if I re-install Access as 64 bit I then can use the 64 bit Perl
Maybe, but I don't think the 64 bit ODBC driver is on the install disk so you need to download it. See 64bit v 32bit and be aware that "Compiled Access databases, like .MDE and .ACCDE files, won’t work unless they are specifically written for the 64-bit version of Office." and all the other caveats under "Reasons to choose the 32-bit version"
do I also have to re-install other parts of Office 10 so that all are 64 bit?
Yes, that is how I read it
poj