Geriatric frailty is associated with oxidative stress, accumulation and defective repair of DNA double-strand breaks independent of age and comorbidities.

Defects in the DNA damage response and repair (DDR/R) network accumulate during the ageing process. Physical frailty, a state of reduced physiological function and decreased resilience to biological stressors, is also exacerbated by aging, but its link with DDR/R aberrations beyond the effect of age and comorbidities is unclear. Fifty-three community-dwelling older adults, aged 65-102 years, who underwent frailty classification according to the Rockwood Clinical Frailty Scale (CFS), and 51 healthy adults younger than 45 years were examined in parallel. The following DDR/R parameters were determined in their peripheral blood mononuclear cells (PBMCs): (1) oxidative stress and abasic (apurinic/apyrimidinic; AP) sites, (2) endogenous DNA damage [alkaline comet assay olive tail moment (OTM) indicative of DNA single-strand breaks (SSBs) and double-strand breaks (DSBs); and γH2AXlevels by immunofluorescence (DSBs only)], (3) capacity of the 2 main DNA repair mechanisms (DSB-repair and nucleotide excision repair). Older individual-derived PBMCs displayed reduced-to-oxidized glutathione ratios indicative of increased levels of oxidative stress and increased AP-sites, as well as increased accumulation of endogenous DNA damage (OTM and γH2AX) and defective DSB repair capacity, compared to younger controls. These DDR/R aberrations were more pronounced in frail vs non-frail older adults. Notably, oxidative stress, AP-sites, DSBs and DSB-repair capacity were associated with individual CFS levels after adjusting for chronological age, sex, Charlson comorbidity index, and polypharmacy. Geriatric frailty is independently associated with increased DNA damage formation and reduced DSB-R capacity, supporting further research into these measures as potential frailty biomarkers.