Background There has been relatively little research on caregivers of patients with Alzheimer’s disease and those with cognitive disorders for long durations. Aim To examine the psychological dimensions, defensive styles strategies, and distress in caregivers of Alzheimer’s patients. Methods Caregivers of 40 patients with Alzheimer’s disease were interviewed and compared with a group of caregivers of diabetic patients on the experience of caregiving, emotional stress, and burden. Caregivers of patients with Alzheimer’s disease were assessed using the Defense-Style Questionnaire and the Involvement Evaluation Questionnaire. Results Caregivers of patients with Alzheimer’s disease used mature, neurotic, and immature defensive strategies to cope with the patient’s symptoms and difficult behavior, and experienced more worry about these problems and led to increased supervision. There were sex differences among caregivers; female caregivers were more prone to worry and overinvolvement than male caregivers. Conclusion Caregivers of patients with Alzheimer’s disease have to cope with a wide range of problems and develop coping defensive strategies. Caregivers worried most about the difficult behavior and symptoms of patients with Alzheimer’s disease. The increased levels of worry, tension, negative feelings, and overuse of mature defenses in caregivers are associated with personal and sociodemographic variables, rather than variables related to the illness itself.