2018, the population over the age of 65 years comprised nearly one-third (28.1%) of the total population. 9 Elderly people are more vulnerable to stroke due to change in hemodynamics. 10 Moreover, abrupt changes in temperature cause respiratory infections. 11 In earlier reports, a relationship between such infections and the occurrence of acute stroke was observed. 12 Regarding stroke, the effect of meteorological factors has studied both outside 8,13,14 and inside Japan. [15][16][17][18][19][20][21][22][23] The relationship between seasonal variation and stroke incidence, 15-17 and weekly variations of temperature on stroke onset 18 have been also studied. In particular for ambient temperature, hourly, 19,20 daily mean of maximum tempera-S troke is the second leading cause of death globally and was responsible for 11% of the 55.4 million global deaths in 2019. 1 Absolute numbers of stroke and burden by death and disability-adjusted life years lost show an increasing trend from 1990 through 2010. 2 In Japan, stroke is still one of the major causes of death 3 and morbidity. 4 Meteorological parameters affect human health, and studies have evaluated this relationship. 5,6 In particular, the effect of air pollution and atmospheric pressure, as well as temperature, on stroke. 7,8 Japan has 4 distinctive seasons with variations of temperature from day to day. In addition, elderly people are greater in number; as of October 1,