Brachial artery flow-mediated dilation (BAFMD) is induced by hyperemic wall shear rate (WSR) following forearm ischemia. In older adults, there appears to be a reduced hyperemic WSR and altered stimulus-response relationship occurring at the brachial artery compared to young adults. However, it is unclear if an altered forearm microvascular response to ischemia influences brachial hyperemic WSR in older adults. We determined the association between brachial hyperemic WSR and forearm skeletal muscle oxygen saturation in young and older adults. Healthy young (n=17, 29±7 yrs) and older (n=32, 65±4 yrs) adults participated in the study. BAFMD by a multi-gate spectral Doppler system and forearm skeletal muscle oxygen saturation by near infrared spectroscopy were concurrently measured. Compared to the young, older adults showed reduced oxygen extraction kinetics [OE: 0.15 (0.12-0.17) vs 0.09 (0.05-0.12) %s-1] and magnitude (SO2deficit: 3810±1420 vs 2723±1240 %s) during ischemia, and oxygen re-saturation kinetics (SO2slope: 2.5±0.7 vs 1.7±0.7 %s-1) upon reperfusion (all p<0.05). When OE in the young and SO2slope in older adults were stratified by their median values, young adults with OE above median had greater hyperemic WSR parameters compared to those with OE below median (p<0.05), but SO2slope in older adults did not show clear differences in hyperemic WSR parameters between those with above/below median. This study demonstrates that, additionally to a reduced microvascular response to ischemia, there may be a possible dissociation of microvascular response to ischemia to brachial hyperemic WSR in older adults, which may result in a further impairment of BAFMD in this cohort.