Old thread, I know, but at my work we're doing computational fluid dynamics, and the increased number of CPU registers that you get under AMD64 as opposed to IA32 really, _really_ help. Compiling our own source code, an opteron 248 under suse 9.1 pro 64-bit runs our code about 2.2 times as fast as a P4 Xeon 3.0GHz w/ suse 9.1 32-bit. While it's still faster than PenTel, we see about a 30% drop when running the same opteron 248 (2.2GHz) under the 32-bit version of suse 9.1. Mind you, this is using compilers that are more heavily optimized for intel platforms than for the opterons.
It's only a matter of time before the 64-bit additions will be more useful, but if you check out the linux world, they have been for quite a long time. A lot of SQL and Apache benchmarks under 64-bit linux completely blow away the performance of the 32-bit compiled versions, largely because of the increased number of CPU registers available under AMD64. Microsoft Office- no, I wouldn't guess that this or most games will be 64-bit for a long, long time, so it all depends on what you're doing.