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Various attempts have been made to define this age, which is around the third quarter of the average life span of human beings. According to Collins Dictionary, this is usually considered to occur approximately between the ages of 40 and 60. sexleketøy The Oxford English Dictionary gives a similar definition but with a later start point the period between youth and old age, about 45 to 60. The US Census lists middle age as including both the age categories 35 to 44 and 45 to 54, while prominent social scientist, Erik Erikson, sees it ending a little later and defines middle adulthood as between 40 and 65. Middle-aged adults often show no signs of aging such as Skin Age loss of skin elasticity and graying of the hair. Physical fitness usually wanes, with a 5–10 kg (10-20 lb) accumulation of body fat, reduction in aerobic performance and a decrease in maximal heart rate. Strength and flexibility also decrease throughout middle age. However, people age at different rates and there can be significant differences between individuals of the same age. Both male and female fertility declines with advancing age. Advanced maternal age increases the risk of a child being born with some disorders such as Down syndrome. Advanced paternal age sharply increases the risk of miscarriage and many birth defects, including up syndrome, schizophrenia, autism, decreased intellectual capacity, and bipolar disorder. Most women go through menopause, which ends natural fertility, in their late 40s or 50s. Rates of infertility among men also increase significantly with age, with an abrupt decline in fertility after age 45. sexleketøy In developed countries, yearly mortality begins to increase more noticeably from age 40 onwards, mainly due to age-related health problems such as heart disease and cancer. However, the majority of middle-age people in industrialized nations can expect to live into old age. Life expectancy in developing countries is much lower and the risk of death at all ages is higher.