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

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. ### Competing Interest Statement AVV has received grants from the Alzheimer's Society, Alzheimer's Research UK, and NIHR BRC, including an NIHR BRC Maudsley Neuroimaging Grant. DA has received research support and/or honoraria from Astra-Zeneca, H. Lundbeck, Novartis Pharmaceuticals, Biogen, and GE Health, and served as paid consultant for H. Lundbeck, Eisai, Heptares, Mentis Cura, Roche Diagnostics and Eli Lilly. ### Clinical Trial NCT06379594 ### Funding Statement The SLaM BHC has received funding from Roche and the Maudsley Charity. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Research Ethics Committee (REC) 22/SC/0109 (South Central - Berkshire B, United Kingdom) gave ethical approval for this work. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes All data produced in the present study are available upon reasonable request to the authors