hi, thank you for providing the brief information about the MRI report A thorough neurological assessment is advised. As the MRI suggest, due to the ageing of the brain, there are couple of changes like the small vessel ischemic changes and parenchymal atrophy, it is an ageing process. So nothing more to worry. Since your father is facing issue with balance, you can undergo physical therapy, as it will help him learn the balancing act and the brain re-training as well will be performed. Since he is aged, a general exercise program under the therapist is needed to improve the blood circulation and metabolism as well. Performing physical therapy will add benefits to overall functional ability of your father. I personally deal with geriatrics and with physical therapy they respond well. Regards Jay Indravadan Patel