Inclusion of older people in interventional clinical trials

Abstract

The population growth and demographic changes have been remarkable in the past century, leading to a massive growth in the older population. Older people constitute the largest group of consumers of medications globally and will continue to be so for the foreseeable future. There has been chronic and unjustifiable underrepresentation of older people in interventional clinical trials, as has been evident in the majority of landmark studies that have been designed to address questions very pertinent to older people as well in many different medical specialties. Chronological age itself or comorbidity, or both in combination, have been instrumental directly or indirectly for systematic exclusion of older people from these clinical trials. Hence the evidence base for treating older people with medical conditions that usually tend to coexist in a given older person is rather patchy and dubious, leading to speculation of benefit from interventions as a result of extrapolation of inferences from trials in younge...