Association between neurodegenerative plasma biomarkers and geriatric depression in older adults with and without clinical dementia in Kinshasa, Democratic Republic of the Congo

IntroductionPrevious Western studies have shown an association between neurodegenerative plasma biomarkers and geriatric depression. However, few studies have examined this relationship in sub-Saharan African countries. This article examines this association in older adults with or without clinical dementia in Kinshasa, Democratic Republic of Congo.MethodsThis cross-sectional study included eighty-one people aged 65 years and older assessed for dementia using the Community Dementia Screening Instrument (CSID) and the Alzheimer’s Disease Questionnaire. Depression and cognitive impairment were assessed using the Geriatric Depression Scale and the African Neuropsychological Battery (ANB), respectively. Plasma biomarkers measured included β-amyloid (Aβ) 40/42, phosphorylated tau 181 (p-tau), neurofilament light chain (NfL), glial fibrillar acid protein (GFAP), interleukins (IL-1β, IL-10), and tumor necrosis factor-α (TNF-α). Logistic regression models were used to estimate the likelihood that these biomarkers are associated with depression, adjusting for sex, age, and education level.ResultsThe mean age of the participants was 72.9 years. Of those suspected of suffering from Alzheimer’s disease (AD), 80% had geriatric depression. High blood pressure was common in participants with suspected AD (60%). People with dementia had significantly lower cognitive scores on all ANB tests than those without dementia. GFAP and NfL were significantly associated with higher odds of geriatric depression, with odds ratios of 1.98 (1.17–3.67; p = 0.02) and 1.76 (1.06–3.20; p = 0.04), respectively. Other biomarkers were not associated with depression.ConclusionThis study suggests a potential role of nonspecific biomarkers of AD, neurodegeneration, and astrocytic glial activation in geriatric depression in older adults in sub-Saharan Africa.

Remote EMDR versus CBT for PTSD after the Kahramanmaraş earthquakes: a randomized trial

BackgroundLarge-scale earthquakes are associated with high and persistent rates of post-traumatic stress disorder (PTSD), depression, and anxiety. Although Eye Movement Desensitization and Reprocessing (EMDR) and Cognitive Behavioral Therapy (CBT) are both guideline-recommended treatments for PTSD, direct randomized comparisons—particularly in post-disaster settings and via remote delivery—remain limited.MethodsIn this randomized, controlled, parallel-group trial (ClinicalTrials.gov Identifier: NCT06758362), 89 adult survivors of the 2023 Kahramanmaraş earthquakes in Türkiye who met DSM-5 criteria for PTSD were assigned to 12 sessions of remotely delivered EMDR (n = 30), CBT (n = 30), or a wait-list control group (n = 29). PTSD severity was the primary outcome, with depression, anxiety, and emotion regulation as secondary outcomes. Assessments were conducted at baseline, mid-treatment, and post-treatment. Analyses followed an intention-to-treat framework using mixed-effects models.ResultsBoth EMDR and CBT produced large reductions in PTSD symptoms compared with the control condition (Cohen’s d ≈ 1.9), alongside moderate-to-large improvements in depression (d ≈ 1.4) and anxiety (d ≈ 1.3). Symptom improvement was evident by mid-treatment and increased through post-treatment. Direct comparisons between EMDR and CBT yielded overlapping confidence intervals, indicating comparable overall efficacy. However, EMDR showed a tendency toward greater reduction in core PTSD symptoms, whereas CBT demonstrated relatively stronger effects on depressive symptoms. Improvements in emotion regulation were observed in both treatment groups but did not reach statistical significance.DiscussionThe findings suggest that both EMDR and CBT are highly effective when delivered remotely in the aftermath of a large-scale natural disaster. Differential response patterns likely reflect distinct therapeutic mechanisms—direct trauma memory processing in EMDR versus cognitive restructuring and behavioral activation in CBT—highlighting their potential complementarity rather than superiority of one approach over the other. The absence of spontaneous improvement in the control group underscores the necessity of structured psychological intervention following earthquake exposure.ConclusionRemotely delivered EMDR and CBT are feasible, effective, and clinically valuable interventions for earthquake-related PTSD. Their comparable efficacy and partially distinct symptom profiles support flexible, needs-based integration of both treatments within disaster mental-health systems.Clinical Trial Registrationhttps://clinicaltrials.gov/study/NCT06758362, identifier NCT06758362.
<![CDATA[Psychiatrist Gus Alva highlights new depression therapies, neuromodulation, and why screening for bipolar disorder prevents antidepressant harm.]]>

The Enhanced Games fit right in with the rest of 2026’s longevity vibes

This Sunday, a group of 42 athletes will gather in Las Vegas to compete in a somewhat unusual sporting competition. Participants in the inaugural Enhanced Games are being encouraged to take performance-enhancing drugs. The goal is to “push the boundaries of human performance.”

The games’ organizers have said that competitors will only be taking substances that have been approved by the US Food and Drug Administration, and that they are all being medically monitored and supervised. But they have also said they expect to see world records broken—and are offering substantial prizes to athletes who succeed in doing so.

As you might expect, the event is generating a mix of curiosity, excitement, and condemnation from various quarters. To me, it feels like very much a reflection of where we are today—an era of peptide-crazed looksmaxxing in which consumers are being encouraged to get thinner than ever, optimize for longevity, and have their “best baby.” It’s 2026, and if you’re not enhancing, what are you even doing?

So, these games. They’ll feature competitions in four categories: swimming, track and field, weightlifting, and strongman (which also involves lifting weights). Many of the competitors already hold national and world records, and some are Olympic medalists. They’ve been paid a salary and will compete for prizes from a $25 million pot. The money has been a major draw for at least some of the athletes.

Another draw is the opportunity to openly experiment with drugs that might boost their performance. In the world of elite sport, every microsecond and every millimeter counts. Athletes—most of whom arguably have genetics on their side already—follow meticulous diet, training, and recovery protocols and wear specially designed gear that allows them to reach for those performance bests.

But within most sporting communities, there are limits. The World Anti-Doping Agency—an international outfit that fights the use of drugs in sports—maintains a lengthy list of “non-approved substances” that are banned in international sporting events. It features many anabolic steroids (which can build muscle), hormones (such as those that stimulate testosterone production or increase the ability of blood to carry oxygen), growth factors (which can stimulate muscle growth and repair, among other things), and more.

Some of these substances have been FDA approved to treat health disorders. And that means they can be used by participants in the Enhanced Games, according to the organization’s rules.

I’ll briefly point out the obvious here—just because a drug has been approved by the FDA doesn’t mean it’s totally safe for everyone and anyone. The risks associated with use of anabolic steroids, for example, include high blood pressure, acne, depression, and liver tumors. Growth hormone use can cause weak muscles, affect vision, and even lead to diabetes.

“Technological doping,” or using improved equipment to gain advantage, has also been supported by the games’ organizers. Last year, participating swimmer Kristian Gkolomeev was reported to have broken a record in a 50-meter freestyle time trial while wearing a polyurethane “super” swimsuit. Such suits have been banned for use in the Olympics since a slew of record-breaking performances in 2008 and 2009. Back then, the swimming governing body ruled that they gave athletes an unfair advantage. But hey, this is the Enhanced Games, where the word “unfair” seems to have a completely different meaning.

Can we expect more records to be broken on Sunday? Maybe. In addition to prize money for winning an event, any athlete who manages to beat a record stands to win up to $1 million, the sum also awarded to Gkolomeev last year following his time trial. But those performances won’t be recognized by official sporting bodies.

Plenty of concerns have been raised about these games. Some argue that they are unsafe and promote risky drug use. Others see them as a “clown show,” and a slap in the face to “clean” athletes who train hard without the use of prohibited drugs. World Athletics president Sebastian Coe has said that anyone who takes part is “moronic,” and World Aquatics, which oversees international competitions in water sports, has banned Enhanced Games participants from its events and activities.

But. The games—and the participating athletes—will still get a huge amount of attention. As a result, so will performance-enhancing drugs. Enhanced, the company behind the games, also runs an online store. There, you can buy a $52 T-shirt emblazoned with the message “I am Enhanced.”

There is also a range of prescription drugs on offer, including peptides “to support recovery, vitality, and longevity.” One of these is a growth hormone that the FDA approved in 1997 for the treatment of children with “growth failure.” The compounded version offered on the Enhanced website, which is not FDA approved, is marketed for longevity, supporting deep sleep and “overall wellness and vitality.” (“Marketed” is the key word here. The drug has, again, not been approved for that purpose.)

It all fits very well with the zeitgeist. Sure, we don’t yet have any drugs that are designed to extend human lifespan. But the search for anti-aging drugs is getting more attention—and funding—than ever. People, particularly women, are seemingly not allowed to visibly age anymore—we have filters and facelifts for that now. The idea that “death is wrong” is gaining acceptance.

And self-experimentation is rife. “Biohacking” was shortlisted for Collins Dictionary’s Word of the Year in 2025. Peptides are everywhere, despite all the unknowns surrounding their safety and effectiveness. So are longevity clinics, despite the fact that most are selling unproven treatments. US states like Montana are making it easier for people to get hold of unapproved “therapies.”

Companies are even offering would-be parents the option to choose the potential future children expected to live longest. Yep—you can supposedly optimize your embryos now, too.

In this climate, the Enhanced Games don’t feel so radical. They feel entirely fitting for our era of questionable optimization despite the risks —an era when, apparently, being human is no longer enough.

Accelerated iTBS for Major Depression

Conditions: Major Depressive Disorder (MDD); Treatment Resistant Depression (TRD)

Interventions: Device: Accelerated Intermittent Theta Burst Stimulation (iTBS)

Sponsors: Istanbul University – Cerrahpasa

Recruiting

Baseline working memory was associated with improvement in psychological quality of life in patients with persistent depressive symptoms: a prospective observational study

BackgroundCognitive dysfunction is prevalent in patients with depressive symptoms and contributes to impaired quality of life (QOL) and functional outcomes. However, the prognostic significance of specific cognitive domains for long-term outcomes remains unclear in patients with persistent depressive symptoms.MethodsIn this prospective observational study, 119 patients completed the detailed examination program in routine clinical care. Of these, 84 patients with persistent depressive symptoms provided consent for study participation and met the eligibility criteria for inclusion in the present study, including completion of the baseline assessment with the Wechsler Adult Intelligence Scale, Fourth Edition (WAIS-IV). The diagnostically heterogeneous cohort included patients with major depressive disorder/dysthymia as well as bipolar and related disorders. The World Health Organization Quality of Life Instrument, Short Version (WHO-QOL-26) and the World Health Organization Disability Assessment Schedule 2.0 were assessed at baseline, three, and six months; 60 participants provided 3-month follow-up data and 50 provided 6-month follow-up data. Primary hierarchical regression analyses were exploratory and conducted using complete-case data.ResultsAt baseline, participants exhibited relatively higher verbal ability and lower processing speed compared to normative data. While no significant group-level improvement in QOL was observed over six months and functioning did not improve overall, the WHODAS 2.0 standardized total score was temporarily higher at 3 months than at baseline. In exploratory analyses of complete cases, higher baseline working memory was significantly associated with greater improvement in the psychological domain of the WHO-QOL-26 at six months (β = 0.40; ΔR² = 0.14; p < 0.01). No other cognitive domains showed such associations.ConclusionsWorking memory was associated with subsequent improvement in psychological well-being and may represent a candidate prognostic marker in patients with persistent depressive symptoms. Given the exploratory nature and modest sample size, these findings require replication in larger, diverse populations.