Associations between cardiac autonomic function and cognition across the adult female lifespan

A growing body of evidence highlights the direct involvement of the autonomic nervous system on cognitive processes. Vagal-mediated heart rate variability (vmHRV), a measure of cardiac autonomic control, has been linked to cognitive outcomes in both healthy and clinical populations. However, few studies have directly examined this relationship in females. Understanding the interplay between vmHRV and cognitive functioning in females is important for elucidating sex-specific mechanisms contributing to cognitive trajectories across the female lifespan. The present review synthesizes the literature examining vmHRV and cognition in females at different transitional life phases, including the menstrual cycle, menopausal transition, and postmenopausal period, and considers the implications of polycystic ovary syndrome. The evidence summarized describes fluctuations in vmHRV and cognitive function across the female adult lifespan; however, notable gaps in the literature are identified. Further research is needed to better understand these complex interactions and to guide the development of targeted strategies to support female cognitive health with advancing age.