Think Dental, Be Active!: A randomised control trial using psycho-education, physical activity and oral health interventions in older adults aged >50 years old, residing in Royal Freemason Benevolent Institute residential aged care facilities.

Group-Based Exercise and Psychoeducation Program + Immediate Dental Treatment This treatment arm will comprise a facilitated group-based physical activity and psychoeducation program of as well as a dental intervention commencing week 1 of the program. Exercise: The exercise component of the program will comprise supervised group exercise classes, independent exercise to be completed by you at home, and weekly physical activity goals. All content and a tracking record will be provided in a workbook. The group exercise classes will be facilitated by an Accredited Exercise Physiologist every week for 12 weeks – 2x classes per week from Weeks 1-4; and 1x class per week from Weeks 5-12. The classes will involve strength exercises including bodyweight exercises such as sit-to-stand exercises, squats or wall push-ups, and may also include exercises that use bands or small weights depending on your strength and level of ability. The first couple of weeks will be utilised to assist participants with getting familiar with exercise and exercising with correct technique. It is only after this introductory stage that we will aim to be exercising at moderate intensity or 5/6 out of 10 on the Modified Borg RPE Scale. All exercises can be adjusted to account for any of the participants’ current physical concerns or limitations. Each class will be approximately one hour. Starting from week 5, the participant will be asked to engage in a home-based exercise program to complement the supervised exercise class. This will involve at least one exercise session that the participant will perform independently. An Accredited Exercise Physiologist will assist the participant with how to design an exercise program that best suits the participant’s physical health status, that is safe, and can be independently completed by the participant. These exercises can mirror those that are performed during the supervised group sessions, e.g. strength exercises, circuit training. In addition to the supervised/home-based exercise sessions, participants will be given weekly physical activity goals that will comprise tasks or exercises that are designed to improve fitness and balance. The goals will be graded throughout the program, in terms of volume, intensity and variety. For example, toward the beginning of the program, participants are asked to aim for 2000 steps more than they usually would walk per day. Toward the middle of the program, participants are asked to walk a total of at least 150 minutes per week at moderate intensity, and to also complete balance exercises that they find challenging. Psychoeducation: These 1-hour psycho-education sessions will occur once per week, from Weeks 1 to 12. The sessions will include informative presentations provided by trained research staff on a range of topics relevant to healthy ageing such as exercising safely at home, vascular risk factors and sleep. Following the presentations, there will be time for questions and group discussion. All information from the weekly psycho-education sessions will also be provided in a workbook that has been developed for this program. Furthermore, attendance at the sessions will be recorded with attendance checklists, and the workbook will be reviewed regularly throughout the program. Dental Treatment: Following diagnosis of dental health status from the baseline assessment, oral hygiene instructions will be provided to participants. Oran hygiene instructions will include how to brush their teeth (frequency and brushing technique) and how to clean the inter-dental spaces. You will be asked to complete the Oral Hygiene Habits (OHH) questionnaire each week during the intervention period (Weeks 1-12). You will also receive individual personalised oral treatment which involves: a. Non-surgical periodontal treatment will be administered in weeks 1, 2, 3 and 4; which will take approximately one hour each week, as necessary. This may involve scaling of hardened dental plaque on the visible tooth and in the cavity between the tooth and the gums; and, b. A maintenance appointment will be scheduled in week 8 for approximately 1-hour, as necessary. If during ANY appointment with the Registered Dental Hygienist, an oral condition is identified or suspected of needing external treatment, you will be provided with a referral to seek third party treatment. The dental treatment will be overseen by a Registered Dental Hygienist.