Research of any nature can have its trickier aspects—a minefield of ethics boards, recruitment challenges, and complex protocols to follow are all par for the course.  So it is unsurprising that people sometimes wonder why researchers would make their jobs even more difficult by focusing on populations that are thought to present even more challenges, like working with an older population.

The answer—surprisingly enough—is that older persons research is incredibly valuable to society in total and maybe isn’t as extra tricky as we tend to think.

What do we tend to think of when considering working with older people?  We perhaps worry that it will be harder to recruit patients who are more likely to be physically unwell.  We have concerns about capacity to consent.  And for longer running studies, we may consider the likelihood of high drop out rates.

According to a study done by Fudge, Wolfe, and McKevitt[1] in 2007, the “[b]arriers to involving older people were:  cultural divisions, language barriers, research skills capacity, ill health, time and resources.”  What is interesting here, though, are their conclusions:  “…factors hindering the involvement of older people in research were the same as reported factors hindering involvement of younger people, suggesting that age, per se, is not a barrier.”

The issue of consent is one that can seem insurmountable to those who have not yet worked with vulnerable populations.  But just as with research on children or other vulnerable adults, there are clear guidelines for us to follow regarding consent of older persons.  The main points from the Directive 2001/20/EC[2] is that when working with incapacitated adults not able to give informed legal consent you make sure that:

1. A legal representative has given consent;
2. The participant has been given information about the study according to their capacity of understanding;
3. If the participant is capable of forming an opinion (note that this is different from capacity to give consent) and explicitly wishes to be withdrawn from the study, this should be considered by the investigator;
4. “The interests of the patient always prevail over those of science and society”

The interest of the patient is one of the big reasons why we do research on this population.  Aging is a process that we will all (hopefully) face—and yet we cannot fully understand it until we are going through it ourselves.  Older persons are a large part of society and the “major user of group of health and social care.”[3]  Only older people are able to talk to their own understanding of the aging process and what an older person’s service use is like—which is often far removed from what service providers think.

From the Canadian Institutes of Health Research[4]:

The aged constitute one of the most vulnerable groups in society, because a disproportionate number labour under reduced mobility, compromised health and diminished capacity.  … It is important that the elderly participate in research for the benefit of people in that age group.  This is so because studies done on younger people may or may not be transferable. 

Quite simply, there is no other population like the population of aging adults.  Any research that is intended to benefit them cannot be done on other groups in the hopes of applying those findings on the older population.  If you want to know about older persons, you must ask older persons.  And that knowledge is worth any extra time we need to spend making sure we do good work throughout the consent and assessment process.