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Drug trials for older people.

We are living in an era of unprecedented aging, with over a billion older people expected to be alive within a few decades. Despite this predictable demographic, drug trials have not kept pace with change and we now have significant evidence-practice gaps. These have arisen due to inappropriate age limits in randomized controlled trials and the near-universal exclusion of frail older people from studies. Suggested solutions include the abolition of age limits in new randomized controlled trials, and the routine measurement of frailty, with a new generation of randomized controlled trials to establish whether treatments remain effective and safe in old age and increasing frailty. We should all have a personal interest in ensuring that drugs used in our old age are truly effective.