The under-representation of older people in clinical trials: barriers and potential solutions

Area of Science:

• Gerontology
• Clinical Trial Methodology
• Health Equity

Background:

• Frail older adults are a core demographic for health services but remain under-represented in clinical research.
• The limited evidence base for this population hinders effective clinical decision-making.
• Exclusion from trials creates an inequitable healthcare landscape for older individuals.

Purpose of the Study:

• To investigate the reasons behind the exclusion of frail older people from clinical trials.
• To propose actionable solutions to enhance the inclusion of this demographic in research.
• To advocate for equitable standards of healthcare and research participation for older adults.

Main Methods:

• Literature review on clinical trial demographics and exclusion criteria.
• Analysis of barriers to older adult participation in clinical research.
• Synthesis of existing strategies and recommendations for improving inclusion.

Main Results:

• Identified significant under-representation of frail older adults in numerous clinical trials.
• Highlighted systemic and practical barriers contributing to exclusion.
• Noted some progress but emphasized the need for continued efforts.

Conclusions:

• The under-representation of frail older adults in clinical trials persists, impacting evidence-based practice.
• Addressing exclusion requires multifaceted solutions targeting trial design, recruitment, and ethical considerations.
• Ensuring equitable participation is essential for advancing geriatric healthcare and research.