Zarit Burden Interview
Also known as: ZBI, Zarit Caregiver Burden Interview, Caregiver Burden Inventory (Zarit), Zarit Burden Scale
The Zarit Burden Interview (ZBI) is the most widely used self-report measure of caregiver burden — the physical, emotional, social, and financial strain experienced by people who care for an impaired older relative, most often someone with dementia. Originating in Steven Zarit, Karen Reever, and Julie Bach-Peterson's 1980 study of relatives of impaired elderly, the instrument asks caregivers to rate how often they feel a series of burdens, such as feeling that caregiving harms their health, social life, or finances, or that they could do a better job. The standard version has 22 items rated 0 (never) to 4 (nearly always), summing to a 0–88 total in which higher scores mean greater burden. Short forms (12-item) and a 4-item screen exist for quick assessment. The ZBI is a cornerstone of family-gerontology and dementia-care research and a routine outcome in caregiver-support interventions.
Key highlights
- The most widely used and validated caregiver-burden measure, with extensive normative data and translations enabling comparison.
- Captures subjective, multidimensional burden across health, emotional, social, financial, and relational domains.
- Available in full, 12-item short, and 4-item screening versions to fit research and clinical time constraints.
- Sensitive to change, making it a standard outcome for evaluating caregiver-support interventions.
Intuition
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How it works
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When to use it
Use the ZBI whenever you need to measure the subjective burden experienced by informal caregivers of impaired older adults — as an outcome in trials of caregiver-support, respite, or psychoeducational interventions; as a screen to identify caregivers at risk of distress, depression, or breakdown of the caregiving arrangement; or as a research variable linking burden to caregiver and patient outcomes. It is appropriate across caregiving contexts (dementia, stroke, frailty, chronic illness) and in many cultures via validated translations. Choose the full 22-item version for detailed research, the 12-item form for routine assessment, or the 4-item screen for triage. It is less suited as a measure of objective care demands, and self-report can be affected by mood and reluctance to admit burden, so pair it with other indicators when needed.
Strengths & limitations
- The most widely used and validated caregiver-burden measure, with extensive normative data and translations enabling comparison.
- Captures subjective, multidimensional burden across health, emotional, social, financial, and relational domains.
- Available in full, 12-item short, and 4-item screening versions to fit research and clinical time constraints.
- Sensitive to change, making it a standard outcome for evaluating caregiver-support interventions.
- Measures perceived burden rather than objective caregiving demands, which it does not quantify.
- Self-report is influenced by caregiver mood, coping style, and reluctance to disclose negative feelings.
- Interpretive severity bands are heuristic and vary across studies and cultures.
- Its factor structure is debated, with different studies extracting different numbers of dimensions.
Common pitfalls
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Applications
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Frequently asked
How is the Zarit Burden Interview scored?
The standard ZBI has 22 items, each rated on a five-point frequency scale from 0 (never) to 4 (nearly always), summed to a total from 0 to 88 where higher scores indicate greater perceived burden. Totals are often interpreted against approximate severity bands (little/none, mild-moderate, moderate-severe, severe). Validated 12-item and 4-item versions use the same response format with proportionally smaller maxima and correlate highly with the full scale.
Does the ZBI measure how much care the caregiver actually provides?
No. The ZBI measures perceived burden — the caregiver's subjective appraisal of strain — not the objective quantity of care. Zarit and colleagues' original finding was precisely that burden depends more on the caregiver's experience, resources, and support than on the patient's level of impairment. To capture objective demands you need separate measures of care hours, tasks, and patient dependency, which can be used alongside the ZBI.
When should I use the short or screening versions?
Use the full 22-item interview for detailed research where measurement breadth matters. Use the 12-item short form for routine clinical assessment or large surveys where respondent time is limited, and the 4-item screening version for rapid triage to flag caregivers who may need fuller evaluation. The short forms, validated by Bedard and colleagues, correlate strongly with the full scale, but the 4-item screen in particular should prompt further assessment rather than serve as a definitive burden measure.
Sources
- 1.Zarit, S. H., Reever, K. E., & Bach-Peterson, J. (1980). Relatives of the Impaired Elderly: Correlates of Feelings of Burden. The Gerontologist, 20(6), 649-655.
- 2.Bedard, M., Molloy, D. W., Squire, L., Dubois, S., Lever, J. A., & O'Donnell, M. (2001). The Zarit Burden Interview: A New Short Version and Screening Version. The Gerontologist, 41(5), 652-657.
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Cite this page
ScholarGate. (2026, June 23). Zarit Burden Interview. ScholarGate. https://scholargate.app/social-gerontology/zarit-burden-interview