Objectives: Patterns of attachment—normative styles of relating to significant others—impact relationships across adulthood. Preliminary studies link attachment with health outcomes but have yet to examine older adults or functional impairment, and the mechanisms behind this relationship remain unclear. This report investigated how attachment predicted symptoms and functional impairment and tested the mediating roles of positive affect (PA) and negative affect (NA). Methods: 1,118 older adults completed measures of attachment, health symptoms, and functional impairment, together with confounds including age, sex, and income. Results: As expected, security and fearful avoidance predicted greater symptomology, but only fearful avoidance predicted greater functional impairment. Negative affect partially mediated links between attachment and outcomes, but only for fearful avoidance. Discussion: Understanding links between attachment, symptom reports, and functional impairment will facilitate better understanding of positive aging versus premature decline, help identify at risk individuals, and guide interventions to assist optimal functioning in later life.