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This study investigated the predictors of risk perception and its effect on older adults’ preventive behavior and/or medical care avoidance during the COVID-19 pandemic. Older respondents (age >50 years) from the MIT COVID-19 Preventive Health Survey reported their social distancing, hand washing, mask wearing, and medical care avoidance between July and October 2020 (n = 4395). Structural equation models were used. Significant predictors of higher risk perception were female gender, older age, poorer health, city residency, personally knowing someone who had COVID-19, and correct knowledge of vaccine/treatment. Higher risk perception was subsequently associated with higher frequency/probability of practicing preventive behavior and/or avoiding medical care. Knowledge had the strongest path coefficient with risk perception. Disseminating correct …