Depressive symptoms are closely associated with cognitive decline and risk of incident dementia, and plasma biomarkers may play a significant role in this relationship. We aimed to investigate the influence of plasma biomarkers and explore the underlying mechanisms.

This study included 1,658 dementia-free community residents recruited in 2009–2011 from the Shanghai Aging Study. At baseline, we assayed plasma phosphorylated tau 217 (p-tau217) and neurofilament light chain (NfL), and assessed depressive symptoms using the Center for Epidemiologic Studies Depression scale. Cox regression models were performed to estimate the risks of incident dementia and Alzheimer’s disease (AD) during the 5-year follow-up. Parallel and serial mediation models were applied to investigate whether plasma p-tau217 and NfL mediated the relationship between depressive symptoms and cognitive decline.

Older adults with depressive symptoms had higher risks of dementia and AD, especially among those with higher concentrations of baseline plasma p-tau217/NfL. Sex-specific analysis revealed that depressive symptoms combined with high plasma NfL increased AD risk in men (hazard ratio, HR [95% confidence interval, CI] = 5.89 [2.01, 17.27], p = 0.001), whereas women with depressive symptoms and high plasma p-tau217 showed higher AD risk (HR [95%CI] = 6.07 [2.82, 13.09], p < 0.001). Parallel mediation analysis revealed that plasma p-tau217/NfL mediated the relationship between depressive symptoms and cognitive decline, respectively. Additionally, serial mediation analysis found p-tau217 precedes NfL within the mediating pathway (β = 0.403, bootstrap 95% CI: 0.347, 0.452).

Plasma p-tau217 and NfL could individually or jointly mediate the relationship between depressive symptoms and cognitive decline.

CHD are structural cardiac anomalies which are a leading cause of childhood mortality and morbidity in India and have multifactorial aetiology. Compromised socioeconomic status augments several environmental stressors and is shown to have a positive association with CHD in offspring. The presented study is an institution-based case-control study to explore the same with CHD as the primary outcome.

A total of 2064 paediatric patients (1760 CHD cases and 304 controls with structurally normal hearts) were analysed. Demographic and socioeconomic status parameters were recorded using the Kuppuswamy scale. Statistical associations were examined using chi-square tests and odds ratios.

Majority of all patients belonged to the upper-lower class. No significant association was found between socioeconomic status and CHD (p = 0.18). However, rural residence was significantly associated with a higher risk of CHD (χ2 = 16.09, p = 0.0011; OR vs. urban = 1.59). A significant association was found between maternal education and CHD prevalence (χ2 = 20.9, p = 0.0001), with uneducated mothers having higher odds of children with CHD. Joint family structure also showed higher odds of having a child with CHD (OR = 1.75, p < 0.001).

While socioeconomic status alone was not significantly associated with CHD in this cohort—likely due to universal free care at our institute—maternal education, rural residence and family structure emerged as critical determinants. These findings highlight the need for targeted public health initiatives focusing on maternal literacy, rural healthcare access, and awareness programmes to improve early CHD diagnosis and outcomes. Further population-based research is needed to elucidate socioeconomic status-CHD associations at a broader level.

To understand how the Go Wish Cards Game (GWCG) can support the expression of values, wishes, and preferences at the end of life among women living with advanced breast and/or gynecological cancer.

This descriptive qualitative study was conducted as part of a larger randomized clinical trial. Participants were recruited from a leading cancer center in Brazil and invited to sort the GWCG cards into three categories: “very important,” “somewhat important,” and “not important.” The 10 cards rated as “very important” were discussed individually to explore their meanings. At the end of the session, participants were asked: “What did it mean for you to play the cards?” Narratives associated with the “very important” cards were analyzed using content analysis based on Bardin’s methodological framework.

Thirty-three women completed the GWCG. Participants described the game as a meaningful opportunity for reflection, communication, and expression of personal values and end-of-life wishes. Discussions of the “very important” cards elicited narratives focused on trust-based relationships, emotional and spiritual support, dignity, and relief from suffering. The most frequently selected cards included wishes such as “to have a doctor I trust and nurses who care about me” and “to have my family and friends with me,” reflecting shared priorities across narratives. Values and wishes were organized into three overarching dimensions: emotional and existential connections; dignity and autonomy; and care and comfort at the end of life. The GWCG was perceived as a valuable tool for facilitating the expression of biopsychosocial and spiritual values.

The findings indicate that the GWCG supports reflection and the articulation of end-of-life values, wishes, and priorities, particularly those related to dignity, autonomy, comfort, and emotional connection. The tool shows potential to promote meaningful conversations and care aligned with what gives purpose and meaning to women living with advanced cancer.

People diagnosed with schizophrenia can have functional impairments in multiple domains. Cognitive impairment is central to schizophrenia and has substantial prognostic value compared with other symptoms of schizophrenia. However, no study has previously investigated directed relationships in a complex system of cognitive, sociodemographic, clinical and quality of life (QOL) variables in people diagnosed with schizophrenia.

To identify the complex relationships of components of cognition with other cognitive components, as well as with clinical and QOL variables.

This study included data from 1450 participants in the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) study. The present study reconstructed a Bayesian network from this data using cognition, clinical, sociodemographic and QOL variables.

Processing speed was centrally associated with all other cognitive domains. Cognitive domains were conditionally independent of positive symptoms but moderately associated with negative symptoms (β = −0.25; P < 0.001). The positive symptoms subscale was independent of QOL, conditioning on third variables. Negative symptoms were moderately associated with QOL (β = −0.33; P < 0.001), and processing speed had a weak association with QOL (β = −0.12; P < 0.001). Processing speed was a central variable in the network.

Intervening with respect to processing speed may be the most beneficial way of improving other cognitive functions. More research is needed on directed networks that include social cognition and global levels of functioning.

Neurodivergence encompasses neurodevelopmental conditions including autism, attention-deficit hyperactivity disorder (ADHD) and Tourette syndrome. Particular physical traits, notably those linked to joint hypermobility, have an established association with both neurodivergence and bipolar affective disorder.

This case-control study tested, first, whether the presence of joint hypermobility predicted bipolar affective disorder and, secondly, whether neurodivergent characteristics were important in understanding this relationship.

Data were collected from 52 participants with self-reported clinical diagnoses of bipolar affective disorder and from a comparison group of 54 participants without diagnosis of bipolar affective disorder. All participants were assessed on screening instruments for autism (Ritvo Autism Asperger Diagnostic Scale; RAADS-R), ADHD (Wender Utah Rating Scale; WURS) and joint hypermobility. Group differences were explored, and odds ratios calculated for the presence of bipolar and neurodivergence given the presence of hypermobility. A mediation analysis was performed to determine the contribution of neurodivergent characteristics to the relationship between joint hypermobility and bipolar affective disorder.

The presence of joint hypermobility significantly predicted the presence of bipolar disorder (odds ratio 5.1; 95% CI = 2.1, 12.4). In the bipolar affective disorder group, the prevalence of likely autism and ADHD was greater (84.6 and 65.4% respectively) than in the comparison group (22.2 and 3.7% respectively). The odds ratio for a diagnosis of bipolar affective disorder was 18.2 (95% CI = (6.70, 49.41)) in those meeting the threshold for likely autism; and 46.89 (95% CI = 9.96, 220.74) in participants meeting the threshold for likely ADHD. Mediation analysis showed that autistic, ADHD and pooled neurodivergent characteristics mediated the link between joint hypermobility and bipolar affective disorder.

This suggests a potential mechanism for affective pathophysiology, through developmental characteristics associated with joint hypermobility. The appreciation of interacting physical and neurodivergent traits to the expression of psychiatric illness has implications for diagnostic formulation, personalised medicine and service design.

Social connections might be protective against depressive and anxious symptoms and dementia in later life. The extent to which social connections are heritable versus modifiable in older age remains unknown.

We aimed to investigate the heritability of social connections and their influence on mental and cognitive health over time among older adults in a longitudinal cohort.

We analysed data from the Older Australian Twins Study (333 monozygotic, 266 dizygotic twins; 65+ years) at three time-points over 6 years. We examined the factor structure and heritability of baseline social connections and their associations with mental and cognitive health longitudinally.

We found three weakly heritable social connections factors: (a) interacting with friends/neighbours/community (h2 = 0.09, 95% CI: 0.00, 0.44); (b) family interactions/childcare (h2 = 0.13, 95% CI: 0.00, 0.43); (c) involvement in religious groups/caregiving (h2 = 0.00, 95% CI: 0.00, 0.19). Strong genetic correlations were observed between depressive symptoms and factors a (r = −0.96) and b (r = −0.60). More frequent baseline interactions with friends/neighbours/community were associated with fewer depressive symptoms cross-sectionally (B = −0.14, p = .004) and longitudinally (B = −0.09, p = 0.006), but the associations between social connections and cognitive health were not significant.

Social connections were weakly heritable, suggesting large environmental determination. Connections with friends/neighbours/community were associated with better mental health cross-sectionally and over time.