Objective To explore the factors related to the progression of leukodystrophy in elderly patients with type 2 diabete.Methods A total of 87 elderly T2DM patients with leukoencephalopathy were selected from the Department of Neurology of China Resources Wisco General Hospital from January 2020 to January 2023. The patients were divided into two groups: no progression group (55 cases) and progression group (32 cases). Basic information of the patients was collected and recorded, including gender, age, years of education, course of diabetes, previous medical history, including history of hypertension, personal information, and laboratory indicators such as triglyceride glucose index (TyG), homocysteine (Hcy), liver and kidney function, blood lipid, blood glucose, and glycosylated hemoglobin (HbA1c). Multivariate Logistic regression analysis was used to investigate the factors affecting the progression of leukinopathy in elderly patients with T2DM.Results There were no significant differences in gender, hypertension, education level, diabetes course, HbA1c, blood glucose, uric acid (UA) and HCy between 2 groups (P＞0.05). The number of patients with history of age, cholesterol, triglyceride, low density lipoprotein and high density lipoprotein in the progressive group were significantly higher than those in the non-progressive group, with statistical significance (P＜0.05). Binary Logistics regression method was adopted to adjust the levels of age, triglyceride, cholesterol, triglyceride, low density lipoprotein and high density lipoprotein. The results showed that the progression of leucomatosis in elderly patients with type 2 diabetes was significantly correlated with age and Tgy index (P＜0.05). Conclusion Age and TyG index are independent risk factors for progression of leukodystrophy in elderly patients with type 2 diabetes