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Introduction The studies on Alzheimer disease highlight the family caregivers burden and his consequences on hostility. Few authors study the burden and the mental health of the caregivers of a demented relative. Aims This study aims at assessing the hostility and emotional load of caregivers of Alzheimer patients and determining the relation between the burden and the psychic health caregivers and its impact on the patient. Methods It is a descriptive cross-sectional study. Patients were recruited from the neurology department of Razi hospital Tunisia between January and June 2013. Consenting caregivers participating in the study were interviewed with a structured survey focused on their socio-demographic characteristics, the characteristics of the aid relationship and the emotional burden felt valued by the Family Attitude Scale (FAS). Results The caregiver was in nearly 60% a child. He lived under the same roof in 78.3% of cases. In 65% of cases, it passes between 12 and 24 hours with the patient. FAS score was 52.4 ± 16.16. Thirty-five percent of caregivers had a significant emotional burden (score > 60). FAS score was not correlated with the age of the helping relationship, cohabitation with the patient or the number of hours spent with him. The children had a greater emotional charge than spouses ( P = 0.001). The wickedness against the patient and abuse, the desire to institutionalize were related to the importance of the emotional charge ( P < 0.001). Conclusions These hostile thoughts are mostly directed against the patient but it can also be directed against oneself causing depression and guilt. [ABSTRACT FROM AUTHOR]