Unpaid family caregivers of people with dementia are faced with a variety of physical, emotional and social stressors. A systematic review of the literature was compiled to summarize existing evidence regarding subjective burden, expressed emotion and psychological distress related to this category of caregiving and to build a multinational representation of these individuals that will facilitate in identifying areas of supportive intervention. A synthesis of 44 data sets that included 5,249 participants from 20 countries indicated that the majority of caregivers are experiencing depression and high levels of distress related to their caregiving role, and that a small number of caregivers are relying on coping strategies that may add to their distress. Results suggest an ongoing need for medical and psychology practitioners to be aware of appropriate supportive and mental health interventions to improve the quality of life for people with dementia and their family caregivers.