Actually, intel is doing it the smart way. I havne't looked at AMD's 64bit.
Anyway, mame doesn't do much direct memory addressing, especially in the windows version. That's what makes windows and directx cool. You don't have to talk to the hardware directly, you let the OS do that. So there really wouldn;t be much change to mame. Just recompile in a 64bit compiler.
I did converting of test tools for IBM form 32bit to 64bit. It wasn't hard ont he intel procs. I hardly had to change a thing. What you get out of the 64bit proc is larger memory addresses and larger storage options. There isn't much else to gain from it. An integer is still and integer. There will probably be a new super huge integer being 64bits long. But the standard integer is still just 32bits in a 64bit system.