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Background: Alzheimer's dementia has a spectrum of health and socioeconomic implications for patients and caregivers. The study is intended to assess the burden of caregivers and explore some of the possible influencing factors. Materials and Methods: A cross-sectional design and purposive sampling were conducted with the semi-structured questionnaire to the caregivers of patients with Alzheimer dementia attending the dementia clinic between January 2019 and June 2019. Results: About 94.2% of the caregivers included in the present study reported a Zarit burden score of 17 and above, indicative of high caregiver burden. There was no significant correlation between the age of patient and caregiver burden (r = −0.18, P = 0.8). In bivariate analysis, the number of comorbid medical illnesses (ρ = 0.37, P < 0.01), number of medication doses taken per day (ρ = 0.42, P < 0.01), Katz activities of daily living (ADL) score (ρ = −0.56, P < 0.01), and additional care burden calculated by counting the number of other care services such as diaper care and bedsore care provided to the patient daily (ρ = 0.48, P < 0.01) were significantly correlated with caregiver burden. In multiple linear regression analysis, the Katz ADL score of patients with dementia (β = −0.38, P = 0.002) was the single most significant correlate of Zarit burden score, representing caregiver burden. Conclusion: There is a high level of burden among caregivers for people with dementia in the Nepalese population. The single most important independent factor affecting caregiver burden was Katz ADL score. This study's outcomes support the idea of the development of long-term care systems for families with high caregiver burden.