Why are the people who take part in clinical research systematically different from those seen in practice? For years older people are systematically excluded from clinical research, with those older than 85 years particularly under-studied. Most research is still done on younger adults, often male, with single diseases and minimal comorbidity. According to the author, funders, ethics committees, and journals must stop older people being under-represented, and more clinical trials should embrace the heterogeneity and multimorbidity of old age in their study designs and funding. Ethics committees should reject all proposals with arbitrary upper age limits, and journals should do likewise.