Need for Redesigning Pharmacologic Research in Older Individuals. A Position Statement of the Geriatric Working Group of the Agenzia Italiana del Farmaco (AIFA)

Discussions about the most appropriate methods for testing the effectiveness and safety of pharmacological intervention for older patients crowded the literature of the past decade, but little action has followed from such a wide discussion. The number of patients aged 65 years and older included in randomized controlled trials raised. However, epidemiological studies have generally demonstrated that the phenotypic emergence of the negative consequences of aging occur much later in life, in the eighth and ninth decade. Interestingly, this is the section of the population that is experiencing a steep demographic expansion, is often affected by severe comorbidity and disability, is the most eager consumer of drugs, and also the most likely to suffer from the iatrogenic consequences of chronic treatment and polypharmacy. In the United States, nearly 90% of patients over 75 years of age receive one or more medications, and the probability of having multiple prescription increases geometrically with age, severity of illness, and poor physical and cognitive function.