Background: Dyspnea-related kinesiophobia refers to restrictions or avoidance of activities due to fear of dyspnea and is prevalent among older adults with chronic obstructive pulmonary disease (COPD). Hence, there is a need to identify subgroups of dyspnea-related kinesiophobia among older adults with COPD to support the development of strategies to increase activity levels. Objective: The purpose of this study was to investigate dyspnea-related kinesiophobia among older adults with COPD, explore heterogeneity in kinesiophobia within subgroups of this population, and analyze the characteristics of different subgroups of kinesiophobia. Method: This cross-sectional study was conducted from November to December 2023 in Fenyang City, Shanxi Province, China, via face-to-face questionnaire surveys of hospitalized adults with COPD aged over 60 years in four secondary or tertiary hospitals. The Breathlessness Beliefs Questionnaire (BBQ) was used to measure dyspnea-related kinesiophobia. Latent profile analysis was employed to classify the subgroups. CChi-square tests and binary logistic regression were used to examine the effects of sociodemographic factors, marital status, education, income, daily activities, general health, and COPD severity across different profiles. Results: A total of 384 older adults with COPD (Male N = 228, aged 60-88) were included in the study. Their average BBQ score was (39.15 +/- 5.59). Latent profile analysis identified two groups: 230 participants (59.9 %) in the low-level kinesiophobia group (C1) and 154 participants (40.1 %) in the high-level kinesiophobia group (C2). Multivariable stepwise binary logistic regression analysis revealed that older adults with COPD who engaged in exercise less than three days weekly reported an average monthly household income of <3000 CNY, unmarried status (including unmarried, divorced, or widowed), a Charlson Comorbidity Index (CCI) >1, more than three exacerbations within one year or with moderate (GOLD 2 Criteria)-severe (GOLD3) COPD were more likely to be the high-level kinesiophobia group (p < 0.05). Conclusion: Dyspnea-related kinesiophobia manifests in two groups among older adults. Targeted interventions for different subgroups should be further developed to promote health and reduce nursing burdens.