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The present study aimed to investigate the reciprocal relationship between caregiver burden and care recipient dependence in activities of daily living (ADLs) from the perspective of frail older adults and their family caregivers in China. Data were derived from a sample of 469 older adult–caregiver dyads that participated in both the 2010 and 2013 waves of the panel study Family Caregivers for the Frail and Very Elderly: Well-Being and Needs in Shanghai. A two-wave cross-lag analysis was used to examine the proposed model. ADL dependence in 2010 was a significant predictor of caregiver burden in 2013. Furthermore, caregiver burden in 2010 was a significant predictor of ADL dependence in 2013. This finding confirms the dyadic model of caregiver burden and care recipient well-being. Implications for interventions and policy to help frail older adults and their family caregivers are discussed.