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Background: Older adults are particularly vulnerable to experiencing hospital-associated functional decline; a multifaceted phenomenon linked to poorer outcomes and increased healthcare costs. Given that functionality serves as a crucial indicator of health in the elderly, various scales have been developed to gauge the continuum of functional ability, potentially serving as prognostic tools to inform tailored interventions., Objectives: The aim of this study is to determine the prevalence of hospital-associated functional decline in an acute geriatric unit and examine its correlation with the functional continuum through a descriptive analysis of the patient population and exploration of associated factors., Results: 142 patients aged 75 and above were included in the analysis, revealing that 57% exhibited hospital-associated functional decline. Among patients with functional impairment, 26% fell into category 4 (dependence for instrumental activities of daily living and pre-frailty). Among the factors examined, age (OR 1.280, 95% CI 1.099 - 1.547) and prior independence (OR 15.939, 95% CI 1.857 - 186.655) were found to be associated with hospital functional decline., Conclusion: Hospital-associated functional decline was observed in over half of the patients, with age and prior independence identified as significant contributing factors. This underscores the importance of implementing intervention measures for all elderly patients during their hospitalization, particularly for frail or pre-frail individuals with some level of instrumental dependency., (Copyright © 2024 SEGG. Publicado por Elsevier España, S.L.U. All rights reserved.)