Abstract: Objective To explore the effect of nimodipine combined with donepezil on serum levels of insulin-like growth factor-1(IGF-1), nucleotide-binding oligomerization domain-like receptor protein 3(NLRP3)and lipoprotein-associated phospholipase A2(Lp-PLA2)in elderly patients with vascular dementia(VD). Methods A total of 124 elderly VD patients were randomly divided into combined group and nimodipine group, with 62 cases in each group. The nimodipine group was treated with nimodipine, and the combined group was treated with donepezil on the basis of the nimodipine group. The scores of Mini-Mental State Examination(MMSE), neurological deficit score, Hasegawa Dementia Scale(HDS)score and Montreal Cognitive Assessment Scale(MoCA)score were compared between two groups. The Barthel Index(BI)and score of Ability of Daily Life Scale were compared between two groups. The hemodynamic parameters and serum levels of IGF-1, Lp-PLA2 and NLRP3 were compared between the two groups before and after treatment. Results The scores of MMSE, HDS, MoCA, ADL and BI as well as serum IGF-1 level significantly increased in both groups after treatment(P<0.05), while the neurological deficit score, whole blood viscosity, plasma viscosity, hematocrit, fibrinogen and relative expression levels of Lp-PLA2 and NLRP3 significantly decreased after treatment(P<0.05). The changes of indexes mentioned above in the combined group were significantly greater than those in the nimodipine group(P<0.05). Conclusion Nimodipine combined with donepezil is effective in the treatment of elderly patients with VD, which - can effectively improve the dementia status, quality of daily life, cognitive function and vascular function.