Psychotropics and the elderly: a critical public health issue-'With no approved drug therapy for severe agitation and aggression in patients with dementia, there is a clear need for more research into pharmacologic and nonpharmacologic treatments.'

摘要

Older people are the largest consumers of prescription medications, yet they are consistently under-represented in drug regulatory trials. This is true even for diseases that almost exclusively occur in the elderly, such as arthritis, dementia and Parkinson's disease. For example, in an analysis involving 9664 subjects who were enrolled in trials studying arthritis, it was found that although more than half of the studies included patients over the age of 65 years, there were only 207 patients (2.1%) in this age group, and only 14 of the 9664 patients studied were aged between 75 and 84 years, with none older than 85 years [l]. Similarly, it was demonstrated that the exclusion criteria for two regulatory trials for cholinesterase inhibitors would have eliminated more than 90% of a community sample of 3470 subjects with possible or probable Alzheimer's disease; overall, only 4.4 or 7.9% would have been provisionally eligible for each of these two trials [2]. Patients provisionally eligible were younger, relatively under-represented by women, better educated, wealthier and were more likely to be White than ineligible patients [2].