BACKGROUND: Physio-Cognitive Decline Syndrome (PCDs) is characterized by the coexistence of MIND (mobility impairment, no disability) and CIND (cognitive impairment, no dementia), which predicts dementia risk. Deteriorating oral health can contribute to malnutrition, cognitive decline, and physical frailty, all of which may exacerbate PCDs symptoms. This study investigates the association between oral health and PCDs, exploring sex differences in this relationship. METHOD: A cross-sectional analysis of the baseline data from the Nanjing Brain Health Cohort included 252 participants aged 60 and older, assessing physical mobility (6-meter walk test, grip strength), cognitive function (MoCA), and oral health (natural teeth count, denture use, tongue and lip motor function, masticatory and swallowing ability, Oral Frailty Index). Logistic regression models were used to examine associations between oral health and PCDs. RESULTS: Among participants, 15.5% were classified as having PCDs. The odds of having PCDs were lower with a higher number of teeth (OR = 0.939, 95% CI: 0.890-0.991, p = 0.021), while impaired tongue and lip motor function increased the odds of PCDs (OR = 3.811, 95% CI: 1.059-13.717, p = 0.041). In females, the odds of MIND and CIND were lower with a greater number of teeth and denture use. For males, the odds of PCDs were higher with oral frailty (OR = 5.202, 95% CI: 1.429-18.940, p = 0.012). CONCLUSIONS: Findings underscore the significant association between oral health and the odds of PCDs among older adults, with sex-specific effects. For women, maintaining natural teeth and proper denture use are associated with lower odds of MIND and CIND, while for men, oral frailty is linked to higher odds of PCDs. Healthcare providers should consider oral health and incorporate sex-specific strategies.