Two Decades of the Walking While Talking Test: A Narrative Review

Objectives: Early research reported that older adults who stopped walking when they began a conversation were more likely to fall in the future. As a systematic measure of dual-task performance, Verghese and colleagues developed the Walking While Talking (WWT) test, in which a person walks at a normal pace while reciting alternate letters of the alphabet. The present paper highlights key findings from the 2 decades of research using the WWT test. Design: Narrative review. Settings and Participants: People who completed the WWT test in clinical and research settings. Methods: A literature review was conducted for studies using the WWT test from 2002 until April 2024. Results: Several studies reported that the WWT test is an easy-to-administer assessment with high face and concurrent validity and good reliability in different populations. Most studies were conducted in older adults; however, the WWT test has also been used in other clinical groups, such as adults with multiple sclerosis. Many studies investigated the cognitive and motor correlates of WWT, finding that performance on the WWT test is consistently associated with balance, executive function, and memory. Several studies have linked the neural underpinnings of WWT performance to the prefrontal cortex and motor regions. Further, the WWT test has been used to predict important outcomes such as dementia or future falls and a limited number of studies have used WWT performance as an outcome of clinical interventions, with mixed results. Conclusions and Implications: Several important directions for future research concerning the WWT test remain, such as an expansion of its clinical applications and a better understanding of the longitudinal trajectory of WWT performance. However, the WWT test is an easy-to-administer, reliable, and sensitive measure of dual-task performance and is useful in many clinical and research settings.