Lots of games here on 64-bit. Only reason to choose 64-bit over 32-bit though is if you have 4gigs of ram. If you don't its more or less a moot point at this time until at least more programs come out that utilize 64-bit.
Yup it will be a full reinstall for 64-bit. Its recommened you do a clean install anyways for operating systems but Vista does quiet a good job taking old files over and deleting alot of the old OS files that aren't needed.
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