measure your blood pressure, and establish a short cognitive check-in ritual. Precision in small habits builds today’s cognitive reserve for tomorrow.