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Cambridge Public Health

 
Senior Research Associate

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 (CC75C) Study, supporting postgraduate students, visiting researchers and external collaborators working on a wide range of ageing-related and neuropathological research projects. A rare resource combining almost three decades of epidemiological data collection and a brain donation programme, CC75C is the longest-running of several population-based studies of ageing run from the Life-course and Ageing group in Cambridge Public Health.  

Jane’s own programme of research, using mixed methods approaches to inform policy and practice affecting older people, has a focus on the growing numbers of ‘older old’ people and common challenges so many face in their later years – falls, osteoporosis, incontinence, social isolation, physical frailty, cognitive impairment and dementia. 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 also works part-time as a fall and fracture prevention clinical nurse specialist in Addenbrooke’s Hospital.

Publications

Key publications: 

Death and the oldest old: Attitudes and preferences for end-of-life care – Qualitative research within a population-based cohort study Jane Fleming, Morag Farquhar, CC75C study collaboration, Carol Brayne, Stephen Barclay PLOS ONE 2016 April 5,DOI: 10.1371/journal.pone.0150686

  • Featured in: BuzzFeed  and The Conversation
  • Ranked in top10% most cited PLOS ONE 2016 papers (56 citations by July 2021)
Other publications: 

Frequency of LATE neuropathologic change across the spectrum of Alzheimer’s disease neuropathology: combined data from 13 community-based or population-based autopsy cohorts

Peter T. Nelson, Carol Brayne, Margaret E. Flanagan, Erin L. Abner, Sonal Agrawal, Johannes Attems, Rudolph J. Castellani, Maria M. Corrada, Matthew D. Cykowski, Jing Di, Dennis W. Dickson,

Brittany N. Dugger, John F. Ervin, Jane Fleming, Jonathan GraffRadford, Lea T. Grinberg, Suvi R. K. Hokkanen, Sally Hunter, Alifiya Kapasi, Claudia H. Kawas, Hannah A. D. Keage, C. Dirk Keene, Mia Kero, David S. Knopman, Naomi Kouri, Gabor G. Kovacs, Sydney A. Labuzan, Eric B. Larson, Caitlin S. Latimer, Renata E. P. Leite, Billie J. Matchett, Fiona E. Matthews, Richard Merrick, Thomas J. Montine, Melissa E. Murray, Liisa Myllykangas, Sukriti Nag, Ruth S. Nelson, Janna H. Neltner, Aivi T. Nguyen, Ronald C. Petersen, Tuomo Polvikoski, R. Ross Reichard, Roberta D. Rodriguez, Claudia K. Suemoto, ShihHsiu J. Wang, Stephen B. Wharton, Lon White, Julie A. Schneider

Acta Neuropathologica, 2022: 144(1), 27-44. doi:10.1007/s00401-022-02444-1

 

PHOENIX (Picking up Hidden Osteoporosis Effectively during Normal CT Imaging without additional X-rays): protocol for a randomised, multicentre feasibility study

Kenneth E S Poole, Daniel D G Chappell, Emma Clark, Jane Fleming, Lee Shepstone, Thomas D Turmezei, Adam P Wagner, Karen Willoughby, Stephen K Kaptoge

BMJ Open 2022;12:e050343. doi: 10.1136/bmjopen-2021-050343

 

Improving uptake of Fracture Prevention drug Treatments: a protocol for development of a consultation intervention (iFraP-D)

Zoe Paskins, Laurna Bullock, Fay Crawford-Manning, Elizabeth Cottrell, Jane Fleming, Sarah Leyland, John James Edwards, Emma Clark, Simon Thomas, Stephen Robert Chapman, Sarah Ryan, J E Lefroy, Christopher J Gidlow, C Iglesias, Joanne Protheroe, Robert Horne, Terence W O'Neill, Christian Mallen, Clare Jinks

BMJ Open, 2021, doi:10.1136/bmjopen-2021-048811

 

Developing a model Fracture Liaison Service consultation with patients, carers and clinicians: a Delphi survey to inform content of the iFraP complex consultation intervention

Laurna Bullock, Fay Crawford-Manning, Elizabeth Cottrell, Jane Fleming, Sarah Leyland, John Edwards, Emma M Clark, Simon Thomas, Stephen Chapman, Christopher Gidlow, Cynthia P Iglesias, Joanne Protheroe, Robert Horne, Terence W O’Neill, Christian Mallen, Clare Jinks, Zoe Paskins

Archives of Osteoporosis, 2021 Mar 24;16(1):58. doi: 10.1007/s11657-021-00913-w.

 

Frailty and neuropathology in relation to dementia status: the Cambridge City over-75s Cohort study.

Wallace, L., Hunter, S., Theou, O., Fleming, J., Rockwood, K., & Brayne, C.
International Psychogeriatrics, 2021, 1-9. doi:10.1017/S1041610220003932

 

TDP-43 Related Neuropathologies and Phosphorylation State: Associations with Age and Clinical Dementia in the Cambridge City over-75s Cohort.

S Hunter, SRK Hokkanen, HAD Keage, J Fleming, T Minett, T Polvikoski, K Allinson, C Brayne on behalf of the Cambridge City over-75s Cohort collaboration.
J Alzheimers Dis 75, 337-350 (2020).

 

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

 

Longitudinal analysis of the impact of loneliness on cognitive function over a 20-year follow-up

Hanyuying Wang, Caroline Lee, Sally Hunter, Jane Fleming, Carol Brayne and The CC75C study collaboration
Aging and Mental Health e-pub 20 Aug 2019, DOI: 10.1080/13607863.2019.1655704

 

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

 

Dying comfortably in very old age with or without dementia in different care settings – a representative “older old” population study.

Fleming J, Calloway R, Perrels A, Barclay S, Farquhar M, Brayne C on behalf of the CC75C study collaboration
BMC Geriatrics 2017 17/222 DOI: 10.1186/s12877-017-0605-2     

   Policy briefing: Key findings and policy implications

 

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
 

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 e-pub: 18 January 2017, DOI: 10.1001/jamapsychiatry.2016.3423
 

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.

 

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, Claire Goodman
Eur J Emerg Med 2015 Apr;22(2):147-8. DOI: 10.1097/MEJ.0000000000000237 [E-pub: 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 City 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

 

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 29(12):1212–1220, December 2014 (e-pub: 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 2014 8:3 (e-pub 10 Apr 2014) http://bjp.sagepub.com/content/8/3/119.full

 

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': > or =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 Society 2010 Jan;58(1) 1-11

   Featured in:

   GeriPal (Geriatrics and Palliative Care blog):  https://geripal.org/last-year-of-life-in-oldest-old/ and

   The Conversation: http://theconversation.com/heres-what-people-in-their-90s-really-think-about-death-58053

 

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.