How Nutrition and Hemoglobin Levels Affect the Health of Older Adults with Myelodysplastic Syndromes

When people with myelodysplastic syndromes (MDS) have other health problems, it can make them more  likely to have treatment side effects and need additional care. As people age, they are more likely to have one or more additional health problems. Over time, these challenges can lead to frailty. Frailty is the word doctors use to describe decreased physical and cognitive functions that affect a person’s day-to-day quality of life. Frailty can also affect how well treatments work to treat MDS.

At the 2025 European Hematology Association conference, researchers presented results from a study about the role nutrition and hemoglobin levels play in older adults with MDS becoming frail. Hemoglobin is a protein in red blood cells that helps move oxygen through the body. Previous research has suggested that higher levels of hemoglobin and good nutrition can reduce the risk of frailty in people with blood cancers. However, the way these factors interact in elderly patients with MDS has not been fully understood. 

Learn more about  the role of frailty in MDS here.

Understanding the connection between nutrition and frailty

Between January and July 2024, there were 152 older patients diagnosed with MDS from 10 hospitals in China enrolled in the study. They completed questionnaires and assessments. Researchers then analyzed the data for any correlations between nutrition, hemoglobin, and frailty. The study used evaluation tools such as the Geriatric-8 (G-8) scale, which screens for frailty, and the Mini Nutritional Assessment Short-Form (MNA-SF), which measures nutritional status.

The study was designed to find the blood-related and general health factors that influence frailty in older adults with MDS. Understanding how these factors are connected could help healthcare teams develop targeted strategies to prevent or reduce frailty for older adults with MDS.

 Better nutrition associated with improved overall health for older adults with MDS 

More than half (56.6%) of the patients met the criteria for frailty. The analysis found:

• Better nutrition was strongly associated with lower frailty.
• Higher hemoglobin levels were also strongly associated with lower frailty.
• Hemoglobin acted as a partial mediator between nutrition and frailty, meaning that part of nutrition’s impact on frailty comes from its effect on hemoglobin levels. 

These findings suggest that improving nutrition in elderly patients with MDS may not only directly improve health but may also do so indirectly by supporting healthier hemoglobin levels. 

Moving toward targeted interventions to improve health of older adults with MDS

This research can help healthcare teams create better strategies for older adults with MDS to maintain independence, function, and quality of life for as long as possible. Examples of possible strategies include nutritional counseling, individualized diet planning, and therapies that support red blood cell production.

What does the connection between nutrition and overall health mean for older adults with MDS?

Frailty has a connection to both nutritional status and hemoglobin levels in older adults with MDS. Targeted interventions that address both nutrition and hemoglobin may help prevent or reverse frailty. Patients and caregivers can discuss with their care teams whether nutritional support and hemoglobin monitoring could be part of their management plan. 

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Source: 

• The Frailty Syndrome: Definition and Natural History

• THE RELATIONSHIP BETWEEN NUTRITION, HEMOGLOBIN, AND FRAILTY IN ELDERLY PATIENTS WITH MYELODYSPLASTIC SYNDROMES: A MEDIATION EFFECT ANALYSIS