Catalysts of Conversation: Examining Interaction Dynamics Between Topic Initiators and Commentors in Alzheimer's Disease Online Communities

Informal caregivers (e.g., family members or friends) of people living with Alzheimer's Disease and Related Dementias (ADRD) face substantial challenges and often seek support through online communities. Understanding the factors driving engagement within these platforms is crucial, as it can enhance communities' long-term value to meet their needs effectively. This study investigated the user interaction dynamics within two large, popular ADRD communities, TalkingPoint and ALZConnected, focusing on topic initiator engagement, initial post content, and the linguistic patterns of comments at the thread level. Using analytical methods such as propensity score matching, topic modeling, and predictive modeling, we found that active topic initiator engagement drives a higher comment volume, and reciprocal replies from topic initiators encourage further commentor engagement at the community level. Practical caregiving topics prompt more re-engagement of topic initiators, while emotional support topics attract more comments from commentors. Additionally, the linguistic complexity and emotional tone of a comment are associated with its likelihood of receiving replies from topic initiators. These findings highlight the importance of fostering active and reciprocal engagement and providing effective strategies to enhance sustainability in ADRD caregiving and broader health-related online communities.