Objective To explore the relationship of the levels of serum vascular endothelial growth factor(VEGF)and brain-derived neurotrophic factor(BDNF)with the severity of vascular dementia(VD)in the elderly patients,and to investigate the predictive value of VEGF and BDNF for prognosis.Methods A retrospective analysis was performed on the clinical data of 102 elderly patients with VD admitted to Affiliated Hospital of Jiangnan University from January 2022 to December 2023.The patients were divided into mild group(37 cases),moderate group(43 cases)and severe group(22 cases)according to the severity of the VD.Fasting venous blood samples were collected within 24 h after admission.The levels of BDNF and VEGF were determined by enzyme-linked immunosorbent assay,and the relationship between BDNF,VEGF and the severity of VD was analyzed.The patients were followed up for 3 months after discharge,and were divided into good prognosis group(77 cases)and poor prognosis group(25 cases)according to the prognosis.The influencing factors of prognosis were analyzed.The predictive value of BDNF and VEGF for the prognosis of patients was analyzed by receiver operating characteristic(ROC)curve.Results The levels of VEGF and BDNF were lowest in severe group,followed by moderate group and mild group(P<0.05).The score of Mini-mental State Examination(MMSE)was negatively correlated with the levels of VEGF and BDNF(P<0.05).Univariate analysis showed significant differences in age,proportion of smoking history and severe disease severity,and the levels of VEGF and BDNF between the good prognosis group and the poor prognosis group(P<0.05).Binary Logistic regression analysis showed that age and disease severity were independent risk factors for the prognosis of patients,and VEGF and BDNF were independent protective factors(P<0.05).The results of ROC curve showed that the sensitivity of VEGF,BDNF and their combination to predict the prognosis of patients was 76.20%,72.00%,92.10%,respectively,the specificity was 75.30%,72.70%,90.90%,respectively,and the area under the curve(AUC)was 0.831,0.805 and 0.938,respectively(P<0.05).Conclusions The severity of VD is significantly negatively correlated with the levels of VEGF and BDNF.The combined detection of BDNF and VEGF levels can effectively predict the prognosis of VD patients.