I can tell you that Penzance Rail Station has level access, and straight out to the adjacent bus station.
The PI is literally across the street from the railway station, it could not physically be any closer or simpler.
As you exit the station (which is by the seaward facing side door) the bus station is ahead of you. For the PI turn right for a few yards, and you will see the PI across the street.
St Ives is an old fishing village and has narrow, congested streets, hills and steps everywhere. A lovely place, although too busy for my liking in high season, but has significant access issues. You can almost always find a hill round any steps, and would be able to get from Downalong to the Tate or the Town Museum or all the restaurants scattered around the harbour.
St Ives Station itself has step free access and a ramp to the platform (source- National Rail) and is straight on the promenade, but Downalong is the other side of the harbour so quite a way from the station. The bus station is up a steep hill from the Town Centre.
I just think St Ives is going to be a hassle for you- not unmanageable, but probably not as pleasant as you might want.