Daily transitions between indoor and outdoor environments involving temperature step changes have been extensively studied in young people, but little attention has been given to age-related differences and the development of thermal prediction models specifically for the elderly. To address this knowledge gap, a study was conducted in a climate chamber using warm-neutral-warm experimental sessions. Twenty-four elderly participants were selected from volunteers who met the health and body shape requirements. Thermal sensation vote (TSV) and mean skin temperature (MST) responses of the elderly were collected and analyzed. The results demonstrate that temperature step changes (3–9 °C) and neutral thermal experiences significantly influence the thermal responses of the elderly. Compared to the young, the elderly exhibit lower TSV, lower MST, lower skin heat loss, and different associations between TSV and skin heat loss. Leveraging these age-related differences, an MST prediction model was established for the elderly. The predicted MST can also serve as an input for the TSV prediction model established in this study. The TSV prediction model is based on skin heat loss and applicable to both transient and steady-state conditions. This study introduces a new approach for predicting the thermal responses of the elderly and enhances understanding of age-related differences in thermal responses.