Background:　Combined　art　activities　can　improve　the　neural　network　function　within　various　brain　regions　involved　in　emotions,　cognition,　and　behavior,　thereby　preventing　or　reversing　cognitive　decline.　However,　few　studies　have　systematically　examined　its　effects.　Furthermore,　the　impact　of　nurse-led　art-based　cognitive　intervention　on　cognitive　and　psychological　health　is　unclear.　Objective:　To　evaluate　the　effects　of　a　nurse-led　staged　integral　art-based　cognitive　intervention　in　older　adults　on　the　Alzheimer＇s　disease　spectrum.　Design:　This　was　a　randomized　wait-list　controlled　trial　with　allocation　concealment　and　blinding　of　outcome　assessors　and　data　analysts.　All　data　were　collected　between　April　2021　and　January　2023　and　analyzed　from　January　to　March　2023.　Setting:　One　memory　clinic　and　four　medical　partnership　communities.　Participants:　A　total　of　144　participants　with　subjective　or　objective　memory　decline　(aged　≥　60　years).　Methods:　Participants　were　randomized　into　an　intervention　group　(n　=　72)　and　a　wait-list　control　group　(n　=　72),　in　a　1:1　ratio.　The　intervention　group　underwent　a　16-week,　24-session　nurse-led　staged　integral　art-based　cognitive　intervention　program,　which　was　based　on　neurocognitive　function　training　patterns.　The　control　group　underwent　the　program　after　the　follow-up　assessment.　General　and　specific　domains　of　cognitive　function　and　other　health-related　outcomes　were　measured　at　baseline　(T0),　immediately　after　the　intervention　(T1),　and　at　the　6-month　follow-up　(T2).　Results:　Of　the　144　participants　(mean　[SD]　age,　71.6　[5.8]　years;　50　[34.7　%]　males　and　94　[65.3　%]　females),　130　and　115　completed　the　questionnaires　at　T1　and　T2,　respectively.　The　average　attendance　rate　in　the　intervention　group　was　86.0　%.　At　T1,　the　intervention　group　showed　greater　improvement　than　the　control　group　did　in　general　cognitive　functions　(MoCA,　between-group　mean　difference,　1.4　[95　%　CIs,　0.4　to　2.5],　p　=　0.009).　Additionally,　the　intervention　group　demonstrated　statistically　significant　improvement　compared　to　the　control　group　in　language,　memory,　quality　of　life,　sleep　quality　and　physical　activity　level　at　T1.　Statistically　significant　group　differences　remained　in　sleep　quality　(PSQI,　between-group　mean　difference,　−　1.3　[95　%　CIs,　−　2.5　to　−　0.1],　p　=　0.035)　at　the　6-month　follow-up.　Conclusions:　In　this　randomized　controlled　trial　of　a　nurse-led　staged　integral　art-based　cognitive　intervention　program,　older　adults　on　the　Alzheimer＇s　disease　spectrum　who　participated　in　the　program　experienced　improved　cognition　and　psychological　health.　Registration:　This　study　was　registered　with　ChiCTR.org　(ChiCTR2100044959)　on　April　3,　2021.　Tweetable　abstract:　A　nurse-led　staged　integral　art-based　intervention　for　older　adults　on　the　Alzheimer＇s　disease　spectrum　experienced　improved　cognition　and　psychological　health.　©　2024　Elsevier　Ltd