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With More Elderly, a Need to Get More Older Adults Accepted in Clinical Trials

Patrick Doheny
Creative Commons

The world is getting older. According to the National Institutes of Health, the number of people aged 65 and up will grow to 1.6 billion by mid-century. 

In the U.S., elderly populations are expected to double over that timeframe -- and as those demographics change, some doctors are cautioning medical research needs to change, too. Especially when it comes to the age groups scientists study when researching new medical advances.

When you think "clinical trial," you might picture a cash-strapped college student running on a treadmill trying to earn a few extra bucks. But as Joann Boyd thinks back to her first clinical trial, she said there was another detail that stood out.

"This very handsome Icelandic doctor was doing a trial," she said. "I didn't know he was handsome until I got there."

Boyd, 77, lives in Avon. Following a career in elementary education, and as a mom raising her kids, she started signing up for clinical trials.

As she thought back to the other participants in her first trial, she said there was another, perhaps more important, detail that stood out.

"We were all, I think, 65, or over 50, anyway," Boyd said.

In other words, she was not your stereotypical young test subject.

Since then, Boyd has participated in a number of other clinical trials as a retired adult. She just wrapped up a study on high-dose flu vaccines at UConn, but Boyd's unusual.

A 2011 study out of the University of Michigan found clinical trials -- studies at the heart of all advances in medical science -- often exclude the elderly. It found more than 20 percent of clinical trials excluded patients above a specific age, which means doctors are often relying on data from younger populations when prescribing certain drugs or treatments for seniors.

George Kuchel, a doctor and director of UConn's Center on Aging, said that's a problem.

"One of the most common misconceptions about aging is the idea that somehow as we get older we get more and more similar to each other," Kuchel said. "In fact, the exact opposite is true."

As people age, Kuchel said the differences between them get more striking. For years, he said, that messiness led to a bias against the elderly. Scientists looking for clean answers to clean questions figured it was just easier to exclude elderly people from clinical trial research. 

"It was not at all uncommon for us to have to take information -- research that was done -- on younger students, often ... people in their 20s or 30s, and then extrapolate those findings to the elderly," Kuchel said. "It became very clear you could not do that, because older adults are not simply older versions of 30 year olds."

In 1996, UConn started a recruitment core. The goal was to create a database of older volunteers. According to Kuchel, its demographics match that of the state. Kuchel said it's a ready pool of people scientists can call upon to better incorporate the elderly into clinical trials.

Today, the database contains more than 26,000 names. More than three-quarters of those people are older than 70.

Lisa Pesceis the recruitment manager for UConn's Center on Aging. She said healthy, older clinical trial participants are some of their best.

"They're timely. They have very few cancelations and they're very committed to the research that we do," Pesce said.

As elderly populations increase, Pesce and Kuchel said it's also important that clinical trials branch out even further in their demographics, particularly when it comes to recruiting frail elderly -- people with with multiple health problems, where prescribing the right drug or treatment is that much more crucial.

"If none of the research that's relevant to their care has been done in that population we too will have failed," Kuchel said, because, he continued, those who are most vulnerable will not be served by research that's so vital to their health.

If you're interested in learning more or participating in a clinical trial, Lisa Pesce said call the UConn Center on Aging at (860) 679-3043 or call Ms. Pesce directly at (860) 679-2305.