Objective To explore the depression， anxiety， and cognitive function of elderly patients with acute ischemic stroke after 12 months of treatment， and analyze their correlation. Methods This study was a cross-sectional survey. From January 2019 to December 2022， 478 elderly patients with mild to moderate acute ischemic stroke and stable conditions after 12 months of treatment in the Neurology Department of Xuanwu Hospital of Capital Medical University were selected as the study subject. The Hamilton Depression Scale （HAMD） and Hamilton Anxiety Scale （HAMA） were used to evaluate the depression and anxiety of patients. The Montreal Cognitive Assessment （MoCA） and Mini-Mental State Examination （MMSE） were used to evaluate the cognitive function of patients， and the modified Rankin Rating Scale （mRS） was used to evaluate the neurological deficit and prognosis of patients. Spearman's correlation analysis was used to analyze the correlation between patients' cognitive function and depression and anxiety. Results 43.51% （208/478） of patients had anxiety symptoms， 39.54% （189/478） had depression symptoms， 64.64% （309/478） had cognitive impairment， and 44.56% （213/478） had cognitive dysfunction. The scores of HAMD and HAMA of female patients were higher than that of male patients， the scores of MoCA and MMSE of patients with≤12 years of education were higher than those of patients with＞12 years of education， the scores of MoCA and MMSE of patients living in rural areas were lower than those of urban patients， and the scores of MoCA and MMSE of patients with hypertension or diabetes were higher than those of patients without hypertension or diabetes， with statistically significant differences （P＜0.01）. Compared with patients with an mRS score of 2， patients with an mRS score of 0 to 1 had lower HAMD and HAMA scores， higher MoCA and MMSE scores， and the differences were statistically significant （all P ＜ 0.001）. Spearman correlation analysis showed that the HAMD score of patients was negatively correlated with the total score of MoCA （r=-0.125， P=0.029）， attention （r=-0.212， P ＜ 0.001）， and speech function （r=-0.129， P=0.024）， and the HAMA score was negatively correlated with the attention （r=-0.180， P=0.002）. Conclusions After 12 months of treatment， some elderly patients with acute ischemic stroke have anxiety， depression， and cognitive dysfunction， and the more severe the symptoms of depression and anxiety， the worse the cognitive function of the patients. Clinical attention should be focused on the emotion and cognition of women， those with low educational years， rural areas， those with severe neurological impairment， hypertension or diabetes.