The SLaM Brain Health Clinic: remote biomarker enhanced memory clinic for people with mild cognitive impairment within a National Health Service mental health trust

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...

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Main Authors: Ashwin V. Venkataraman, Pooja Kandangwa, Roos Lemmen, Rutvi Savla, Mazda Beigi, Devon Hammond, Daniel Harwood, Justin Sauer, Latha Velayudhan, Clive Ballard, Anna-Katharine Brem, Chris Kalafatis, Dag Aarsland
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Language:English
Published: Cambridge University Press 2025-01-01
Series:BJPsych Open
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Online Access:https://www.cambridge.org/core/product/identifier/S2056472424008299/type/journal_article
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author Ashwin V. Venkataraman
Pooja Kandangwa
Roos Lemmen
Rutvi Savla
Mazda Beigi
Devon Hammond
Daniel Harwood
Justin Sauer
Latha Velayudhan
Clive Ballard
Anna-Katharine Brem
Chris Kalafatis
Dag Aarsland
author_facet Ashwin V. Venkataraman
Pooja Kandangwa
Roos Lemmen
Rutvi Savla
Mazda Beigi
Devon Hammond
Daniel Harwood
Justin Sauer
Latha Velayudhan
Clive Ballard
Anna-Katharine Brem
Chris Kalafatis
Dag Aarsland
author_sort Ashwin V. Venkataraman
collection DOAJ
description 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.
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spelling doaj-art-560bbff5b37c407ca3387431bbd10de02024-12-19T05:44:34ZengCambridge University PressBJPsych Open2056-47242025-01-011110.1192/bjo.2024.829The SLaM Brain Health Clinic: remote biomarker enhanced memory clinic for people with mild cognitive impairment within a National Health Service mental health trustAshwin V. Venkataraman0https://orcid.org/0000-0001-7977-1948Pooja Kandangwa1Roos Lemmen2Rutvi Savla3Mazda Beigi4Devon Hammond5Daniel Harwood6Justin Sauer7Latha Velayudhan8Clive Ballard9Anna-Katharine Brem10https://orcid.org/0000-0003-0295-6834Chris Kalafatis11Dag Aarsland12https://orcid.org/0000-0001-6314-216XCentre 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, UKCentre for Healthy Brain Ageing, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UKCentre for Healthy Brain Ageing, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UKCentre for Healthy Brain Ageing, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UKSouth London and Maudsley NHS Foundation Trust, London, UKSouth London and Maudsley NHS Foundation Trust, London, UKSouth London and Maudsley NHS Foundation Trust, London, UKSouth London and Maudsley NHS Foundation Trust, London, UKCentre for Healthy Brain Ageing, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK South London and Maudsley NHS Foundation Trust, London, UKCollege of Medicine and Health, University of Exeter, UKCentre for Healthy Brain Ageing, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK University Hospital of Old Age Psychiatry, University of Bern, SwitzerlandCentre for Healthy Brain Ageing, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK South London and Maudsley NHS Foundation Trust, London, UKCentre 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, NorwayBackground 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. https://www.cambridge.org/core/product/identifier/S2056472424008299/type/journal_articleRemote brain health clinicbiomarkersold age psychiatrymild cognitive impairmentdementia
spellingShingle Ashwin V. Venkataraman
Pooja Kandangwa
Roos Lemmen
Rutvi Savla
Mazda Beigi
Devon Hammond
Daniel Harwood
Justin Sauer
Latha Velayudhan
Clive Ballard
Anna-Katharine Brem
Chris Kalafatis
Dag Aarsland
The SLaM Brain Health Clinic: remote biomarker enhanced memory clinic for people with mild cognitive impairment within a National Health Service mental health trust
BJPsych Open
Remote brain health clinic
biomarkers
old age psychiatry
mild cognitive impairment
dementia
title The SLaM Brain Health Clinic: remote biomarker enhanced memory clinic for people with mild cognitive impairment within a National Health Service mental health trust
title_full The SLaM Brain Health Clinic: remote biomarker enhanced memory clinic for people with mild cognitive impairment within a National Health Service mental health trust
title_fullStr The SLaM Brain Health Clinic: remote biomarker enhanced memory clinic for people with mild cognitive impairment within a National Health Service mental health trust
title_full_unstemmed The SLaM Brain Health Clinic: remote biomarker enhanced memory clinic for people with mild cognitive impairment within a National Health Service mental health trust
title_short The SLaM Brain Health Clinic: remote biomarker enhanced memory clinic for people with mild cognitive impairment within a National Health Service mental health trust
title_sort slam brain health clinic remote biomarker enhanced memory clinic for people with mild cognitive impairment within a national health service mental health trust
topic Remote brain health clinic
biomarkers
old age psychiatry
mild cognitive impairment
dementia
url https://www.cambridge.org/core/product/identifier/S2056472424008299/type/journal_article
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