Introduction. Demographic aging of the population, especially pronounced in the Russian Federation (the proportion of people over 65 years of age has reached 17.7%), makes the problem of age-related diseases extremely significant. Anemia affects more than 30% of the world's population, and after the age of 50, its prevalence increases dramatically, exceeding 20% at the age of 85 and older. Despite the recognition of anemia as a blood disease, its specific impact on key geriatric syndromes in older patients remains insufficiently studied. Objective. To study the relationships and the impact of anemia on the deterioration of geriatric status in elderly and senile patients. Materials and methods. A one-stage study was conducted on 96 patients (mean age 76.2 years; 61.5% women) with comorbid pathology (HT, CHF, CHD, type 2 DM). All patients were divided into groups according to the presence/absence of anemia (WHO criteria). Laboratory parameters (Hb, red blood cells, RDW, inflammation indices, IVI, PLR, MLR) and geriatric statuses were assessed: cognition (MMSE), functional activity (Barthel, Lawton scales), motor function (Tinetti) and nutritional status (MNA). Results. Patients with anemia showed a significant decrease in hemoglobin and red blood cell levels, accompanied by an increase in RDW by 14.8%. There was a significant increase in markers of inflammation: IVI by 76.9%, PLR by 29.8%, and MLR by 20%. Anemia was associated with a deterioration in all components of geriatric status: cognitive decline (MMSE: 22 vs 26 points, mild dementia), impaired balance and walking, reduced basic (ADL) and instrumental (IADL) activities, and malnutrition. Discussion. Direct strong correlations were established between hemoglobin levels and geriatric indicators: malnutrition (r=0.961), cognitive abilities (r=0.821), and daily activity (r=0.751). The obtained regression models show that a decrease in hemoglobin levels is a predictor of the severity of these syndromes. Conclusions. The presence of anemia in patients of older age groups significantly worsens the somatic status due to the activation of systemic inflammation and leads to negative changes in functional and cognitive status, as well as nutritional deficiency. A significant relationship has been proven between a decrease in hemoglobin and the progression of malnutrition, cognitive dysfunction, and limitation of daily activity.