Abstract: Objective:To investigate the clinical factors of cognitive impairment in elderly patients with lacunar infarction(LI),and provide reference in improving the cognitive function of patients.Methods:One hundred and seventeen elderly patients with LI(LI group) were subdivided into the bilateral group,left group and right group according to the lesion location,and 100 healthy people were set as the control group.The score of Montreal cognitive assessment scale(MoCA) between two groups was compared.The influencing factors of cognitive function in elderly patients with LI were analyzed using the single factor analysis and multi factor logistic regression analysis.Results:Among 117 cases,the total score of MoCA was(24.92±2.96),the cognitive dysfunction in 64 cases(54.70%) were found.The delayed recall,attention,language,visual space/executive function and MoCA score in LI group were lower than those in control group(P<0.05 to P<0.01).The delayed recall,language,visual space/executive function and MoCA score in right group were higher than those in bilateral group and left group(P<0.05 to P<0.01),and which in left group was higher than that in bilateral group(P<0.05 to P<0.01).The attention score in right group was higher than that in bilateral group(P<0.01).The analysis result of influencing factors showed that the lesion location,hypertension,diabetes mellitus and protein disease were the independent risk factors of cognitive function in elderly patients with LI(P<0.05 to P<0.01).Conclusions:The elderly LI patients complicated with cognitive dysfunction is often,and the visuospatial/executive function,attention,language,memory disorders are the major performances,the cognitive dysfunction in bilateral or left side lesions patients is more obvious,the lesion location,severe protein lesion,hypertension and diabetes are the related risk factors affecting the cognitive dysfunction in elderly patients with LI.