BackgroundThe effects of multiple-modality exercise on arterial stiffening and cardiovascular fitness has not been fully explored. ObjectivesTo explore the influence of a 24-week multiple-modality exercise program associated with a mind-motor training in cardiovascular health and fitness in community-dwelling older adults, compared to multiple-modality exercise (M2) alone. MethodsParticipants (n=127, aged 67.5 [7.3] years, 71% females) were randomized to either M4 or M2 groups. Both groups received multiple-modality exercise intervention (60min/day, 3days/week for 24-weeks); however, the M4 group underwent additional 15min of mind-motor training, whereas the M2 group received 15min of balance training. Participants were assessed at 24-weeks and after a 28-week non-contact follow-up (52-weeks). Resultsat 52-weeks, the M4 group demonstrated a greater VO2max (ml/kg/min) compared to the M2 group (mean difference: 2.39, 95% CI: 0. 61 to 4.16, p=0.009). Within-group analysis indicated that the M4 group demonstrated a positive change in VO2max at 24-weeks (mean change: 1.93, 95% CI: 0.82 to 3.05, p=0.001) and 52-weeks (4.02, 95% CI: 2.71 to 5.32, p=0.001). Similarly, the M2 group increased VO2max at 24-weeks (2.28, 95% CI: 1.23 to 3.32, p<0.001) and 52-weeks (1.63, 95% CI: 0.43 to 2.83, p=0.008). Additionally, the M2 group decreased 24h SBP (mmHg) at 24-weeks (−2.31, 95% CI: −4.61 to −0.01, p=0.049); whereas the M4 group improved 24h DBP (−1.6, 95% CI: −3.03 to −0.17, p=0.028) at 52-weeks. ConclusionMind-motor training associated with multiple-modality exercise can positively impact cardiovascular fitness to the same extent as multiple-modality exercise alone.