Objectives: In a randomised controlled trial, we investigated whether a cognitive training based on rhythm-music and music improvisation exercises had positive effects on executive functions in older participants.Methods: Thirty-five residents in a guest home with mild-moderate cognitive impairment and healthy ageing were randomly assigned to an experimental group (n = 18) featuring cognitive music training composed of 12 bi-weekly 70-min sessions, and a control group (n = 17) attended 12 bi-weekly 45-min sessions of gymnastic activities offered by the institute. A neuropsychological test battery was administered at baseline and at the end of treatment, including the Mini-Mental State Examination, verbal fluency test, Trail Making Test A, attentional matrices test and clock-drawing test.Results: Pre-test and post-test comparison showed a significant improvement for the experimental group reflected in the Mini-Mental State Examination (F(1,33) = 13.906; p < 0.001; pη2 = 0.296), verbal fluency test (VFL) (F(1,33) = 6.816; p < 0.013; pη2 = 0.171), and clock-drawing test (F(1,29) = 16.744; p < 0.001; pη2 = 0.366), while the control group did not show any significant improvements. In addition, there was a tendency towards significance for the Trail Making Test A (F(1,20) = 3.268; p < 0.086; pη2 = 0.140). Regarding the attentional matrices test, no significant differences were found for the experimental group (F(1,29) = 2.833; p < 0.103; pη2 = 0.089), while the control group had a significant performance reduction (F(1,29) = 3.947; p < 0.050; pη2 = 0.120).Conclusion: The use of a cognitive protocol based on music-rhythmic exercises and music improvisation exercises is associated with improved cognitive functions in older people with mild-moderate cognitive impairment regardless of the individual's degree of cognitive reserve. Copyright © 2017 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]