The SLaM Brain Health Clinic: remote biomarker enhanced memory clinic for people with mild cognitive impairment within a National Health Service mental health trust
Centre for Healthy Brain Ageing, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK South London and Maudsley NHS Foundation Trust, London, UK
Pooja Kandangwa
Centre for Healthy Brain Ageing, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
Roos Lemmen
Centre for Healthy Brain Ageing, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
Rutvi Savla
Centre for Healthy Brain Ageing, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
Mazda Beigi
South London and Maudsley NHS Foundation Trust, London, UK
Devon Hammond
South London and Maudsley NHS Foundation Trust, London, UK
Daniel Harwood
South London and Maudsley NHS Foundation Trust, London, UK
Justin Sauer
South London and Maudsley NHS Foundation Trust, London, UK
Latha Velayudhan
Centre for Healthy Brain Ageing, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK South London and Maudsley NHS Foundation Trust, London, UK
Clive Ballard
College of Medicine and Health, University of Exeter, UK
Centre for Healthy Brain Ageing, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK University Hospital of Old Age Psychiatry, University of Bern, Switzerland
Chris Kalafatis
Centre for Healthy Brain Ageing, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK South London and Maudsley NHS Foundation Trust, London, UK
Centre for Healthy Brain Ageing, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK South London and Maudsley NHS Foundation Trust, London, UK Centre for Age-Related Research, Stavanger University Hospital, Norway
Background The novel South London and Maudsley Brain Health Clinic (SLaM BHC) leverages advances in remote consultations and biomarkers to provide a timely, cost-efficient and accurate diagnosis in mild cognitive impairment (MCI). Aims To describe the organisation, patient cohort and acceptability of the remote diagnostic and interventional procedures. Method We describe the recruitment, consultation set-up, the clinical and biomarker programme, and the two online group interventions for cognitive wellbeing and lifestyle change. We evaluate the acceptability of the remote consultations, lumbar puncture, saliva genotyping, and remote cognitive and functional assessments. Results We present the results of the first 68 (mean age 73, 55% female, 43% minoritised ethnicity) of 146 people who enrolled for full remote clinical, cognitive, genetic, cerebrospinal fluid and neuroimaging phenotyping. A total of 86% were very satisfied/satisfied with the remote service. In all, 67% consented to lumbar puncture, and 95% of those were very satisfied, all having no significant complications. A total of 93% found taking saliva genotyping very easy/easy, and 93% found the cognitive assessments instructions clear. In all, 98% were satisfied with the Cognitive Wellbeing Group, and 90% of goals were achieved in the Lifestyle Intervention Group. Conclusions The SLaM BHC provides a highly acceptable and safe clinical model for remote assessments and lumbar punctures in a representative, ethnically diverse population. This allows early and accurate diagnosis of Alzheimer's disease, differentiation from other MCI causes and targets modifiable risk factors. This is crucial for future disease modification, ensuring equitable access to research, and provides precise, timely and cost-efficient diagnoses in UK mental health services.
