Age-related decreases in executive function and an increase in arterial stiffness and plasma homocysteine levels are related to the risk of dementia. However, the association between executive function, arterial stiffness, and homocysteine levels remains unclear. This study aimed to investigate the relationship between executive function, arterial stiffness, and plasma homocysteine in 82 middle-aged and older women. The Stroop interference time, Brachial-ankle Pulse Wave Velocity (baPWV), and plasma homocysteine concentration were collected. The correlation analyses revealed that the Stroop interference time was significantly correlated with plasma homocysteine (r = 0.40, p < 0.001) and baPWV (r = 0.38, p = 0.001). In addition, plasma homocysteine levels were significantly correlated with baPWV (r = 0.48, p < 0.001). In the mediated analyses, the plasma homocysteine level directly (b = 0.24; p = 0.037) and indirectly (b = 0.12, 95% confidence interval [0.007, 0.238]) affected the Stroop interference time. These results suggest that higher plasma homocysteine levels are associated with a decline in executive function mediated by higher artery stiffness in middle-aged and older women.
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