Objectives: The study aimed to explore the association between the combination of osteoporosis and sarcopenia and the prevalence of mild cognitive impairment (MCI) in Chinese community-dwelling older adults. Design: A cross-sectional study. Setting and Participants: Older adults aged >= 65 years in the Shanghai community participated in this physical examination. Methods: The dual-energy X-ray image of the forearm bone of each participant whose T score is equal to or less than-2.5 is defined as osteoporosis. Sarcopenia was diagnosed according to the 2019 Asia Working Group for Sarcopenia (AWGS) standard. The Mini Mental State Examination (MMSE) and the Instrumental Activities of Daily Living (IADL) scales were used to diagnose patients with MCI. Results: This study was conducted on 1058 (47.0% male) Chinese community-dwelling participants with a mean age of 71.79 +/- 5.31 years. Participants were classified into mutually exclusive groups based on sarcopenia and osteoporosis: normal, osteoporosis alone, sarcopenia alone, and co-occurring groups. We found that the MCI prevalence of the 4 groups was 9.0% (n = 47), 11.1% (n = 44), 22.7% (n = 10), and 28.3% (n = 26) in the normal, osteoporosis alone, sarcopenia alone, and co-occurring groups, respectively. The prevalence of MCI was significantly greater in the co-occurring group [odds ratio (OR), 4.00; 95% confidence interval (CI), 2.32-6.89] than in the sarcopenia alone group (OR, 2.99; 95% CI, 1.39-6. 42). After adjusting for potential confounding factors, the co-occurring group remained the only statistically significant group (OR, 2.29; 95% CI, 1.17-4.4 8). Conclusions and Implications: In our study, although sarcopenia and osteoporosis did not independently affect the prevalence of MCI, the co-occurrence of osteoporosis and sarcopenia can synergistically increase the prevalence of MCI in Chinese community-dwelling older adults. (c) 2025 The Author(s). Published by Elsevier Inc. on behalf of Post-Acute and Long-Term Care Medical Association. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/ licenses/by-nc-nd/4.0/).