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In this study we explored caregivers’ self-efficacy for managing people aged 65 and over with dementia behavior disturbance (DBD) and examined factors associated with the perception of care burden. A purposive sample of 162 community-dwelling people aged 65 and over with dementia and 162 primary family caregivers in Taiwan participated. The results revealed that frequency of DBD, caregivers’ female gender, caregivers’ level of education, relationship with care recipient, hours of care, and caregiver’s self-efficacy in managing DBD were significantly correlated to the care burden, and explained up to 36.1% of the variance. Moreover, self-efficacy of DBD management in relation to inappropriate sexual behaviors, aggressive behaviors, general aimlessness, and lack of cooperation significantly contributed to the caregivers’ perception of care burden. Healthcare professionals could use these results to design appropriate interventions to alleviate the care burden.