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Have you discounted a UTI? Has she had her thyroid checked? Diabetes? Every other possible reason for the confusion should be explored because these can be addressed with meds or other treatments. I'm hoping she has an assigned PoA, someone younger than you (sorry, you are 90 and may have your own issues at some point). In order for her PoA to have active authority it will require an official diagnosis in her medical records. Please make sure she has this in place before she her condition worsens, if it is indeed dementia. May you both receive peace in your hearts on this journey.
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Most people with Alzheimer's are more than aware that there is something wrong with their brain, though they may not want to admit it.
What would you hope to accomplish by telling her? It really won't change things or make things any better, in fact it may just make her angry.
My husband was diagnosed with vascular dementia in 2018, which is the most aggressive of all the dementias, with a life expectancy of only 5 years, and I never shared that info with him, as to me it served no purpose. He died a little over 2 years later.
I guess if you feel she should be told, I would have the doctor tell her, as then she can be mad at him/her instead of you. Although again, I am sure she is more than aware that there is something going on with her brain.
I wish you the very best.
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Some confusion and memory loss may just be mild cognitive impairment which can happen as we age. Sometimes it doesn't progress.
Often with AD anosognosia occurs, and so the person will be unaware of their losses and deny them, possibly getting very irritated with the caregiver in the process (and this is consistent across the board--they don't remember what they did or didn't do beyond a few minutes, so trying to reason or tell them will just be frustrating for you, and agitate them). If there is testing to support a diagnosis then the physician/provider can tell her if it's something she can process, but if forgotten I wouldn't revisit it. A lot of people choose not to tell their loved ones-it's a devastating diagnosis, and knowing isn't going to do anything other than cause worry. My mom knows she has 'memory problems' and that's as far as we go. However, some people don't like feeling as if they are lying to their loved one. It's a very individual decision.
This was helpful to me: http://www.dementiacarestrategies.com/12_pt_Understanding_the_Dementia_Experience.pdf
And this:
https://tamcummings.com/stages-of-dementia/
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What would you tell her, that you think she's forgetful, seems confused? Would you tell her you think she may have Alzheimer's? How would she react to your telling her that? Confusion and short term memory loss are certainly signs of dementia, but to jump to the conclusion that she may have AD is way too premature. There are many reasons for dementia symptoms, some say as many as 80- 100, some treatable, many not. Other than confusion and memory, does she function normally during the day? Can she carry on a normal conversation? Has she become apathetic about her appearance or hygiene? Does she have a family history of dementia? All of these questions and many others can help to evaluate her cognitive state. At her next doctor visit, have her screened for dementia. Today, most doctors do dementia screening for patients over 65 as part of a routine visit. There is no routine screen for AD.

So, at this point, don't say anything, it's too early to guess the reason for her symptoms. Make an appt with her doctor and go with her so you can tell the dr what you witness in her behavior. If dementia is suspected, a follow up visit with a specialist would be ordered.
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