People over 75 are disproportionately underrepresented in research, despite an aging population. The exclusion of older adults—including those with multiple long-term conditions, frailty, and cognitive impairment—from the research limits the generalizability of the findings to the entire population. This situation creates gaps in the evidence base for the care of these vulnerable groups and increases the risk of exacerbating existing health inequalities. The solution is to remove arbitrary age restrictions and design studies that allow the participation of adults with a reduced ability to consent. Research must also address implicit barriers to participation, such as the lack of available study information and the physical, financial, and logistical burdens associated with research participation. A paternalistic approach that justifies the exclusion of underserved groups by concerns about perceived risks ignores the potential harms of not including older people in research.