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Medical records of the 15,924 twin‐pairs in the National Academy of Sciences‐National Research Council (NAS‐NRC) twin registry were collected for an additional 16 years through 1994 when the surviving twins were aged 67 to 77 years. Compared with earlier analyses (Hrubec, Z., and Omenn, G. S., Alcohol. Clin. Exp. Res., 5:207‐215, 1981), when subjects were aged 51 to 61, there were 23% more diagnoses of alcoholism (34.4 per 1,000 prevalence), 32% more diagnoses of alcoholic psychosis (5.4 per l,000), and 25% more twins with liver cirrhosis (17.7 per 1,000). Overall, 5.3% of the cohort had at least one of the diagnoses related to alcoholism. Probandwise concordance rates (%) were: alcoholism—26.7 monozygotic (MZ), 12.2 dizygotic (DZ) (p < 0.0001); alcoholic psychosis—17.3 MZ, 4.8 DZ (p < 0.05); and cirrhosis—16.9 MZ, 5.3 DZ (p < 0.001). Concordance for any diagnosis related to alcoholism was …