Background: To compare the effect of dance and gymnastic intervention on cognition and neuropsychiatric symptoms in elderly with cognitive impairment. Methods Twenty-three older adults (64-90 years-old), attending the day care center and diagnosed with cognitive impairment, were randomized to a 16-week dance intervention or a gymnastic intervention (60 min/week). Cognitive function (MMSE), neuropsychiatric symptoms (GDS-15, NPI), and physical function (TUG, ADL) were evaluated at the baseline and at the end of the intervention. After estimation by the Borg scale, these two physical activities were performed at similar intensities (60-70% HRR). Results MMSE score was significantly increased after the intervention in dance group (+3.3/+14%, p=0.03), especially memory recall (+1/+220 %, p=0.03), but not for the gymnastic group. GDS-15 and NPI decreased significantly (p<0.001) after the intervention in both groups However, no significant effect was noted for TUG and ADL. Conclusion The study findings support the potential utility of dance as a multimodal intervention for improving cognition. A low frequency ecological dance intervention (1time/week; 60 min) is sufficient to enhance cognition. In further practise, dance exercise could be more practised in community-dwelling.