Long the definitive procedure of medical research, clinical trials have proven time and time again to be an effective and efficient means of collecting critical medical data. Data which then determines whether or not the drug, device, program or procedure, works for real patients.
What happens though when the demographics participating in the clinical trials are not a diverse enough crowd?
Oftentimes, when it comes to clinical trials, the elderly are the demographic who are the least represented in clinical trials, yet at the same time the demographic that could benefit most from being represented in these clinical trials. In the long term this cripples even the best health care providers from providing optimal treatment to their older patients.
What is it that is keeping the elderly from participating in these trials that could be so beneficial to them?
Multiple factors have contributed to keeping the elderly mostly absent from clinical trials. Studies have found that even the most prestigious medical journals have excluded older people with age limits and restrictions, barring them the opportunity to participate.
Unfortunately as people get older, their health problems tend to increase and their chances of being affected by multiple diseases, disorders and complications increases too. The increased number of comorbidities present in elderly populations make the demographic less desirable to researchers who want a “cleaner” clinical trial. Coupled with the fact that the elderly are typically prescribed medications at three times the rate of those under the age of 50.
Lack of transportation, and/or the ability to drive, is another obstacle many older people face when it comes to participating in a clinical trial that is held in a facility away from their residence. Without the support of family members, or the help of a caretaker, even those of the older demographic who are interested in participating cannot simply because it is not feasible for their situation.
It is apparent that those who are conducting clinical trials need to investigate ways to remedy this problem so that their clinical trials are more easily translatable to the general population they intend to help.
One suggested strategies for mitigating these issues include increasing the study sample size to allow meaningful conclusions to be drawn from data even when it includes patients with comorbidities.
Another useful strategy is to ensure that the clinical sites for your study are easily accessible for the elderly. Keeping centers nearby to the elderly population you are studying and out of difficult to access areas of cities is an important step to increasing participation in clinical trials.
Reimbursement for costs associated with participation in the study, particularly for site visits, is a great way to increase participation among those who would like to help advance our scientific understanding, but due to their own circumstances cannot. 
Most of all make sure that your participants have both realistic expectations for their own outcomes in the study and an understanding of the potential their participation has to help others in the future.