Senior Research Associate

BA (Hons), RGN, MPhil, PhD

E-mail:  jane.fleming@phpc.cam.ac.uk

Telephone:  01223 330341

Background

Dr Jane Fleming moved into research from a clinical background in nursing, mainly with older people, through epidemiology training and a PhD on falls and their consequences in older old age.  She has since co-ordinated the Cambridge City over-75s Cohort Study, the longest-running of several population-based studies of ageing run from the Public Health, Ageing and the Brain research group at the Cambridge Institute of Public Health.  Using mixed methods approaches to inform policy and practice affecting older people, her programme of work has a focus on the growing numbers of the “older old” and those with dementia.

Research Interests

Particular interests include: very old people’s care needs, preferences and transitions towards the end of life; the role that exercise, social and physical activity can play in postponing frailty, maximising independence and quality of life; policy implications and impacts on older people and their carers, both family and staff working across care settings.  She is part of the Cambridge Palliative and End of Life Care Group and affiliated with the Clinical Nursing Research Group, both in the Department of Public Health and Primary Care’s Primary Care Unit. As a member of the Dementia, Frailty and End of Life Care theme within the National Institute for Health Research’s Collaboration for Leadership in Applied Health Research and Care – East of England, she is collaborating on research into older people with dementia’s use of emergency ambulance services – the RODES study, – and research into frail older people’s care trajectories, and is jointly leading a study exploring the impacts of dementia case-finding in acute hospitals on older people’s care after leaving hospital – the CASCADE study.  She is a former co-convenor of the Qualitative Research Forum at CIPH and is currently on the working group coordinating the Cambridge Nurses & allied health professionals in Research group. Along with local voluntary group members she helped set up the Public Involvement in Research into Ageing and Dementia advisory group.

Selected Publications

Longitudinal analysis of the impact of loneliness on cognitive function over a 20-year follow-up
Aging and Mental Health e-pub 20 Aug 2019, DOI: 10.1080/13607863.2019.1655704

When frail older people relocate in very old age who makes the decision?
Fiona Scheibl, Morag Farquhar, Jackie Buck, Stephen Barclay, Carol Brayne and Jane Fleming on behalf of the Cambridge City over-75s Cohort (CC75C) study collaboration
Innovation in Aging Volume 3, Issue 4, August 2019, igz030, DOI: 10.1093/geroni/igz030

Putative risk alleles for LATE-NC with hippocampal sclerosis in population-representative autopsy cohorts
Suvi R. K. Hokkanen, Mia Kero, Karri Kaivola, Sally Hunter, Hannah A. D. Keage, Anna Kiviharju, Anna Raunio, Pentti J. Tienari, Anders Paetau, Fiona E. Matthews, Jane Fleming, Caroline Graff, Tuomo M. Polvikoski, Liisa Myllykangas and Carol Brayne on behalf of the EClipSE collaboration Brain Pathol e-pub 3 Aug 2019, DOI:10.1111/bpa.12773

The experience of transitions in care in very old age: implications for general practice
Fiona Scheibl, Jane Fleming, Jackie Buck, Stephen Barclay, Carol Brayne and Morag Farquhar on behalf of the Cambridge City over-75s Cohort (CC75C) study collaboration
Family Practice e-pub June 2019, DOI: 10.1093/fampra/cmz014

Case finding for dementia during acute hospital admissions: a mixed-methods study exploring the impacts on patient care after discharge and costs for the English National Health Service.
Anne-Marie Burn, Frances Bunn, Jane Fleming, David Turner, Chris Fox, Alexandra Malyon, Carol Brayne
BMJ Open 2019;9(6):e026927.

Is loneliness associated with increased health and social care utilisation in the oldest old? Findings from a population-based longitudinal study
Hanyuying Wang, Emily Zhao, Jane Fleming, Tom Dening, Kay-Tee Khaw, Carol Brayne & The CC75C Study Collaboration
BMJ Open 2019;9:e024645

Mortality risk of loneliness in the oldest old over a 10-year follow-up
Hanyuying Wang, Yue Leng, Emily Zhao, Jane Fleming, Carol Brayne & The CC75C Study Collaboration
Aging & Mental Health, e-pub 17 Nov 2018. DOI: 10.1080/13607863.2018.1510897

Dementia case-finding in hospitals: a qualitative study exploring the views of healthcare professionals in English primary care and secondary care
Anne-Marie Burn, Jane Fleming, Carol Brayne, Chris Fox, Frances Bunn
BMJ Open 2018;8:e020521. DOI: 10.1136/bmjopen-2017-020521

Lack of associations between modifiable risk factors and dementia in the very old: Findings from the Cambridge City over-75s Cohort Study
Kay Deckers, Sebastian Köhler, Martin van Boxtel, Frans Verhey, the CC75C study collaboration, Carol Brayne, Jane Fleming
Aging and Mental Health e-pub: 2 February 2017, DOI: 10.1080/13607863.2017.1280767

Dying comfortably in very old age with or without dementia in different care settings – a representative “older old” population study.
Jane Fleming, Rowan Calloway, Anouk Perrels, Morag Farquhar, Stephen Barclay, Carol Brayne on behalf of the CC75C Cambridge City over-75s Cohort study collaboration  BMC Geriatrics 2017 DOI 10.1186/s12877-017-0605-2

Policy briefing: Key findings and policy implications

Delirium accelerates cognitive decline in late life: a neuropathological study in 987 individuals from three population-based cohort studies Daniel H.J. Davis, Graciela Muniz Terrera, Hannah A.D. Keage, Blossom C.M. Stephan, Jane Fleming, Paul G. Ince, Fiona E. Matthews, Colm Cunningham, E. Wesley Ely, Alasdair M.J. MacLullich, Carol Brayne, on behalf of the EClipSE Collaborative Members JAMA Psychiatry (Published online January 18, 2017. doi:10.1001/jamapsychiatry.2016.3423)

Very old people dying – what would relatives like to have seen managed differently? Fleming J, Evans R, Scheibl F, Buck J, Barclay S, Farquhar M, Brayne C, and Cambridge City over-75s Cohort (CC75C) study collaboration. BMJ Supportive & Palliative Care 2016; 6(3):392.

Using ambulance service PCRs to understand 999 call-outs to older people with dementia. Buswell M, Lumbard P, Fleming J, Ayres D, Brayne C, Goodman C. Journal of Paramedic Practice 2016; 8(5):246-251.

Death and the oldest old: Attitudes and preferences for end-of-life care – Qualitative research within a population-based cohort study Fleming J & Farquhar M [joint first authors], CC75C study collaboration, Brayne C, Barclay S.  PLoS ONE 2016;11(4):e0150686.

Featured on BuzzFeed: http://www.buzzfeed.com/tomchivers/the-only-thing-im-worried-about-is-my-sister

Exploring attitudes and preferences for dementia screening in Britain: contributions from carers and the general public Steven Martin^*, Jane Fleming, Sarah Cullum, Tom Dening, Greta Rait, Chris Fox, Cornelius Katona, Carol Brayne and Louise Lafortune BMC Geriatrics 2015, 15:110  doi:10.1186/s12877-015-0100-6

Does dementia matter? Is dementia an important factor in 999 call-outs to older people? Buswell M, Amado S, Goodman C, William J, Fleming J, Lumbard P, et al. Emergency Medicine Journal 2015 Jun 1;32(6):e14-e15.

Difference between how ambulance service personnel use paper and electronic patient care records when attending older people at home Marina Buswell, Jane Fleming, Philip Lumbard, Larissa S Prothero, Sarah Amador and Claire Goodman Eur J Emerg Med  2015 Apr;22(2):147-8. doi: 10.1097/MEJ.0000000000000237 [Epub ahead of print 2015 Jan 2]

Unplanned, urgent and emergency care: what are the roles that EMS plays in providing for older people with dementia? An integrative review of policy, professional recommendations and evidence Marina Buswell, Philip Lumbard, Larissa Prothero, Caroline Lee, Steven Martin, Jane Fleming, Claire Goodman Emerg Med J Published Online First: 2 December 2014 doi:10.1136/emermed-2014-203941

The relationship between back pain and mortality in older adults varies with disability and gender – results from the Cambridge over-75s Cohort (CC75C) study Rachael E Docking, Jane Fleming, Carol Brayne, Jun Zhao, Gary J Macfarlane, Gareth T Jones and the Cambridge City over-75s Cohort (CC75C) study collaboration European Journal of Pain Published online: 28 JUL 2014 DOI: 10.1002/ejp.568

Time period, birth cohort and prevalence of dementia in mainland China, Hong Kong and Taiwan: a meta-analysis Wu Y-T, Lee H-Y, Norton S, Fleming J, Matthews F, Brayne C Int J Ger Psych Volume 29, Issue 12, pages 1212–1220, December 2014 (first published online: 22 MAY 2014 DOI: 10.1002/gps.4148)

Pain reporting in older adults: the influence of cognitive impairment Rachael E Docking, Jane Fleming, Carol Brayne, Jun Zhao, Gary J Macfarlane, Gareth T Jones and the Cambridge City over-75s Cohort (CC75C) study collaboration British Journal of Pain (e-pub 10 Apr 2014 http://dx.doi.org/10.1177/2049463714527437)

Health-related Quality of Life in the Cambridge City over-75s Cohort (CC75C). Development of dementia-specific scale and descriptive analyses. J Perales, TD Cosco, BCM Stephan, J Fleming, S Martin, JM Haro, C Brayne BMC Geriatrics 2014 14:18 doi:10.1186/1471-2318-14-18

Place of death and end-of-life transitions experienced by very old people with differing cognitive status: retrospective analysis of a prospective population-based cohort aged 85 and over Anouk J. Perrels, Jane Fleming, Jun Zhao, Stephen Barclay, Morag Farquhar, Hilde M. Buiting, Carol Brayne and the Cambridge City over-75s Cohort (CC75C) study collaboration Palliative Medicine, 2014 Mar 3;28(3):220-233 (e-pub ahead of print Dec 2013)

Prevalence studies of dementia in mainland China, Hong Kong and Taiwan: a meta-analysis. Wu Y-T, Lee H-Y, Norton S, Chen C-F, Chen H-X, He C-L, Fleming J, Matthews F, Brayne C PLOS One 2013 Jun 11;8(6):e66252. doi: 10.1371/journal.pone.0066252.

Neuropathological correlates of falling in the CC75C population-based sample of the older old Richardson K, Hunter S, Dening T, Xuereb JH, Matthews FE, Brayne C, Fleming J and the Cambridge City over-75s Cohort (CC75C) study neuropathology collaboration Current Alzheimer Research 2012 Jul;9(6):697-708 [e-pub ahead of print 2 Apr 2012]

Epidemiology of back pain in older adults:  Prevalence and risk factors for back pain onset Rachael E Docking, Jane Fleming, Carol Brayne, Jun Zhao, Gary J Macfarlane, Gareth T Jones and the Cambridge City over-75s Cohort (CC75C) study collaboration Rheumatology 2011 Sep;50(9):1645-53 [E-published 23 May 2011] doi:10.1093/rheumatology/ker175

Place of death for the “oldest old”: ≥85-year-olds in the CC75C population-based cohort Fleming J, Zhao J, Farquhar M, Brayne C, Barclay S and the Cambridge City over-75s Cohort (CC75C) study collaboration British Journal of General Practice 2010 (April); 60(573): e171-179, DOI: 10.3399/bjgp10X483959.

The “oldest old” in the last year of life: population-based findings from CC75C study participants aged at least 85 at death Zhao J, Barclay S, Farquhar M, Kinmonth AL, Brayne C, Fleming J and the Cambridge City over-75s Cohort (CC75C) study collaboration Journal of the American Geriatrics Association 2010 Jan;58(1) 1-11

Neuropathological correlates of dementia in over-80-year-old brain donors from the population-based Cambridge City over-75s Cohort (CC75C) study Brayne C, Richardson K, Matthews FE, Fleming J, Hunter S, Xuereb JH, Paykel E, Mukaetova-Ladinska EB, Huppert FA, O’Sullivan A, Dening T, and the Cambridge City over-75s Cohort (CC75C) study neuropathology collaboration Journal of Alzheimer Disease 2009 Aug;18(3) 645-658

Inability to get up after falling, subsequent time on floor, and summoning help: prospective cohort study in people over 90. Jane Fleming, Carol Brayne and the Cambridge City over-75s Cohort (CC75C) study collaboration BMJ 2008;337:a2227.

Falls in advanced old age: recalled falls and prospective follow-up of over-90-year-olds in the Cambridge City over-75s Cohort study.  Jane Fleming, Fiona E Matthews, Carol Brayne and the Cambridge City over-75s Cohort (CC75C) study collaboration BMC Geriatrics 2008, 8:6.

Cohort profile: the Cambridge City over-75s Cohort (CC75C). Fleming J, Zhao E, O’Connor DW, Pollitt PA, Brayne C and the CC75C study. International Journal of Epidemiology 2007 Feb;36(1):40-6.

Population levels of mild cognitive impairment in England and Wales. J. Fleming, F.E. Matthews, M. Chatfield and C. Brayne. In: Holly A. Tuokko, HA and Hultsch, DF (Eds) Mild cognitive impairment: International perspectives. Psychology Press, 2006

Fracture risk factors relate to ultrasound measures in women aged over 90 years.  Fleming J and Brayne C.  Osteoporosis International 2004; 15(Suppl 2): S28, P51. Proceedings of 10th International Conference on Osteoporosis, Harrogate, Nov-Dec 2004.

Fracture risk factors and fracture-protective prescriptions in nonagenarians: The Cambridge City over-75s Cohort Study followed-up after 17 years. Fleming J and Brayne C. Age and Ageing 2005; 34(Suppl 1): i21. Proceedings of British Geriatrics Society Autumn Meeting, Harrogate, Oct 2004.

Heel ultrasound measurements in nonagenarians: the Cambridge City Over-75s Cohort. Fleming J and Brayne C. Osteoporosis International 2003; 14(Suppl 2): S22, P17. Proceedings of 9th Bath International Conference on Osteoporosis, Bath, Jun 2003.

Teaching

Jane is involved in supervision and liaison arrangements for visiting researchers and masters student internships, as well as for postgraduate students on the department (the Department of Public Health and Primary Care runs 3 masters courses:  M.Phil in Epidemiology, in Public Health and in Clinical Sciences (Primary Care Research)).  She is an occasional lecturer for the  psychiatric epidemiology module in the M.Phil programmes and the public health/ageing modules for undergraduate medical students.

Student and other collaborator projects to date:

PhD Students

• Loneliness and social isolation in older old age.  Hanyuying Wang, doctoral student, University of Cambridge (PhD advisor, 2015-2018)
• The ‘LIBRA’ Index and incident dementia in the very old – investigating associations between modifiable risk factors and dementia in the CC75C study.  Kay Deckers, doctoral student, Maastricht University (co-supervisor for visiting PhD fellowship, 2016)

Masters Students

• Hippocampal sclerosis and its association with TDP-43, granulovacuolar degeneration, and cognitive impairment: A population-based autopsy study.  Suvi Hokkanen, Masters in Public Health, Karolinska Institute, Stockholm, 2013
• The “oldest old” and their perceptions and experiences of informal and formal social care – socio-political review, descriptive epidemiology and qualitative findings from the CC75C study. Rehana Ratnatunga, MPhil Public Health, University of Cambridge, 2012
•  Predictors of place of death in older people – at home in the community or in care homes: the Cambridge City over-75s Cohort (CC75C) study. Funmi Oleboyede, MPhil Public Health, University of Cambridge, 2012
• What is preventing the very old from getting out and about as much as they would like to? Physical and psychosocial correlates of feeling homebound in older old age. Cherie Chua (Chua Xue Li), MPhil Public Health, University of Cambridge, 2012
• Characteristics and relations amongst measures of hearing impairment and physical health, cognitive function and social well-being in the elderly population of the city of Cambridge. Maria Del Mar Yacaman, M.Phil Public Health, University of Cambridge, 2012
• APOE4 and neuropathology. Josephine Garth, MSc Cellular Pathology, University of the West of England, 2011
• Comparison of place of death and end-of-life transitions experienced by “older old” people of different cognitive status: ≥ 85 year-olds in the CC75C population-based cohort. Anouk Perrels, MSc Health Sciences, Vrie Universitiet, Amsterdam, 2010

Undergraduate medical students – student selected research placement liaison/supervision

• Death certificate registration of dementia. Rebecca Grant, MBChir, School of Clinical Medicine, University of Cambridge, 2011
• Loneliness and cognitive impairment. Harriet Pepper MBChir, School of Clinical Medicine, University of Cambridge, 200

Undergraduate students – supervision of final year thesis

• Cognitive Impairment, and Social Interaction, Physical Activity and Intellectual Engagement: Evidence from the Cambridge City over-75s Cohort. Hanna-Maria Hirvonen, MSc Biological Anthropology, University of Cambridge, 2011

Visiting researchers – supervision of research placements

• Can the Short Physical Performance Battery predict outcomes in very old age? Stephanie Fu, Associate Lecturer and Research Fellow, Division of Physiotherapy, School of Health & Rehabilitation Sciences, University of Queensland, Australia, 2010
• Social and physical activity correlates of cognition in old age. Chen Chuanfeng, Associate Professor, Department of Psychology, Ningbo University, China, 2011
• Health-related quality of life in the Cambridge City over-75s Cohort: Development of a dementia-specific scale and descriptive analyses. Jaime Perales, visiting PhD student, University of Barcelona, 2012