Physicians and pharmaceutical companies often are at a loss in knowing the effect of medications and procedures on the elderly because this population, with its multiple illnesses and multiple medications, often cannot qualify for medical research.

The lack of evidence physicians have on elderly patients represents “one of the more challenging medical problems an aging America must confront,” according to a report in USA Today.

When physicians prescribe medications to patients 75 and older, they often must base decisions partly on results from studies in younger patients, partly on their clinical experience and partly on guesswork. Also, problems with some medications among elderly patients might not appear until after the treatments reach the market.

“The elderly are basically understudied guinea pigs in the post-market approval phase of drug distribution,” said Alta Charo, a profession of medicine and bioethics at the University of Wisconsin.