Image via WikipediaOlder persons are often severely underrepresented in clinical trials of new drugs, therapies, and devices. Usually, their exclusion from these studies can not be scientifically justified. Some studies actually have age cutoffs, but more often the exclusion of older persons is more indirect. For example, most older persons have more than one disease. A study of a treatment for disease X may exclude a person who also happens to have disease Y, even though persons with disease Y will be part of the target population for therapy once the treatment is approved. Sometimes, the exclusion of the elderly is even more subtle---such as excluding subjects who need transportation assistance to get to the study center.The exclusion of older persons from clinical studies, whether through direct exclusion of older persons, or indirect exclusions based on factors such as comorbidity or functional impairment is rarely justificable. If an elder would be a realistic candidate for the therapy being studied, there is no valid reason for their exclusion.
The absence of older persons from clinical studies has adversely impacted our ability to care for them. For a multitude of problems common in older persons, the best approach to care is not clear because we have minimal research which informs what works and what does not work in older persons.
These concerns are discussed in an excellent article in the Journal of American Geriatrics Society titled, "Fighting Age Discrimination in Clinical Trials." The article examines many of the barriers that have inhibited enrollment of older persons in clinical research and proposes solutions. It calls for steps to end age discrimination in clinical trials.
Age Discrimination in Clinical Research: Time For Action | GeriPal - Geriatrics and Palliative Care Blog
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