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

Frail older people are still under-represented in clinical trials. The evidence-base for clinical decision-making in this age group is poor even though older patients are the core business of health services. We examine possible causes for the exclusion of older people from clinical trials and propose possible solutions for this unjust and inequitable situation. Some progress has been made but more needs done to ensure equality and uniformly high standards of health care for older people.