Including older people in clinical research

Antipsychotics in people with dementia: frequency of use and rationale for prescribing in a UK mental health service

“…This suggests that prescribing clinicians considered the risks associated with first-generation antipsychotics to be greater and this is in consensus with the literature. 3 Although risperidone is the only antipsychotic currently licensed for short-term treatment of BPSD in dementia (maximum 6 weeks), in our sample, quetiapine, the least potent and most sedative antipsychotic in its class, was by far the preferred choice. This could be attributed to the fact that the initial recommendation from the Committee on Safety of Medicines had identified only olanzapine and risperidone as increasing the risk of stroke.…”

“…3 We searched the PubMed, PsycINFO and PsycARTICLES databases for publications on CAN using the following terms: addiction, drug dependence, heroin AND methadone; the search yielded only four studies, conducted primarily in mental healthcare systems. [4][5][6][7] Nevertheless, surveys using non-standardised assessments have found high levels of unmet needs, particularly legal, basic, financial, family, social services, medical and mental healthcare, in addiction patient groups.…”

Cáncer de mama en mujeres adultas mayores, características clínicas e histopatológicas y resultados del tratamiento con intención curativa

“…A pesar de la mayor frecuencia de CM en el AM no hay consenso acerca de los estudios de prevención con mamografía en las mujeres mayores de 70 años 24 . Tampoco se ha definido la terapia sistémica para este grupo etario, siendo escasos los estudios fase III 8,25 , por lo que las decisiones terapéuticas para el AM son basadas en indicaciones definidas para las pacientes más jóvenes, modificadas según la presencia de co-morbilidades, la valoración de la capacidad funcional y las expectativas de vida 3,6,26 .…”

Including the very elderly in clinical trials

“…A number of factors lead researchers and companies either to exclude the elderly from clinical trials altogether, or to limit their involvement based on a rigid set of exclusion criteria that do not reflect the patient population to which the licensed drug will eventually be prescribed [6]. As a result, drug prescription is based on data extrapolated from trials on younger, fitter patients, and the elderly recipient is effectively being administered a drug whose age-specific effects have not been scientifically assessed and which may precipitate an avoidable adverse drug reaction.…”