Families of autistic children with sensory needs who live in rural areas and places where in-person visits are not possible may benefit from additional therapy delivery options. To assess parents' and therapists' acceptability of a telehealth delivery of occupational therapy using Ayres Sensory Integration® (OT-ASI) and to evaluate preliminary changes in children's daily life skills and autism symptoms. One-group pilot feasibility trial. Telehealth delivery to the home environment. Families (N = 6) with children ages 4 to 12 yr, diagnosed with autism and sensory difficulties, able to follow simple directions, willing to participate in 10 telehealth sessions, willing to complete pre and post measures, and with access to Wi-Fi-enabled devices. Telehealth delivery of 10 OT-ASI sessions. Sensory feature measures included the Sensory Processing Measure and a sensory screening tool adapted from the Evaluation of Ayres Sensory Integration®. Parent measures included goal attainment scaling, Pediatric Evaluation of Disability Inventory Computer Adaptive Test, and Pervasive Developmental Disorders Behavior Inventory. The fidelity measure was adapted from the ASI® Fidelity Measure. Acceptability and feasibility were evaluated via semistructured interviews with parents and therapists. Parents and interventionists were highly satisfied with OT-ASI and indicated that it was feasible to deliver. Children improved in individualized goals and functional skills as well as socialization and showed a decrease in overall autism symptomatology. Telehealth delivery of OT-ASI is feasible and acceptable while maintaining strong fidelity. It can extend the reach and impact of occupational therapy services to autistic children and their families, particularly those facing barriers to in-person care. Plain-Language Summary: Many autistic children process or respond to sensation differently from other children, which can affect their participation in daily life activities. Occupational therapy using Ayres Sensory Integration® (OT-ASI) is an evidence-based intervention that can help these children participate more fully in daily life activities and reach personal goals. During the coronavirus disease 2019 pandemic, the OT-ASI intervention was updated for online delivery. This online approach was rated by parents and interventionists as feasible and helpful. Children met goals and improved social communication and responsibility skills. More research is needed to confirm and expand on these results.

Transcranial direct current stimulation (tDCS) of the primary motor cortex is being discussed as an adjunct to therapy for Parkinson's disease (PD). The effectiveness of tDCS in PD remains controversial, and there are no data evaluating the efficacy and safety of tDCS in PD in our country. Objective: to evaluate the clinical efficacy of a course of anodal tDCS applied to the primary motor cortex as part of a comprehensive treatment regimen for patients with stage II–III PD according to the Hoehn and Yahr scale, including its effects on motor, cognitive and affective symptoms, as well as the safety and tolerability of the method. Material and methods. A prospective, randomised, controlled trial was conducted involving 46 patients with idiopathic PD (25 men and 21 women; mean age 63.9 ± 11.2 years). The main group (n = 24) received 10 sessions of anodal tDCS to the M1 region (2 mA, 20 min, daily, for 2 weeks), whilst the control group (n = 22) received sham stimulation. The following parameters were assessed before and after the course: motor (Unified Parkinson's Disease Rating Scale – UPDRS; Activity of Daily Living – ADL), cognitive (Montreal Cognitive Assessment – MoCA; Frontal Assessment Battery – FAB; Trail Making Test, Parts A and B – TMT-A, TMT-B; Cue Sensitivity Index of the free recall test with selective cues – CSI) and affective (Starkstein Apathy Scale; Geriatric Depression Scale – GDS; State-Trait Anxiety Inventory – STAI). Results. After covariate adjustment, a statistically significant between-group advantage of active tDCS was found for 8 of 11 assessed outcomes: UPDRS-III (d = -0.49; p < 0.01), ADL (d = -0.59; p = 0.016), apathy (d = -1.07; p < 0.01), depression according to GDS (d = -0.63; p = 0.013), trait anxiety according to STAI (d = -0.67; p = 0.018), state anxiety according to STAI (d = -0.58; p = 0.041), TMT-A (d = -1.00; p = 0.025), and MoCA (d = 0.52; p = 0.024). The most pronounced effects were observed for apathy and TMT-A. No statistically significant between-group differences after adjustment were found for TMT-B (d = -0.39; p = 0.188), FAB (d = -0.25; p = 0.095), and CSI (d = 0.34; p = 0.29). No serious adverse events were recorded throughout the study period. Conclusion. Transcranial direct current stimulation (tDCS) of the primary motor cortex has a high safety profile and may be considered as an adjunctive method in the comprehensive rehabilitation of patients with stage II–III PD, with the most pronounced effects observed in the affective domain and in terms of cognitive processing speed.

The transition from work to retirement is a critical shift in an individual's later life. Utilizing retrospective data from the 2014 China Health and Retirement Longitudinal Study (CHARLS), this study employed sequence analysis to identify typical retirement transition patterns, followed by multiple regression analysis to examine their association with physical health. Five groups of retirement trajectories are identified: "Not Retired," "Early Retirement," "Late Retirement from Agricultural Employment," "Statutory Retirement," "Late Retirement from Self-employment". The "Statutory Retirement" and "Early Retirement" groups typically complete their retirement transition earlier, often retiring at the statutory age with substantial pension support. In contrast, the "Not Retired," "Late Retirement from Agricultural Employment," and "Late Retirement from Self-employment" groups exit the labor force later in life. These individuals are primarily engaged in agricultural production or self-employment and generally lack robust pension insurance. Regression analysis found a significant association between retirement transition patterns and physical health. The "Statutory Retirement" group demonstrates lower Instrumental Activity of Daily Living (IADL) (B = -0.393, P < 0.001), and NAGI (B = -0.791, P < 0.001) scores. The "Late Retirement from Self-employment" group also showed lower IADL (B = -0.356, P < 0.01) and NAGI (B = -0.555, P < 0.001) scores. The "Early Retirement" group exhibits a lower NAGI score (B = -0.345, P < 0.001). In contrast, the "Late Retirement from Agricultural Employment" group was associated with higher scores in Activities of Daily Living (ADL) (B = 0.212, P < 0.05) and IADL (B = 0.407, P < 0.01). Contact with children moderated the relationship between retirement transition and physical health. Increased intergenerational contact had a stronger positive correlation with health for individuals in the "Late Retirement from Agricultural Employment" group but showed no significant health benefit for those in the "Statutory Retirement" group.

To elucidate determinants of long-term patient-reported outcomes (PROs) following colorectal cancer (CRC) surgery in older adults, focusing on the impact of ostomy creation, nutritional status, and living conditions on functional independence and quality of life (QoL). This single-center, prospective observational study included patients aged ≥ 75years who underwent elective CRC resection between July 2020 and December 2023. Comprehensive geriatric assessments were performed preoperatively, and PROs-including Instrumental Activities of Daily Living (IADL), EQ-5D, and EQ-VAS-were reassessed more than one year postoperatively. The primary outcomes were postoperative changes in IADL and QoL. Modified Poisson regression identified independent determinants of long-term decline in each PRO domain. Sixty patients (median age 79years; 60% female) completed one-year follow-up. IADL declined in 35.6% of patients, EQ-5D in 26.6%, and EQ-VAS in 43.3%. Multivariate analysis revealed that stoma formation was independently associated with IADL decline (adjusted RR = 3.37, 95% CI 1.50-7.54, p = 0.003), whereas living alone postoperatively correlated with preserved IADL (adjusted RR = 0.14, 95% CI 0.02-0.87, p = 0.035). Low preoperative BMI (< 20kg/m2) was significantly associated with EQ-5D deterioration (adjusted RR = 5.25, 95% CI 1.20-22.94, p = 0.027). No significant predictors were identified for EQ-VAS decline. Among older CRC patients, stoma creation predicts long-term functional decline, while low BMI predicts QoL deterioration. Conversely, independent living appears protective for functional maintenance. Integrating PROs into perioperative assessment and tailoring surgical, nutritional, and social interventions may enhance survivorship outcomes in this aging population.

To determine whether the ratio of human nonmercaptalbumin to total albumin (HNA%) and serum bilirubin-two oxidative stress-related biomarkers-predicts incident disability in activities of daily living (ADL) among older adults with type 2 diabetes. In this longitudinal cohort study, we followed 101 adults aged ≥70 years with type 2 diabetes who had no baseline ADL disability. The primary outcome was incident ADL disability requiring long-term care certification, a standardized national system in Japan indicating clinically significant physical impairment. Cox proportional hazards models, restricted cubic splines, and nonparametric bootstrap resampling (1,000 iterations) were used to assess associations. During the 7-year follow-up, 28 participants (27.7%) developed ADL disability. Those who became disabled had higher HNA% and older age, and lower serum bilirubin and albumin at baseline. Restricted cubic splines demonstrated linear increases in disability risk with higher HNA% and linear decreases with higher bilirubin. In the primary multivariable model including HNA%, bilirubin, and age, all remained independent predictors (HNA%: HR 1.063, 95% CI 1.005-1.124; bilirubin: HR 0.740, 95% CI 0.562-0.975; age: HR 1.115, 95% CI 1.032-1.206). This model improved discrimination compared with age alone, demonstrated the lowest Akaike's Information Criterion, and showed good calibration. Bootstrap analyses confirmed the robustness and stability of the model. Higher HNA%, lower serum bilirubin, and their combined assessment predicted future ADL decline in older adults with type 2 diabetes. These complementary redox biomarkers may contribute to improved risk stratification for functional deterioration.

Pain, decreased quality of life, and functional impairment are common symptoms of knee osteoarthritis (KOA), a degenerative joint disease. Surgery is reserved for advanced cases, and conservative treatment is primarily palliative. Although platelet-rich plasma (PRP) therapy is a novel regenerative strategy, the influence of PRP composition on its effectiveness remains unclear. The aim of this review is to determine whether PRP activation and platelet and leukocyte enrichment are associated with improved pain and functional outcomes in KOA at 6 and 12 months. The systematic review included 56 randomized controlled trials (RCTs), involving a total of 5251 patients. Of these, 53 RCTs involving 5031 participants were included in the network meta-analysis. PRP treatments were compared with other nonsurgical interventions and placebo. Primary outcomes included Western Ontario and McMaster Universities Arthritis Index Score (WOMAC), Knee Injury and Osteoarthritis Outcome Score (KOOS), and visual analog scale (VAS), while International Knee Documentation Committee Score (IKDC), Lequesne Index, and EuroQol (EQ)-VAS were assessed as secondary outcomes. PRP formulations were categorized on the basis of activation status and Mishra's classification system. Both direct and indirect comparisons were performed using a frequentist network meta-analysis approach. Comparing PRP with different activation states at 6 and 12 months revealed that PRP activation exerted significant benefits in specific KOOS domains at 12 months (KOOS Activities of Daily Living, KOOS Sport and Recreation Function, and KOOS Knee-Related Quality of Life). Generally, the performance of high-platelet PRP was not statistically different from that of low-platelet PRP in most of the assisted questionnaires and domains. Considering activated PRP, no significant variation was detected between Mishra's categories, indicating that increased leukocyte and platelet enrichment ratios confer no additional benefit. Overall, the data suggest that PRP activation could play a key role in the treatment outcomes of KOA and could compensate for variation in both platelet and leukocyte enrichment. There is a need for RCTs to assess the effect of platelet composition and activation status in the clinical performance of PRP in KOA. Level I, systematic review and network meta-analysis.

Context: Length of stay (LOS) is a metric for evaluating the utilization of residential care and informing future long-term care policies. Decreases in LOS have previously been observed in the Swedish setting. However, whether this trend has continued is unexplored. Objectives: To examine changes in residential care LOS between 2015 and 2023 among persons with and without cognitive impairment, and to assess the effects of socio-demographic factors, cognitive impairment, and activities of daily living (ADL) on LOS. Methods: Persons ≥65 years who moved into residential care between 2015 and 2023 in Stockholm municipality (N = 18,805). Data on residents’ characteristics, moving-in date, and date of death were retrieved from the longitudinal SNAC Stockholm Eldercare study. Hazard regression was used to assess factors associated with LOS, and Laplace regression was used to examine changes in LOS from the 10th to the 50th percentiles. Findings: Most residents moving in were women, aged 86 years, and requiring extensive daily support. Cox regression showed that older age, male gender, lower income, greater ADL needs, and no cognitive impairment predicted shorter stays and higher death risk. LOS declined for cognitively impaired residents in the 40th and 50th percentiles. Limitations: Cognitive status was assessed before moving in and not measured during stay. The definitions of LOS vary across studies, which complicates comparisons. Implications: Most people who moved into residential care were cognitively impaired, leading to longer stays. This should be considered for future care resources allocation. Population ageing and rising cognitive impairment will increase the need for residential care.

To describe the associations of treated neovascular AMD with the risk of disability, falls, fractures and mood disorders in a large sample representative of the French population. Analyses were based on 77 582 individuals belonging to the 'Echantillon Généraliste des Bénéficiaires', a 1/97 random sample of the French population, aged 65 years or more on 1 April 2009 and followed until 31 December 2019. Treated neovascular AMD (nAMD) was identified through the reimbursement of anti-VEGF drugs, intravitreal injections and after exclusion of other pathologies requiring the use of intravitreal anti-VEGFs. Activities of daily living (ADL) disability was identified using a previously developed algorithm, while falls, fractures, head trauma and mood disorders were identified using relevant ICD codes and medications. Associations of nAMD with outcomes were assessed using Cox models with nAMD as a time-dependent variable and adjustment for confounders. During the study period, 1662 cases of incident nAMD were identified. After adjustment for age, sex, Charlson comorbidity index and number of drugs, nAMD was significantly associated with the occurrence of ADL disability (Hazard ratio (HR): 1.19, 95% confidence interval (CI): 1.08-1.30; p = 0.0002) and of mood disorders (HR: 1.19, 95%CI: 1.07-1.32; p = 0.002). Associations with falls, fractures and head trauma were not statistically significant. Treated neovascular AMD remains associated with a 19% increased risk of disability and mood disorders, while no association was detected with falls, fractures and head trauma. These results are consistent with a major improvement in functional outcomes, with respect to the pre-anti-VEGF era.

Instrumental activities of daily living and objective physical activity in people with cardiovascular disease.

Disabilities are common and untreatable in many older adults. This proteome-wide discovery study identified cortical proteins that may provide resilience for disabilities in older adults. Participants were 850 decedents (mean age 89.3 years [SD: 6.6] at death, 67% female) from two longitudinal cohort studies with proteome-wide data collected from the dorsal lateral prefrontal cortex, indices of 10 Alzheimer's disease and related dementia (ADRD) pathologies, and measures of mobility disability, instrumental activities of daily living (IADLs), and activities of daily living (ADLs) prior to death. Linear regression models adjusting for demographics identified proteins related to each disability phenotype correcting for multiple comparisons (p < 5 × 10-6). Resilience proteins-operationalized as proteins related to residual disability after adjusting for ADRD pathologies-were aggregated into resilience index scores for each disability instrument and their associations with adverse health outcomes were tested. Exploratory functional enrichment analyses identified molecular pathways associated with resilience proteins. We identified 12 resilience proteins related to mobility disability, 215 for IADL and 291 for ADL disability. Models with resilience index scores accounted for an additional 2.7%, 3.3%, and 3.5% of the variance of mobility, IADL, and ADL disability, respectively, compared to 1.7%, 2.7% and 2.0%, for ADRD pathologies. In exploratory analyses, key enriched Gene Ontology terms were predominantly related to mitochondrial function. Further work targeting these cortical proteins is needed to demonstrate that they provide resilience for disability in older adults and can facilitate functional independence in old age, though future work is needed to demonstrate protective mechanisms. Ultimately, targeting these proteins may lead to therapies that maintain functional independence in aging adults.

Physical activity and sleep influence fatigue in myasthenia gravis (MG), and digital health technologies (DHT) enable objective monitoring of these behaviors in daily life. Using this approach, we evaluated whether a lifestyle intervention targeting physical activity or sleep hygiene could reduce fatigue in MG. In this three-arm, randomized controlled trial (DIG-MG; NCT05992025), 72 MG patients completed 6 weeks of baseline monitoring with a DHT ring (OURA), followed by 12 weeks of (i) physical activity guidance, (ii) sleep hygiene education, or (iii) observation, and a 6-week follow-up. The primary outcome was the MG Activities of Daily Living (MG-ADL) score 1 week postintervention. Secondary outcomes included Fatigue Severity Scale (FSS) scores; exploratory outcomes were DHT-derived physical activity and sleep parameters. Baseline MG-ADL scores were similar (median: 5.0). Postintervention medians were 4.0 (physical activity), 3.5 (sleep hygiene), and 3.0 (control), with no significant differences (p = 0.073). Clinically meaningful MG-ADL improvement occurred in six, seven, and six participants, respectively. FSS scores showed no group differences (p = 0.992), with clinically relevant improvement in eight participants in each intervention group and five controls. Participants were more physically active than expected: 64.7% exceeded 600 MET-min/week at baseline. DHT adherence was excellent. REM sleep was lower than expected, while deep sleep was preserved. Self-reported data aligned with DHT measurements. Digital lifestyle interventions were feasible and well-accepted but did not improve MG-ADL or FSS in this unusually active population. However, DHT-based monitoring may support individualized follow-up, and reduced REM sleep warrants further investigation as a fatigue-related factor.

Patient factors associated with caregiver burden in informal caregivers of older adults with cancer: A multicentre cross-sectional study.

Impact of hearing aid use on cognitive function in elderly individuals with hearing loss: a prospective study.

This study aimed to investigate the impacts of combining hand function training with robot-assisted upper-limb rehabilitation on upper-limb function, developmental outcomes, and activities of daily living (ADLs) in children with brain lesions. This single-subject, multiple-baseline study involved 3 children with brain lesions. During the baseline phase, the participants received conventional occupational therapy. In the intervention phase, hand-assisted activities were combined with robot-assisted upper-limb rehabilitation. Each session was evaluated using the InMotion®ARM system. Upper-limb function, developmental status, and ADLs were evaluated before and after the intervention. Visual analysis was performed, and the difference between preintervention and postintervention assessments was calculated to compare outcomes. All participants demonstrated improvements following the intervention, with average increases of 8.33 points in the Fugl-Meyer Assessment for Upper Extremity and 17.25 points in the Pediatric Motor Activity Log. Consistent improvements in personal-social development were also observed based on the Korean Developmental Screening Test for Infants and Children, Second Edition. Session-based assessments using InMotion®ARM indicated enhanced aiming accuracy and reduced movement duration across all participants. Combining hand function with robot-assisted upper-limb rehabilitation positively affected the upper-limb function, developmental progress, and ADLs in children with brain lesions. Future large-scale studies are warranted to confirm these findings and explore their broader clinical applicability.

Exploring the association of frailty and swallowing function with postoperative changes in activities of daily living among older patients undergoing cardiac surgery.

Fear of falling is associated with physical functioning, activity performance, and participation in individuals with multiple sclerosis.

BackgroundAmyloid PET-positive mild cognitive impairment (MCI) is a prodromal stage of Alzheimer's disease (AD), but its longitudinal clinical and biomarker trajectories vary considerably. Evidence linking oral interventions to amyloid-related biomarkers in this population remains limited.ObjectiveTo compare 18-month clinical outcomes and longitudinal changes in plasma amyloid-β (Aβ) oligomerization tendency and amyloid PET burden according to Ginkgo biloba use in amyloid PET-positive MCI.MethodsThis retrospective cohort study included 35 amyloid PET-positive MCI patients who underwent baseline and 18-month clinical evaluations, serial plasma Aβ oligomerization measurements using the Multimer Detection System-Oligomerized Aβ (MDS-OAβ) assay, and paired baseline and 18-month 18F-FC119S amyloid PET. Patients received Ginkgo biloba extract 240 mg/day (n = 21) or Non-Ginkgo cognitive enhancers (n = 14). Clinical stability, conversion to AD dementia (Korean Instrumental Activities of Daily Living ≥0.40), changes in MDS-OAβ, and changes in global cortical standardized uptake value ratio (SUVR) were assessed.ResultsBaseline characteristics were comparable between groups. At 18 months, all Ginkgo-treated patients remained clinically stable, whereas 57.1% of Non-Ginkgo patients showed cognitive decline. Conversion to AD dementia occurred in none of the Ginkgo group and in 28.6% of the Non-Ginkgo group. Plasma MDS-OAβ decreased with Ginkgo but increased without Ginkgo. Global amyloid PET SUVR remained stable in the Ginkgo group and increased in the Non-Ginkgo group.ConclusionsIn amyloid PET-positive MCI, Ginkgo biloba use was associated with sustained clinical stability, reduced plasma Aβ oligomerization tendency, and attenuation of amyloid PET progression over 18 months.

Purpose: This study aimed to investigate the associations between nutritional status, functional capacity, frailty, and depression in older adults, and to evaluate how these parameters relate to body mass index.Materials and methods: A cross-sectional retrospective study was conducted by reviewing the records of patients who applied between January 01, 2024, and January 31, 2025, and included 417 older adults (mean age: 74.2±6.5 years; 61.1% female). Nutritional status was assessed using the Mini Nutritional Assessment, functional capacity with the Katz Index of Independence in Activities of Daily Living and Lawton-Brody Instrumental Activities of Daily Living Scale, frailty with the Clinical Frailty Scale. Physical performance was evaluated using the Timed Up and Go and Sit-to-Stand tests. Spearman's correlation coefficients and Kruskal-Wallis tests were used for statistical analysis.Results: Mini Nutritional Assessment scores were positively correlated with both basic (Katz, ρ=0.35; p&amp;lt;0.001) and instrumental (Lawton-Brody, ρ=0.32; p&amp;lt;0.001) activities of daily living. A significant negative correlation was observed between Mini Nutritional Assessment and Clinical Frailty Scale (ρ=-0.30; p&amp;lt;0.001). Mini Nutritional Assessment also showed weak but significant positive correlations with physical performance tests. A positive correlation was found between Body Mass İndex and Mini Nutritional Assessment (ρ=0.38; p&amp;lt;0.001); lower Body Mass İndex was associated with increased frailty (ρ=-0.21; p&amp;lt;0.001) and decreased performance in basic daily activities (Katz, ρ=0.16; p=0.001). However, the correlation between Mini Nutritional Assessment scores and Geriatric Depression Scale was weak and not statistically significant (ρ=-0.04, p=0.210).Conclusion: This study highlights the critical role of adequate nutrition in maintaining functional independence, reducing frailty, and supporting physical performance in older adults. Moreover, the relationship between nutritional status and depressive symptoms was found to be weak and did not reach statistical significance. Nutritional status should be a core component of geriatric assessments and addressed through multidisciplinary interventions.

Aim: Extracellular vesicles (EVs) contribute to stroke rehabilitation by mediating intercellular signaling during inflammation and tissue repair. Here we report EV-associated surface proteins as potential biomarkers for predicting recovery of activities of daily living (ADL) during the subacute phase of ischemic stroke (IS). Methods: IS patients and healthy controls (HCs) were recruited for this study, with serum samples analyzed across three study stages. In the discovery subset (10 IS, 6 HCs), serum proteomics was used to identify differentially expressed proteins (DEPros) and perform Gene Ontology (GO) enrichment analysis. In the exploration subset (7 IS, 12 HCs), a proximity-dependent barcoding assay (PBA) was employed to profile surface proteins on individual EVs and screen for biomarker candidates. In a validation cohort, patients were grouped by ADL improvement (little-effect recovery, LE, n = 30; obvious-effect recovery group, OE, n = 22) based on Longshi Scale and Barthel Index assessments at admission and at 3 months follow-up. Targeted biomarker validation was performed with enzyme-linked immunosorbent assay (ELISA) and receiver operating characteristic (ROC) analysis. Results: A total of 113 DEPros were identified, with GO term enrichment in EV-related pathways. PBA profiling revealed matrix metalloproteinase 9 (MMP9), carcinoembryonic antigen-related cell adhesion molecule 1 (CEACAM1), melanoma cell adhesion molecule (MCAM), and gelsolin (GSN) as candidate biomarkers. In the validation cohort, MMP9 and CEACAM1 were significantly elevated in the LE group. ROC analysis showed area under the curve (AUC) of 0.726 for MMP9 and 0.700 for CEACAM1 in distinguishing LE from OE. Conclusion: Elevated serum levels of EV-associated biomarkers MMP9 and CEACAM1 were associated with poor ADL recovery, supporting their potential as prognostic biomarkers for stroke rehabilitation outcomes.

Aim: Polypharmacy is increasingly prevalent among older adults and has been suggested as a potential risk factor for adverse health outcomes, including cognitive impairment and functional decline. Therefore, this study aimed to investigate the associations of polypharmacy with cognitive impairment and functional status among community-dwelling older adults using nationally representative data from the 2023 Korean Elderly Survey. Methods: A cross-sectional analysis was conducted using data from 9,898 community-dwelling older adults without a diagnosis of dementia. Polypharmacy was defined as the concurrent use of five or more physician-prescribed medications. Cognitive function was assessed using the Korean version of the Mini-Mental State Examination (K-MMSE), with cognitive impairment defined as a score ≤ 23. Functional status was evaluated using the Korean Activities of Daily Living (K-ADL) and Korean Instrumental Activities of Daily Living (K-IADL). Logistic regression was used to estimate odds ratios and 95% confidence intervals (CIs) for cognitive impairment, while multiple linear regression analyses examined associations with functional status. Models were sequentially adjusted for sociodemographic characteristics, health behaviors, and the number of chronic diseases. Results: Polypharmacy was associated with increased odds of cognitive impairment in the crude model (OR = 1.70, 95% CI: 1.40–2.05); however, this association was attenuated and became non-significant after adjustment for sociodemographic and health-related factors. In contrast, polypharmacy remained independently associated with poorer functional status in fully adjusted models, showing higher K-ADL scores (B = 0.14, p = 0.007) and K-IADL scores (B = 0.43, p &lt; 0.001). Conclusions: Polypharmacy was independently associated with functional impairment but not with cognitive impairment after comprehensive adjustment, suggesting that functional decline may represent a more sensitive and immediate consequence of complex medication use in older adults. These findings underscore the need for comprehensive geriatric assessment approaches that integrate medication review with functional evaluation.