In recent years, China is gradually moving towards an aging society, and nursing care for the elderly group is a topic that needs urgent attention nowadays. In order to control the risk in the nursing process of the elderly group, this paper proposes an assessment and optimization model of nursing risk. Data were obtained through the CGRA Geriatric Nursing Risk Scale, and the processed data were subjected to logistic regression, according to the regression results, targeted and graded nursing care was provided to the elderly with different nursing risk levels. The assessment found that nursing risk was higher in females (p<0.05) and that nursing risk increased with age. Among the many influencing factors, physical activity was a protective factor for nursing risk. And after graded nursing care based on nursing risk assessment results, the experimental group had no risk events, the satisfaction of service users reached 100%, and the nursing risk assessment score was significantly reduced (p<0.05).