Abstract: Objectives: To evaluate the effectiveness of an Acceptance and Commitment Therapy (ACT)-based cognitive intervention on quality of life (QOL) and cognitive function among older adult residents with mild cognitive impairment (MCI) in residential care. Methods: A randomized controlled trial was conducted with 215 older adults residents from six senior care facilities in southern Spain, allocated to an intervention group (n = 103) and a control group (n = 112). The intervention group participated in ACT-based cognitive training sessions twice weekly for 12 weeks. Assessments were conducted at baseline, post-intervention, and six months post-intervention. Structural equation modeling (SEM) examined relationships among intervention exposure, cognitive outcomes, emotional well-being, and QOL. Results: The intervention group demonstrated significant improvements in cognitive function (MMSE +2.1 points, p < .001) and QOL (QOL-AD + 4.1 points, p < .001), while the control group showed slight declines. SEM analysis (beta?² = 98.45, df = 72, p < .01; CFI = .94; RMSEA = .04) identified psychological flexibility (beta = .35, p < .001) and social engagement (beta = .21, p < .01) as significant predictors of QOL, explaining 42% of its variance (R² = .42). Conclusions: ACT-based interventions effectively enhance QOL and cognitive function in older adult residents with MCI. Psychological flexibility and social engagement are key contributors to improved outcomes. Clinical implications: Integrating structured ACT-based cognitive interventions in long-term care settings may support mental resilience, well-being, and cognitive health in older populations.

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