The SLaM Brain Health Clinic: a remote biomarker enhanced memory clinic for patients with mild cognitive impairment within an NHS mental health trust

Abstract

Introduction: 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). Aim: To describe the organisation, patient cohort, and acceptability of the remote diagnostic and interventional procedures. Methods: We describe the recruitment, consultation setup, the clinical and biomarker program, and the two online group interventions for cognitive wellbeing and lifestyle change. We evaluate the acceptability of the remote consultations, lumbar puncture (LP), saliva genotyping and remote cognitive and functional assessments. Results: We present the results of the first 68 (mean age 73, 55% female, 43% ethnic minority) of 146 patients who enrolled for full remote clinical, cognitive, genetic, cerebrospinal fluid, and neuroimaging phenotyping. 86% were very satisfied/ satisfied with the remote service. 67% consented to LP and 95% of those were very satisfied, all having no significant complications. 93% found taking saliva genotyping very easy/easy and 93% found the cognitive assessments instructions clear. 98% were satisfied with the cognitive wellbeing groups and 90% of goals were achieved in the lifestyle intervention group. Conclusion: 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, 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.