Abstract Background: Anemia is common in older adults aged 65 years and older, associated with morbidity, mortality, and increases the risk for cognitive decline [1]. The aim of the study was to evaluate the association between anemia and risk factors for poor cognitive function in elderly patients. Patients and method: This study included one hundred elderly patients at internal medicine department in Assiut University hospital, which chosen randomly for three months from the first of January 2018 to the end of March 2018. Each elderly patients were assessed through socio-demographic data, hemoglobin level, activities of daily living (ADL), Mini-Mental State Examination (MMSE), Body mass index (BMI) and Charlson Comorbidity Index (CCI) Results: Anemia was shown in 78 % of patients, in comparison to patients without anemia, anemic patients showed significantly poor MMSE score (19±3.4 vs. 24±2.5; p<0.001), high CCI (3.7±1.2 vs. 2.8±0.85; p=0.001) and associated with severe functional impairment (38.5%vs 13.8%; p<0.001). A significant negative correlation between MMSE scores with age (r= -0.357, p<0.001) and CCI (r= -0.508, p<0.001) were detected. Conclusion: Older age, low education level, anemia, and comorbidity are predictive for impaired cognitive function. Increased BMI and full daily activities are protective against cognitive function impairment. Recommendation: Health education program for elderly regarding the causes, risk factors and treatment of anemia.