1 Faculty of Medicine, Department of Biomedical Science, Université de Montreal, Montreal, QC, Canada.
2 Research Center, Montreal Heart Institute, Montreal, QC, Canada.
3 Centre de recherche de l'Institut Universitaire de Gériatrie de Montréal (CRIUGM), Montréal, QC, Canada.
4 Department of Medicine, Universite de Montreal, Montreal, QC, Canada.
5 PERFORM Centre, Concordia University, Montreal, QC, Canada.
6 INDI Department, Concordia University, Montreal, QC, Canada.
7 Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.
8 Department of Psychology, Concordia University, Montreal, QC, Canada.
9 LITO laboratory, Inserm, Institut Curie, Orsay, France.
10 Montreal Neurological Institute, Montreal, QC, Canada.
11 Department of Neurology and N

It is well established that sex differences exist in the manifestation of vascular diseases. Arterial stiffness (AS) has been associated with changes in cerebrovascular reactivity (CVR) and cognitive decline in aging. Specifically, older adults with increased AS show a decline on executive function (EF) tasks. Interestingly, the relationship between AS and CVR is more complex, where some studies show decreased CVR with increased AS, and others demonstrate preserved CVR despite higher AS. Here, we investigated the possible role of sex on these hemodynamic relationships. Acquisitions were completed in 48 older adults. Pseudo-continuous arterial spin labeling (pCASL) data were collected during a hypercapnia challenge. Aortic pulse wave velocity (PWV) data was acquired using cine phase contrast velocity series. Cognitive function was assessed with a comprehensive neuropsychological battery, and a composite score for EF was calculated using four cognitive tests from the neuropsychological battery. A moderation model test revealed that sex moderated the relationship between PWV and CVR and PWV and EF, but not between CVR and EF. Together, our results indicate that the relationships between central stiffness, cerebral hemodynamics and cognition are in part mediated by sex.