This cohort examines transition rates between states of frailty over a 12-month period and evaluates the risk factors involved in such transitions. Frailty was defined as having 3 or more of the 5 criteria: weight loss, weakness, exhaustion, slow walking speed, and low physical activity. A total of 36.8% of the participants made transitions between states of frailty. History of cancer (odds ratio [OR], 3.4; 95% confidence interval [CI], 1.1-10.9), urinary incontinence (OR, 2.9; 95% CI, 1.3-6.1), and lower advanced activities of daily living (OR, 1/0.8; 95% CI, 0.6-0.9) were significant predictors of worsened frailty. Frailty is a dynamic process with transitions in both directions, worsening and improvement, even within such a short period.