This was a prospective cohort design study that followed a group of older adults for up to 12 months. Two hundred and ninety-one participants with a mean age of 81.4 ± 9.1 years were recruited. Signs of aspiration were screened by the Yale Swallow Protocol. Variables investigated for risk were oromotor functions, self-perception of swallowing function, cognitive function, and medical history. Seventy participants were revisited for a follow-up aspiration screening 8 to 9 months later. Multivariate logistic regression found that male sex, need for assistance for feeding and mobility, reduced cognitive function, subjective judgement of swallowing function, and oromotor function were major variables that can be used to screen for older adults who may require referrals for swallowing assessment. Those who continue to show signs of aspiration across time exhibit a more frail profile than their counterparts who do not.