Background <p>Given the increasing prevalence of Mild Cognitive Impairment (MCI) among the elderly as a precursor to dementia, understanding how targeted interventions can improve daily functioning and delay cognitive decline is critical to improving quality of life in aging populations.</p> Objective <p>To investigate the effects of hand exercises and cognitive training on cognitive functions, hand skills, grip strength, dual-task-performance and interactions in elderly individuals with MCI.</p> Materials and methods <p>A randomized, single-blind study was conducted with 47 participants aged 65 and older living in nursing homes. Participants were divided into hand exercise group (HEG = 15), cognitive exercise group (CEG = 15) and control group (CG = 17). Exercise was applied to HEG and CEG for 8 weeks. Cognitive functions, grip strength, hand skills, motor-motor dual task performance (MMDTP), motor-cognitive dual task performance (MCDTP), motor-motor dual task interaction (MMDTI), motor-cognitive dual task interaction(MCDTI) and Manual Ability Measurement (MAM-36) were assessed.</p> Results <p>HEG improved in hand skills, grip strength, MCDTP, MMDTP, and MAM-36, with reduced MCDTI. CEG showed gains in cognition, MMDTP, and hand use (<i>p</i> &lt; 0.05).</p> Conclusions <p>Hand exercises enhance motor and functional ability, while cognitive exercises supports cognitive performance and MMDTP.</p> Trial registration <p>The clinical protocol of the study was registered in the ClinicalTrials.gov system, registration number: NCT06837493.</p>