Based on the report it seems the cause is lack in RAM? Like 32GB isn't enough for 2019 iMac??
You have more than enough RAM. Simply restart your computer more often than every nine days. Restarting clears RAM and empties caches:
System Software:
macOS Mojave 10.14.6 (18G8022)
Time since boot: About 9 days
A restart will probably take care of this as well:
Runaway user process - A user process is using a large percentage of your CPU.
If you are concerned about RAM, stop using Chrome:
Top Processes Snapshot by Memory:
Process (count) RAM usage (Source - Location)
Google Chrome Helper (Renderer) (29) 6.43 GB (Google, Inc.)
Google Chrome (2) 1.29 GB (Google, Inc.)
EtreCheckPro 1.00 GB (Etresoft, Inc.)
Adobe Premiere Pro CS6 954 MB (? - /Applications/Adobe Premiere Pro CS6/Adobe Premiere Pro CS6.app)
Dock (3) 906 MB (Apple)
Chrome and its minions are using nearly 25 percent of your RAM at the time of testing. Not acceptable.
Your Fusion drive is running at similar speeds to other 4K iMacs. That should not be an issue.
Try disconnecting your external drives and testing for an hour or so. Some externals can slow performance,
You have some apps and plug-ins that are older than your computer. Best practice: upgrade if you need them—dump 'em if you don't.
Notifications:
uTorrent.app
6 notifications
Torrent softare will slow your computer.
The system mods Etrecheck reports are always a breeding ground for poor performance.