An opinion column in today’s issue of The New York Times tackles a long-standing tension in the clinical trial world: the reluctance to include older subjects, even though they’re most of the population taking medications. Trials routinely bar senior citizens from their ranks, in part because researchers and drug regulators worry that the older you are, the more likely you are to have complicated health conditions that make testing new drugs more challenging. The opinion piece cites a paper published in The Journal of the American Medical Association back in 2007, which found that nearly 40% of trials in big-name journals between 1994 and 2006 excluded people over 65.
It’s time for the system to change, the authors say. “Older Americans are our patients, too. We can’t leave them out,” write physician Donna Zulman and psychologist Keith Humphreys, who work at Stanford University School of Medicine in California and the Veterans Affairs health care system. Extrapolating results from young individuals to older ones is dicey, because biology shifts with age. Furthermore, “advanced age is not a reliable proxy for poor health,” Zulman and Humphreys argue. Researchers can still exclude trial volunteers if they have certain health conditions—but “not on their age alone.”