Objective To investigate the effects of a cognitive-exercise dual-task training programme for elderly osteoporosis patients in the community. Methods Based on literature review and expert consultation, a cognitive-exercise dual-task training programme was developed for elderly osteoporosis patients. Then a total of 44 elderly osteoporosis patients in community were recruited from July to September 2024, and were randomized into a control group and an intervention groupby using a random number table, with 22 cases in each group. The control group used Otago and Baduanjin exercises, while the intervention group additionally performed the cognitive-exercise dual-task training programme for 12 weeks. Results Totally 21 patients in the control group and 20 patients in the intervention group completed the study. After the training, the time of dual-task timed walking test in the intervention group was significantly shorter than that of the control group, and the gait scores in the intervention group were significantly higher than those of the control group (all P＜0.05); while there were not statistically significant differences between the two groups in static balance, timed walking test time, and ABC balance confidence scores (all P＞0.05). Conclusion Cognitive-motor dual-task training is conducive to improving the gait and dynamic balance of community-dwelling elderly patients with osteoporosis, alleviating their fear of falling, and preventing falls.